Despite decades of research demonstrating clear benefit, physical activity has received little interest from physicians in the prevention and treatment of neurological disease, including stroke, Parkinson’s, dementia, and mood disorders.
Physically active men and women have a 25 to 30 percent reduced risk of stroke when compared with those who are inactive. After a stroke, greater aerobic fitness, muscle strength, and physical endurance improves functional abilities such as walking as well as improved self-confidence and general well being.
Physical activity is critical to the well-being of Parkinson’s patients and should be introduced in the early stages of the disease. No adverse events related to exercise exposure in people with Parkinson’s disease have occurred in the various published controlled studies.
Numerous published studies have demonstrated that regular physical activity benefits patients with MS and strong evidence exists of improvements in muscle function, aerobic fitness, quality of life, and mobility.
Mild cognitive impairment is a clinical entity characterized by cognitive decline greater than expected for an individual’s age and education level but does not interfere notably with everyday function. Dementia is a broad descriptive term that encompasses a number of slowly progressive degenerative conditions. Exercise has cognitive benefits for older adults with mild cognitive impairment.
Does physical activity benefit cognitive function in people with dementia? The evidence is still insufficient. Nevertheless, older people with dementia still have the same need for physical activity as other seniors with an array of benefits from improved depression, fewer behavioral disturbances, and a positive effect on mobility.
Depression has a lifetime prevalence of between six and twenty percent worldwide, with the rate of depression increasing over the past 50 years. The WHO ranks depressive disorders as the fourth largest health problem in the world. More than 100 cohort studies over many decades demonstrate that regular physical activity is effective in reducing the onset of depression.
The findings of RCTs show that exercises reduces the number and severity of symptoms of depression in both depressed and non-depressed adults. The magnitude of the effect is generally about 40 to 50 percent greater than placebo or non-pharmacological treatments.
The ACSM physical activity guidelines of approximately 150 minutes per week of aerobic activity and one to two sessions of strength-based training are an appropriate foundation for clients with the conditions above. Paul McCrory and Teresa Liu-Ambrose discuss in greater detail the above and other illnesses and provide numerous references in Chapter 54, “Exercise to treat neurological diseases and improve mental health,” of Clinical Sports Medicine.
For more information on exercise prescriptions for over 60 medical conditions download a free copy of the Swedish National Institutes of Public Health, Physical Activity in the Prevention and Treatment of Disease (www.fyss.se).