In this session, we will progressively challenge our body, our brain and our voice. We will associate the vowels of the alphabet to one movement and the consonants to another movement. Then we will repeat each movement while spelling out words and sentences accordingly.

If needed, use the detailed descriptions of the exercise in the assignment .PDF file below to help you follow the video. You can also use the instructions later, without watching the video, to exercise following the music you prefer. Create new sentences and send it to us or to other people with Parkinson's to help them exercise!

In this session, we will use the days of the week to progressively challenge our motor and cognitive skills. We will be mimicking exercise-based movements while keeping attention to the days of the week that will be spoken out loud and displayed onscreen. You will be progressively challenged to divide and alternate your attention to focus more on your voice, on your movement or on both.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

In this session, boxing, cognitive and fun exercises are merged into one higher-intensity training session that will challenge your capacity to talk, think and move.

We will grab our 'kitchen gloves' to exercise and fuel your competitive side, keep you engaged, and get you in the fighting mode. Let’s also take a peek on how this approach can be uniquely applied with a small group with people with Parkinson's.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

In this session movement, voice and cognitive exercises will be integrated progressively into a rhythm-based training session. While performing three distinct amplitude-based movements, stay attentive to the changes imposed by the three different music patterns.

Escape your routine for a moment with an upbeat video that is recommended for those recently diagnosed with Parkinson's, but does not exclude possible adaptations for anyone who is living with the condition.

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video. You can also use the audio file without watching the video for an additional workout.

In this session, we will focus on dance as a form of exercise. There will be three dance activities that will integrate progressive challenges. This session was designed for those who want to push themselves physically a bit more – while still being fully accessible to adapt for everyone.

Regardless of your level of difficulty, all exercises can be done in a seated version.

Get prepared for a vigorous, stimulating, and energetic 10-minutes dance session!

If needed, use the more detailed descriptions of the exercise in the .PDF file worksheet below to help you follow or better understand the video.

In this exercise session, we will use a dice to challenge our quick responses, voice, movement and memory. Once you've learned six amplitude-based movements, you will be challenged to move continuously through the activities in response to a rolling dice presented onscreen.

You will be progressively challenged to compete against time and against the instructors, repeating the movements as quickly and widely as you can. Performing this session in competition with family is recommended to enhance the fun. If needed, you can perform all exercises in a sitting position.

In this episode, you will be challenged to punch out numbers performing two different amplitude whole-body movements. Then we will increase the challenge by asking you to focus on one sequence of numbers (1 to 10) while ignoring all other numbers popping up in the background.

This activity challenges your ability to rapidly process information and take quick decisions, and will train your capacity to stay focused on one activity. Importantly, strong selective attention skills help us to not get lost by distractions during daily life activities.

In this session, we will challenge you to quickly spot the image of coronavirus popping up on the screen, in different positions, and remember which movement to use to hit it away. At the same time, we will be walking to the beat of the music in a constantly-moving forest environment.

Push yourself to make your broadest and fastest movements in a standing or sitting position, while rapidly processing and analysing changing visual information.

This exercise is designed to strengthen specific cognitive skills of attention, quick response and working memory, as well as motor skills such as aerobic capacity, amplitude of movement and quick motor reactions.

In this session, we will challenge you to compare some numbers and decide which one is the biggest in size (font) and then which one is the biggest in value.

Your response will be given with movements: we will associate the size to one movement and the value to another movement. Then we will progressively challenge you by increasing speed and later to alternate your attention to randomly focus on either value or size.

In this session, we will challenge you to perform several movements as we walk in a moving forest environment; the way we count repetitions will be our vocal and cognitive challenge.

Push yourself to make movements as broad and fast as possible, while rapidly processing and reacting to changing visual information, and using a loud, clear voice.

This exercise is designed to strengthen specific cognitive skills of focused attention and working memory, as well as aerobic capacity, amplitude of movement and quick motor reactions.

Are you interested to see how Josefa and John's exercise method works in the practice? Then watch these live session videos – featuring people from different countries in the world doing the exercise classes and interacting with Josefa and John in real time!

You can also watch all the videos together in our Parkinson's Europe ExerciseCast YouTube playlist. 

Episode 1

• Live session 1 – featuring Rui, person with young-onset Parkinson's
• Live session 2 – featuring Greg and his wife and care partner Phylis
• Live session 3 – Q&A session featuring Andy Butler from Parkinson's People

Episode 2

• Live session 1 – featuring John, person living with Parkinson's for 11 years, who had DBS surgery 3.5 years ago
• Live session 2 – featuring Jill, person with Parkinson's diagonsed at the age of 50

Episode 3

• Live session 1 – featuring Idelta, Rui Camilo and Rui Couto from Portugal

Episode 4

• Live session 1 – featuring a group of 25 people from Colorado

Episode 6

• Live session 1 – featuring Sara and her family from Sweden and Fulvio from Spain

Videos in Portuguese

• Live session 1 – Rui, 38 anos com Parkinson juvenil
• Live session 2 – E se os familiares e cuidadores participassem nas sessões de exercício?
• Live session 3 – Aula de Boxe para doentes Parkinson com Idelta e João

Parkinson's Europe ExerciseCast is a web-based exercise programme that offers people with Parkinson's exercises that are challenging and surprisingly fun by combining voice, movement and cognition tasks. It is based on the work of physiotherapist Josefa Domingos and speech language pathologist John M. Dean, both specialised in working exclusively with Parkinson's for over 15 years.

