Local opinion: Exercise is medicine for Parkinson’s — so why aren’t we prescribing it?

and analysis of the writer:

In the early 2000s, a revolution began in Parkinson’s Disease. Animal studies showed for the first time that exercise wasn’t just beneficial — it was medicine. It could prevent, slow, and reverse PD symptoms, even in animals with advanced PD.

This promise of this data in animals compelled me to leave academia in 2010 to start a nonprofit and get started implementing exercise as medicine. Parkinson Wellness Recovery — PWR!, located in Tucson, was one of the first organizations globally to treat exercise as frontline medicine for PD. A unique model, PWR! integrates PD-specific rehabilitation and community exercise programs into the plan of care. For 15 years, we’ve provided cutting-edge personalized exercise coaching and specialized, high-intensity rehab that focuses on whole-body motor and cognitive training. We have trained over 12,000 rehab and exercise professionals worldwide on the translation of science into real-world settings, programs, and techniques required to help people with Parkinson’s get better and stay better.

Also during the last two decades, exercise trials in humans have more than tripled, echoing the results of early animal studies. When people with PD are pushed to do more than they think they can, physically and cognitively, their brains change for the better. We know that people can get better and stay better with ongoing exercise — decreasing motor and nonmotor symptoms, improving mobility, and increasing participation in life. There is more to be done to prove that exercise in humans slows disease progression, but the evidence is accumulating.

Yet the system is still largely failing.

— Only 9% of people see a trained PD specialist for their diagnosis. Nearly 80% see general neurologists and primary care providers, many of whom are unaware of exercise’s life-changing potential.

— Only 20% of people with PD see a physical therapist. Referrals to rehab are an afterthought, depriving patients of early intervention—when exercise could have the greatest impact.

— Insurance plans limit therapy appointments, and most offer no subsidies for PD-specific exercise programs.

— People told to start exercising are not referred to a PD exercise professional for consultations, education and coaching so that they can safely and effectively increase their exercise baseline.

— By the time many patients start exercising, symptoms may have worsened, making recovery harder.

— Fragmented care: There’s little collaboration between doctors, therapists, and community fitness programs. Patients are left navigating a maze alone.

The result? Preventable decline — more falls, hospitalizations, and faster cognitive deterioration.

This isn’t just a gap in care. It’s a moral failure. We can — and must — do better.

The science is clear: exercise is the most promising disease-modifying therapy for PD. It reduces reliance on medication, decreases motor and nonmotor symptoms, improves motor function, provides empowerment and self-agency, enhances quality of life, and allows people to continue doing what they love. But science alone isn’t enough.

We need systemic change:

— Mandate PD-specific education for all neurologists and primary care providers

— Prioritize immediate referrals to PD-trained rehab specialists at diagnosis

— Overhaul insurance policies to make therapy limits consistent with clinical guidelines

— Subsidize approved exercise programs by certified PD exercise specialists to sustain benefits from therapy and prevent avoidable decline

— Build bridges between medical providers, rehab professionals, and community fitness resources to keep people engaged in exercise for life.

At PWR!, we’ve shown what’s possible. Our rehab, exercise, and training programs are blueprints for success. But scaling this requires collective action. Patients deserve a system that treats exercise as seriously as a pill bottle.

Two decades ago, Parkinson’s was seen as a one-way street of decline. Today, we know better. The PD exercise revolution is here. It’s time the healthcare system joined it.

Learn more about the movement at www.pwr4life.org. April is Parkinson’s Awareness Month.