While training for the New York City marathon in 2012, Mike DeBartolo couldn't understand why he was losing energy, stamina, and gait coordination on his left side. Eventually he developed night tremors and some cognitive fogginess. It wasn't until five years later that he was diagnosed with Parkinson's disease and understood the cause of his symptoms.
The medication he was prescribed helped somewhat, but he still had occasional problems with coordination and fine motor skills. When DeBartolo, now 62, began looking for another activity to help him stay physically and mentally sharp, he thought back in time—to ping-pong, which he had played growing up and used to play with his wife and three children. He joined a program called Parkinson's Players Ping Pong at Northwestern Medicine's Lake Forest Hospital, not far from his home in Winnetka, IL. “Parkinson's affects so many things,” says DeBartolo, who worked in fundraising. “With repetition, playing ping-pong has improved my hand-eye coordination and decision-making, as well as my ability to play.”
Jan Sanford, 72, who was diagnosed with Parkinson's disease in November 2019 and also has rheumatoid arthritis, plays ping-pong with other people who have Parkinson's as well as with volunteer college athletes once a week. “There's something about it that helps all my movements—they're more fluid and controlled—and the effect continues for a few hours after,” says Sanford, a retired medical administrator in Waldwick, NJ. And the social and emotional rewards have also been valuable, she says. “It's such a great group of people. We're happy to be with each other, help each other, and learn from each other. I've made so many friends along the way.”
As doctors, physical therapists, and patients like DeBartolo and Sanford will attest, playing ping-pong (aka table tennis) can reduce numerous symptoms of Parkinson's. “The game requires balance, hand-eye coordination, rhythmic movements, concentration, and motor planning—all of which are affected by Parkinson's,” says Linda Egan, a physical therapist and coordinator of the Parkinson's disease program at Lake Forest Hospital. “Among those who play consistently, we see improvements in all of those areas. The activity is physical, cognitive, and social, all of which are so important for people with Parkinson's.”
The visual cues and hand-eye coordination required for table tennis may help general movement and reduce incidents of “freezing,” says Kelvin Chou, MD, FAAN, endowed professor of neurology at the University of Michigan in Ann Arbor, referring to the feeling of being stuck in place that some people with Parkinson's experience.
A small body of research supports these benefits. In a pilot study in Clinical Parkinsonism & Related Disorders published in 2021, people with Parkinson's disease participated in a weekly exercise session that included table tennis practice and games (as well as stretching and warm-ups). After six months, the subjects experienced improvements in their motor function and their ability to perform activities of daily living. Another study, published in the Archives of Rehabilitation Research and Clinical Translation in 2020, found that playing table tennis twice a week for 10 weeks improved participants' balance control, walking speed, and mental well-being.
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Exactly how table tennis benefits the brain isn't understood, but there are some clues. “Like other aerobic activity, ping-pong can activate areas of the brain involved with motor planning, coordination, memory, and neuroplasticity [the brain's ability to make new neurons and connections],” says Neil Shetty, MD, assistant professor of movement disorders at Northwestern University in Chicago. A possible mechanism is that exercise may boost the release of dopamine, a neurotransmitter that's deficient in people with Parkinson's, says Dr. Chou.
“Based on what I've seen anecdotally, exercises like ping-pong that incorporate balance, rhythm, and body control are more beneficial than activities that don't,” says David Russell, MD, PhD, director of clinical research at the Institute for Neurodegenerative Disorders in New Haven, CT. “Table tennis is all about reaction,” he adds. “It allows people with Parkinson's to access brain circuits that are still intact.”
And it's fun, says Elana Clar, MD, assistant professor of neurology at Hackensack University Medical Center in New Jersey. “The social component is what makes it magical,” she says. “The regulars truly become friends—it's heartwarming and inspiring.”
PingPongParkinson, a nonprofit organization that has chapters in 23 countries and holds an annual world championship, was established in 2017 by Nenad Bach, a Croatian American musician who'd been diagnosed with Parkinson's in 2010. Bach, who lives in Croton-on-Hudson, NY, discovered the benefits of table tennis for his symptoms after a friend invited him to play at a local recreation center in 2016. By that time, the musician recalls, “I couldn't play syncopation on guitar anymore. I stumbled with my fingers on the strings. That was very difficult to take.”
The day after Bach first played ping-pong with his friend, he noticed he felt “50 percent better.” He played the following week, and again his stiffness, movement, and thinking abilities were better the day after. So he upped his game and began playing two or three times per week. “After four months, I could play syncopation,” says Bach, now 69, who still plays ping-pong a couple of times a week. And he's performing once more: “It's like a day-and-night difference—I can play the guitar and the piano,” he says. “It's a joy to be back at it.”
At some table tennis centers and programs, people with Parkinson's play against those who don't have the disorder. “I think that pushes them to play at a higher level than they would otherwise,” says Dr. Clar, who co-founded a chapter of PingPongParkinson in New Jersey. Bach agrees. “I try to play with people who are better than I am, to challenge myself,” he says. “I can lose and still be happy.”
What to Expect from a Table Tennis Program
To find a local ping-pong program for people with Parkinson’s disease, or to establish one, consult PingPongParkinson.org. Sessions usually start with a stretching routine, followed by skill instruction, practice drills, and playing games. Most venues provide paddles and balls so you just need to be appropriately dressed (in casual clothes or athletic wear) and ready to play.
The optimal frequency of playing hasn’t been studied, and “the rate of improvement is hard to predict because there are so many variables,” says Elana Clar, MD, assistant professor of neurology at Hackensack University Medical Center in New Jersey. Factors that contribute to those differences include medications people take and other therapies or forms of exercise they engage in.
“Even so, we think consistency helps maintain skill development and benefits quality of life for people with Parkinson’s disease,” says Neil Shetty, MD, a neurologist and assistant professor of movement disorders at Northwestern University in Chicago.
“The more you play, the better you’re going to get,” says Linda Egan, a physical therapist and coordinator of the Parkinson’s disease program at Northwestern Medicine’s Lake Forest Hospital in Illinois. “If people stop exercising for four to six weeks, I have seen their symptoms return. The hope is that once they resume playing, those gains in symptom improvement will return.”
