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Research Review: HIIT and Resistance Training

Updated: Dec 24, 2023

Everyone says exercise is medicine, but not all exercise is the same. We hear a lot about aerobic exercise, cycling, boxing, and dance being beneficial for people with PD. High intensity interval training (HIIT) and resistance training are two forms of exercise that I see are less utilized but when you look at the research, they are some of the best forms of exercise to help control blood sugar levels, lower cholesterol, lower high blood pressure, reduce risk of cardiovascular events, improve balance, and improve quality of life. Let's learn the effects that might have on someone with PD.



High Intensity Interval Training


What is HIIT?

HIIT incorporates several rounds that alternate between minutes of high intensity movements to low intensity movements. High intensity movements should increase the heart rate to at least 70-80% of your heart rate max. The intensity of the recovery portion/low intensity should be around 40-50% of your heart rate max.


You can calculate your heart rate max through this equation: 220 minus your age


If you are on any blood pressure medications, your heart rate will not increase the way it would normally. Therefore, that equation will not be appropriate for you. Instead, take a look at the chart below. It is called rate of perceived exertion. Basically it is a chart that describes how hard the workout feels.



When completing HIIT, you want to be somewhere between 4 and 8. For those who are new to this type of training, try sticking with 4-6 for a few months until you have improved your endurance and cardiovascular conditioning. If you are someone that has exercised at a high intensity often, try sticking with a 7-8. Not every workout needs to be a 7-8, but having a vigorous workout throughout the week does lend to some incredible health changes.



What does the research say?

Amara et al found that high-intensity exercise rehabilitation improves objective sleep outcomes in PD. "Exercise is an effective non pharmacological intervention to improve this disabling non motor symptom in PD."


Kelly et al found that an acute bout of high-intensity exercise increases resting-state brain activity within the bilateral substantia nigra, right ventral medial prefrontal cortex and left ventral lateral prefrontal cortex in exercise trained individuals with PD. Basically, these are all the major parts of the brain that are impacted by PD. When we see an increase in brain activity, that means we have the potential to make new and stronger brain connections that will us move better!



Jansen et al found that high intensity aerobic exercise, achieved via a forced or voluntary mode, improved PD symptoms and bimanual dexterity. Sustained improvement of upper extremity motor control after the exercise is over indicates high intensity exercise enhances central nervous system functioning and suggests exercise may be a candidate for altering PD progression.



Is it safe?

Garcia-Pinillos et al compared a 12-week low-moderate intensity training to high-intensity training. Not only did they find that both forms of exercise are safe (no adverse events like a cardiovascular event or injury in the participants) but they found that the high-intensity interval training based program showed significant improvements on body composition (fat to muscle ratio), upper- and lower-body muscle strength, mobility, and balance in older adults compared to low-moderate-intensity training.


Not only is it safe but it is more effective! Of course, always talk with your doctor before starting a new form of exercise. If you are someone with a history of heart conditions and are not currently exercising, try a low-moderate intensity plan first. After a few months of consistent training you can try a high-intensity exercise program.




Resistance Training


What is resistance training?

1–2 multi joint exercises per major muscle group


2–3 sets of 6–12 repetitions 2–3 times per week


1-3 minute rest between sets


Intensities of 70–80% of 1 repetition maximum (1RM). A 1RM means you are only able to move a load (weight) one time. Think about a bicep curl. If I could only do a bicep curl with 10lbs once, that is my 1RM. Therefore, I should be exercising using 7-8lbs. Not everyone knows their 1RM for every exercise and that is where the chart below comes in! It is recommended for older adults who don't know their 1RM to save 4-5 reps left in the tank with each set of an exercise when performing sets at 70-80% intensity. In other words, if I can do 10 bicep curls but not 11, I am going to stop at the 5th or 6th rep. It is important to be honest with yourself when you are choosing a weight. Does it feel like you can do 20 reps of the exercise? Then the weight is too light and you are not building strength!


Credit: Institute of Clinical Excellence


What does the research say?

Filho et al found that after 9 weeks of a progressive resistance training reduces bradykinesia (slowness of movement) and improves functional performance in patients with mild to moderate PD.


Ortiz-Rubio et al found that a 8-week resistance training program was found to be effective at improving dynamic balance and fatigue in patients with PD


Ferreira et al found a significant reduction in anxiety level and increase in quality of life after 24 weeks of resistance training.





Big Takeaways


There are recommendations that are made for every American to stay healthy and active. Those recommendations are:


150 to 300 minutes of moderate aerobic exercise

OR

75 to 150 minutes of vigorous aerobic exercise

AND

> 2 days of resistance training

PLUS

300 minutes of Physical Activity


Physical activity are activities we do day to day like laundry or gardening or cleaning. Things that when we are done we might say to ourselves "phew I did my exercise for the day." Exercise, on the other hand, is specific in the intensity, rest, and movement. It is planned. Both Physical activity and exercise are very important, but make sure you are not relying on physical activity as your exercise.


Most people go too easy with exercise and overtime it becomes very unproductive. If you are staying with the same weight and the same set/rep range, you are not building strength but you are probably losing strength. Make sure you push yourself or go to someone who really understands exercise to make sure you are exercising like you should be!



Source:

Older Adult faculty from Institute of Clinical Excellence

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