As someone with Parkinson's disease, Jill Smith, 68, knows the value of exercise. And on the days when she'd rather not move a muscle, she reminds herself of how good she'll feel after walking on the treadmill or using the elliptical for 15 minutes. “No matter how poorly I feel before I exercise, I leave in a much better place,” says Smith, a retired telecommunications manager in Park Ridge, IL. “Reminding myself of that keeps me going back.” Joining a karate class for people with Parkinson's also helps, she says.
Plenty of people lack motivation to exercise, but those with neurologic disorders may face more stumbling blocks, such as poor mobility and balance, muscle weakness, pain, depression, and feeling self-conscious or embarrassed, according to a 2016 study in Disability and Rehabilitation.
Knowing the benefits of physical activity may get people moving. A 2022 study in Neurology found that among people with Parkinson's disease, regular exercise over time was associated with slower loss of postural and gait stability, better processing speed, and greater functionality in activities of daily living. A meta-analysis in Sports Medicine in 2022 found that endurance exercise, along with sensorimotor training, improved symptoms such as poor balance and pain, as well as quality of life, in people with neuropathy. And a 2022 review in the International Journal of Environmental Research and Public Health found that yoga and aerobic and water exercise improved balance and walking ability in people with multiple sclerosis (MS). Exercise also improves cognitive function in adults over age 50, according to a 2018 meta-analysis in the British Journal of Sports Medicine.
Still sitting on the couch? Consider these strategies from physical therapists.
Identify your goals. Ask yourself what you want to get out of exercise. Maybe you want to reduce pain, increase strength, prevent falling, or just be able to play with your young children or grandchildren. Write down your goals and post them in prominent places, suggests Samantha Salvaggio, a life coach who has had MS since she was 19. “So many things are working against you when you have a chronic illness. Remembering my purpose is helpful when I don't want to exercise,” says Salvaggio, 36, a chronic-illness coach in Durham, NC. “If I don't move, I feel like I'll lose coordination, balance, and strength. I want to stay strong and connected to my body.”
Schedule your workouts. Pick a time of day that aligns with your daily responsibilities and energy level, then “schedule it on a calendar like a doctor's appointment,” says Ryan Glatt, a physical therapist at the Pacific Brain Health Center at the Pacific Neuroscience Institute in Santa Monica, CA. This helps make workouts a priority and makes you less likely to skip them.
Increase the fun factor. “Enjoyment should be a big part of any exercise,” says Glatt. Think about an activity you might like, whether it's dancing, swimming, playing tennis or pickleball, or doing a chair workout. And then ease into it slowly and carefully.
Keep workouts fresh. “Change up what you do to make it interesting,” says Carolee Winstein, PhD, professor of biokinesiology and physical therapy at the University of Southern California. Incorporate different activities (think walking, cycling, swimming, tai chi, and yoga) and vary the setting and the people you exercise with.
Call it something else. “Some people have a bad association with exercise, so cast it as moving and breathing fresh air,” says Dr. Winstein. And modify expectations about what a workout should be. Salvaggio used to think exercise always had to be intense. Now she knows even less-intense exercise is just as beneficial.
Anticipate feeling good. If you're in a bad mood or feeling lethargic, don't ditch your workout. Instead, remind yourself that you'll feel better afterward.
Make it social. “If you exercise with a friend or neighbor or someone with the same neurologic disorder, you'll be more accountable and less likely to cancel,” says Alison Kraus, PT, DPT, a neurologic physical therapist at the University of Florida Health Rehab Center at the Norman Fixel Institute for Neurological Diseases in Gainesville. The same is true if you bond with people in a group exercise class. A 2017 study in the International Journal of Behavioral Nutrition and Physical Activity found that having strong social support is associated with greater levels of exercise among older adults. For Smith, having support from her karate instructors and other people in the class pushes her to stay active. “We're all dealing with the same things, and the feedback we get from each other encourages us to continue,” she says.
Adopt the 10-minute rule. If you don't feel like exercising on a particular day, strike a bargain with yourself: Walk or work out for 10 minutes. If you really don't want to continue, give yourself permission to stop. “It's rare that after you've warmed up and you're in the groove you're going to quit at that point,” says Dr. Winstein. Most likely, you'll be willing to commit to another 10 minutes, then another 10 minutes, and so on. But even if you do quit after the first 10 minutes, that's better than doing nothing, Dr. Winstein notes.
Try intermittent exercise. Instead of doing a full workout in one go, break it into three 10-minute or two 15-minute sessions throughout the day. This strategy may be especially helpful for those experiencing fatigue or pain. “The goal is to identify the threshold of fatigue and/or pain, and exercise below that,” Glatt says. If walking at a moderate-to-vigorous pace for 30 minutes is too much, experiment with doing 10-minute walks. Similarly, divide strength-training workouts into five-minute bouts of squats, step-ups, calf raises, bicycle crunches, bicep curls, and the like. As an added perk, short bursts of exercise throughout the day could increase energy levels by helping regulate the nervous system and getting dopamine going, says Malia Sako, an occupational therapist at Re+active Physical Therapy and Wellness in West Los Angeles and Torrance, CA.
Pay attention to progress. Keep a workout record or log, noting the type of movement you do, how long and at what intensity you do it, and how it feels. Then, over time, “compare what you can do now to last year or last month,” advises Dr. Winstein. “Seeing improvement and progress can be motivating.”
Fight fatigue. “We know that if you do some light aerobic exercise, you can ease fatigue, improve your sleep-wake cycle, and build energy,” says Kraus. To ensure that you get physical, she suggests you plan exercise and make movement a priority. “You wake up in the morning with a full tank of gas that slowly empties throughout the day,” Kraus explains. “Build in breaks during the day to refill the tank by taking a nap” or having a healthy snack before you exercise. You also could schedule your exercise for first thing in the morning when your energy tank is full.
Offer yourself mini-rewards. As incentive, promise yourself a small treat—such as a healthy smoothie or an episode of your favorite TV show or podcast—after you exercise. Or buy some new exercise clothes once you reach a certain milestone, such as exercising four times a week for a month, Sako says. These external rewards can keep you going until your motivation becomes internal.
Consult a physical therapist. If mobility, balance, or pain is a challenge, ask for a referral to a physical therapist who can help you determine what you can do, Glatt says. Activities like yoga, Pilates, boxing, karate, and strength training all can be done in a chair. Or use a wall for step jacks, squats, and push-ups, Sako suggests. “Find strategies that work for you.”
Persist. For some, exercise is “better than a drug to improve overall physical, cognitive, and mental health,” says Dr. Winstein. “People may not appreciate that until they become physically active, but once they reap the benefits, they're hooked.” The key, she adds, is to stick with it.
