Sep 18, 2026 · 55 min · 11 segments
In this podcast, Dr Williams continues the discussion with Dr Meredith Spindler and Dr Nabila Dahodwala about Parkinson’s disease, now focusing on long term management and treatment.
Meredith SpindlerGuest
Nabila DahodwalaGuest
Kendall WilliamsHost
So something you said struck me as being somewhat remarkable, and that is that exercise is the only thing that slows the progression of illness.
And we're gonna talk about a lot of medications, and there's this long list of potential medications that you can put patients on, but none of them are gonna do anything to slow the progression of the disease.
I see places advertising it near me, you know, just private gyms, but also just the magnitude of effect.
I mean, how much can people get? How much can you slow the progression with exercise?
People always want to know, like, what exercise should I do? How often? At what intensity? And those are all questions that we don't have the answers to.
What we do know is that most exercises are helpful, at least in the short term, in terms of reducing falls, improving quality of life, even maybe reducing how much medicines people need to take.
And the evidence that it slows the progression of disease is still like in the animal models and in the basic science, not yet in like clinical trials of humans.
Although I don't think anyone is going to argue that point, just because the evidence is pretty convincing that it like helps promote neuronal health.
And I think a lot of these pathways are similar across neurodegenerative conditions that have accumulation of an abnormal protein that the similar kind of lifestyle modifications and preventative measures work across
I'll offer what I tell patients in terms of what I mean when I say, you know, exercise slows the progression of disease and here's what you should do.
I believe that the evidence that's been the most compelling in the animal models has been with aerobic exercise.
And so I recommend what the American Heart Association recommends for goals for aerobic exercise, which is 150 minutes a week.
But I say that this is what I recommend for that benefit, but also adding in weight training about twice a week to keep your muscles and bones strong, and also stretching and daily to keep you limber because there can be rigidity with this.
So that's what I sort of recommend as like the foundation of an exercise regimen.
I also, they'll ask me, well, what kind of aerobic exercise? I say, whatever you're going to actually do and whatever is safe, of course, too.
So something you said struck me as being somewhat remarkable, and that is that exercise is the only thing that slows the progression of illness.
And we're gonna talk about a lot of medications, and there's this long list of potential medications that you can put patients on, but none of them are gonna do anything to slow the progression of the disease.
I see places advertising it near me, you know, just private gyms, but also just the magnitude of effect.
I mean, how much can people get? How much can you slow the progression with exercise?
People always want to know, like, what exercise should I do? How often? At what intensity? And those are all questions that we don't have the answers to.
What we do know is that most exercises are helpful, at least in the short term, in terms of reducing falls, improving quality of life, even maybe reducing how much medicines people need to take.
And the evidence that it slows the progression of disease is still like in the animal models and in the basic science, not yet in like clinical trials of humans.
Although I don't think anyone is going to argue that point, just because the evidence is pretty convincing that it like helps promote neuronal health.
And I think a lot of these pathways are similar across neurodegenerative conditions that have accumulation of an abnormal protein that the similar kind of lifestyle modifications and preventative measures work across
I'll offer what I tell patients in terms of what I mean when I say, you know, exercise slows the progression of disease and here's what you should do.
I believe that the evidence that's been the most compelling in the animal models has been with aerobic exercise.
And so I recommend what the American Heart Association recommends for goals for aerobic exercise, which is 150 minutes a week.
But I say that this is what I recommend for that benefit, but also adding in weight training about twice a week to keep your muscles and bones strong, and also stretching and daily to keep you limber because there can be rigidity with this.
So that's what I sort of recommend as like the foundation of an exercise regimen.
I also, they'll ask me, well, what kind of aerobic exercise? I say, whatever you're going to actually do and whatever is safe, of course, too.
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