Parkinson's Europe ExerciseCast brings together people with Parkinson's to exercise – and to share​​ ideas and tips ​to keep well and fit in the challenging and worrying times of the world-wide COVID-19 crisis.

This collection of free exercises is specifically designed to address common Parkinson's issues, and also provides examples of its application to other people with Parkinson's, to their carers and family members.

If you wish to use these exercises within your own networks, all we request is that you credit Parkinson's Europe as the content source – please check our copyright policy and email [email protected] for more information.

For each video, a brief description is also available (as a .PDF and/or audio file form) to make it easier to follow and perform the exercises without the need to watch the video.

Additionally, we also challenge you to perform the exercise tasks and to send us your own video to share with other people via this page. Sharing your experience with others will help motivate them in these difficult times! Help us help others. Help us transforming social distancing into “distant socialising” and making a difference – one episode at a time.

Stay active. Stay positive.

People with Parkinson’s benefit from non-pharmacological interventions, such as physiotherapy and cognitive training, with both physical and cognitive outcomes. Combining these different interventions may be beneficial – positive evidence about dual or multitask training is emerging with regard to older adults and people with Parkinson's.

Dual or multitasking is commonly defined as 'the capacity to simultaneously perform two or more tasks during transfers, ambulation and other gait-related activities'. As such, dual or multitask training refers to training individuals to be able to perform simultaneously two or more tasks; each of these tasks can be performed independently, measured separately and can have distinct goals.

Initial research in this area concluded that 30 minutes once a week for three weeks of multiple-task gait training is feasible in five people with Parkinson's (I-III H&Y, mean age of 61 with a mean of 8 years with Parkinson's)¹, and leads to sustained benefits in terms of multiple-task walking velocity, levels of fatigue and anxiety. Later, Brauer and Morris² showed that one 20-minute dual-task training session in 20 patients increased step length during ambulation on a 10-meter pathway, while simultaneously enabling patients to perform a variety of added tasks. More recently, a randomised clinical trial involving 121 people with early to mid-stage Parkinson's showed that dual task gait improved when compared to a control period without training³. The study implemented two dual-task training programmes, one with consecutive training and one with concurrent (i.e. integrated) dual-task training delivered in the home setting. Importantly, benefits were retained after 12-week follow-up. This novel training program had excellent compliance from people with Parkinson's and did not increase the risk of falls.

There are three main reasons why therapists use dual-task training in clinical practice:

• to improve dual task performance in daily activities
• to enhance learning by making activities progressively more complex
• to enhance motivation and engagement.

Parkinson's Europe ExerciseCast with specifically adapted multitask exercise programmes is an excellent example on how to apply this approach to people with Parkinson's and how to facilitate adherence to international guidelines advising therapist to integrate dual-task training into clinical practice.

Sharing the framework for such a programme may offer insights into the development of future research and community exercise care services for Parkinson's that incorporate the complexity of the cognitive challenges in Parkinson's. This ultimately may lead to initial treatment suggestions for those who decide to start or to research such a program for Parkinson's.

References

1. Canning, C. G., Ada, L., & Woodhouse, E. (2008). Multiple-task walking training in people with mild to moderate Parkinson’s disease: a pilot study. Clinical Rehabilitation, 22(3), 226–233.
2. Brauer, S. Morris, M., (2009) Can people with Parkinson's disease improve dual tasking when walking?, Gait & Posture, Volume 31(2),229-233
3. Strouwen, C. , Molenaar, E. A., Münks, L. , Keus, S. H., Zijlmans, J. C., Vandenberghe, W. , Bloem, B. R. and Nieuwboer, A. (2017), Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial. Mov Disord., 32: 1201-1210.
4. Conradsson, D., Löfgren, N., Nero, H., Hagströmer, M., Ståhle, A., Lökk, J., & Franzén, E. (2015). The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial. Neurorehabilitation and neural repair, 29(9), 827–836.
5. Ghai, S., Ghai, I., & Effenberg, A. O. (2017). Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis. Clinical interventions in aging, 12, 557–577.

• Bishop's Stortford Independent Parkinality columnist Julie Walker on how to get support and exercise when living with Parkinson's disease during the coronavirus pandemic
• Parkinson's Europe launches Parkinson’s exercise programme for support during COVID-19 crisis

Articles from Parkinson's Life online magazine

• Parkinson's Europe ExerciseCast: How to stay active during the coronavirus crisis