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Exercise & Parkinson’s Disease: What 109 Clinical Trials Reveal About Movement and the Aging Brain

Written by Maria Stevens, MD - Director of Fitness & Education | Jan 13, 2026 6:45:30 PM

Parkinson’s disease isn’t rare. It is the second most common neurodegenerative disorder after Alzheimer's.

More than 1 million Americans are currently living with it, and nearly 90,000 more are diagnosed every year. By age 60, the lifetime risk rises sharply—meaning many of us will eventually know someone with Parkinson’s.

And while medications help with tremor and rigidity, they do not stop the progression of motor decline.

But one thing does consistently change the trajectory of the disease: exercise.

A systematic review — Exercise sustains motor function in Parkinson’s disease: Evidence from 109 randomized controlled trials on over 4,600 patients by Zhang, Li, Wang, Ba, & Liu (2023) — brings twenty years of clinical data together to answer one powerful question:

Which types of exercise actually preserve motor function in Parkinson’s disease?

What the Study Looked At

This review analyzed 109 randomized controlled trials, covering 14 different forms of exercise, including:

  • Dancing

  • Nordic walking

  • Yoga

  • Aquatic training

  • Strength training

  • Tai Chi

  • Qigong

  • Multimodal training

  • And more

Across these studies, 4,631 adults with PD were tracked using validated measures of motor function, balance, mobility, and hand dexterity.

The authors conducted both network meta-analysis and meta-regression to examine:

  1. How exercise affects the long-term progression of motor symptoms

  2. Which exercise types work best for specific outcomes

Key Findings

Exercise slows motor decline—non-exercise groups continue to worsen.
Motor symptoms, mobility, and balance all showed slower deterioration in people who exercised compared to those who did not.

Some exercises outperform others depending on the goal:

General Motor Symptoms

  • Dancing ranked highest overall (rhythmic stimulation appears to help bypass impaired basal ganglia circuits)

Mobility & Balance

  • Nordic walking was the most effective. Aquatic training and dancing also scored highly.

Hand Function (Manual Dexterity)

  • Qigong showed the most promise (likely due to its emphasis on hand posture, tactile awareness, and fine motor control).

Long-Term Effects

  • Only one test — the Timed Up-and-Go (TUG) — showed a clear linear improvement over time, suggesting it may be the most sensitive marker of meaningful change.

The takeaway is clear:
Consistent training slows the progression of Parkinson’s-related motor decline.

Why Exercise Works

Parkinson’s reduces dopamine and disrupts motor pathways—but movement can activate alternative neural circuits.

The study highlights two mechanisms:

  1. External cueing (like music or poles) that improves initiation and sequencing

  2. Motor learning from complex movements (dance, yoga, multimodal training)

This promotes neuroplasticity—your brain’s ability to adapt—something medication alone cannot achieve.

What This Means for You (or Someone You Love)

If you or a loved one has Parkinson’s, exercise is not “optional.” It’s foundational therapy.
And not just any exercise:

  • Dance for overall motor function

  • Nordic walking or aquatic training for mobility & balance

  • Qigong for hand function

  • Yoga, multimodal training, and Tai Chi for generalized benefits

But the biggest message from the data is this:

Movement is medicine.
The earlier it becomes part of your life, the more resilient your brain and body remain over time.

How This Connects to FITNESS SF

At FITNESS SF, we think about health across the entire lifespan.

Neurodegenerative conditions aren’t abstract—they affect real people, including our members and their families. Our goal is to make movement accessible, safe, and empowering for everyone.

Across FITNESS SF gyms, we offer:

  • Safe training environments with space to move, balance, and practice gait

  • Trainers experienced in working with chronic conditions

  • Aquatic options at our Fillmore location

  • A culture that prioritizes long-term health

If you or someone you care about is facing mobility challenges, we’re here to help you develop a plan that supports strength, balance, and independence.

Because movement isn’t just exercise, it's literally medicine.

*The content on this blog is provided for general informational purposes only. It does not constitute medical advice. No responsibility or liability is assumed for any actions taken based on the information provided.