Over 100,000 Canadians live with Parkinson’s Disease (PD), which is currently believed to be the fastest-growing neurological disorder in the world. (Parkinson Canada, 2023; Dorsey et al., 2018). PD is characterized by the gradual deterioration of brain neurons over time which leads to distinct symptoms including rest tremors, stiffness, decreased mobility, slower movements, and a ‘slouched’ posture.
Individuals with PD are also likely to develop Dementia; four out of every five patients with PD do. (Johns Hopkins Medicine, 2024). Those who develop Dementia while living with PD are diagnosed with Parkinson’s Disease Dementia (PDD). PDD significantly intensifies the challenges faced by those with PD, adding cognitive decline to the physical symptoms affecting memory, attention, and problem-solving abilities.
Regular physical activity provides numerous advantages for most people. For individuals living with PDD, these benefits are especially pronounced. They include:
- Improved motor signs (measured through the Unified Parkinson’s Disease Rating Scale)
- Improved functional mobility and balance (measured via the Timed Up and Go)
- Improved quality of life (reported by patients through the PDQ-39 questionnaire)
- Reduced freezing of gait (measured through the Freezing of Gait Questionnaire)
- Reduced risk of adverse events such as falls
This post delves into how music therapy can further boost the quality of life for individuals with PDD. By blending exercise with music, those living with PDD can discover profound therapeutic benefits adding richness to their quality of life and well being.
How Does Music Therapy Work?
Music therapy uses sounds, music and singing to support and develop emotional expression, cognitive abilities, physical coordination, and social interactions (Machado Sotomayor et al., 2021). This often occurs within a collaborative partnership between the PDD patient and an athletic trainer.
The auditory cue provided by music helps patients improve their balance, speed, rhythm, and continuity of walking (Pereira et al., 2018). Incorporating singing while walking has demonstrated improvements in stride length, speed, and consistency of steps, while also reducing irregularities in walking patterns (Harrison et al., 2019). Moreover, when music therapy is conducted in group settings, selecting familiar and enjoyable songs has fostered discussions that promote stronger connections and unity among participants (Machado Sotomayor et al., 2021).
How to Integrate Music Therapy into an Exercise Session for Someone with PDD: A Step-By-Step Guide
The benefits of incorporating music therapy into structured exercise sessions pave the way for deeper discussion on how coaches, trainers, and health professionals can effectively leverage music into their client’s fitness routines for improved outcomes. Here is how I would implement it for someone with PDD:
Step 1: Gain clearance from a physician or medical professional
Before embarking on a new exercise program, it’s widely recommended to obtain clearance from a medical professional. This is especially true for patients living with PDD as there may be other health concerns which should be considered.
Step 2: Determine which exercises are most optimal
Patients with PDD typically have limited cognitive and physical function compared to non PDD patients. Thus, exercise selection should be relative to their ability while still providing them with benefits. If you are uncertain about the suitability of some exercises, consulting with a physical therapist may be a prudent decision.
Step 3: Design a routine
It is best to think about what kind of exercise and intensity the patient will be engaging in before selecting the type of auditory intervention. The goal is to challenge the patient’s muscular ability without endangering them. The following is an example of a routine designed for an individual with less advanced symptoms of PDD:
| Warm-up (5 minutes) | 40 seconds of:
High knees, butt kicks, modified Frankenstein walks, toe taps and heel walks |
| Resistance training (25-35 minutes) | 2 sets of 10 – banded row and forward lunges
3-4 minute rest in between sets 2 sets of 10 – box squats and Pallof press 3-4 minute rest in between sets 2 sets of 10 –banded pull aparts and leg abduction 2-3 minute rest in between sets 2 sets of 10- toe raises and bretzels 2-3 minute rest in between sets |
| Cool-down | Pec minor stretch (30 seconds each)
Soleus stretch (30 seconds each) Hip flexors (30 seconds each) |
Step 4: Create a playlist
It is best to create a music playlist that caters to each client’s preferences and coordinates specific songs with certain exercises. The playlist should also be flexible enough to accommodate adjustments in the workout routine, whether some exercises don’t go as planned or take more or less time than expected. Here is the same routine from step 3, with music added:
| Section | Exercise, sets, reps | Music suggestions |
| Warm-up | 40 seconds of:
High knees, butt kicks, modified Frankenstein walks, toe taps and heel walks |
(Don’t Fear) The Reaper – Blue Oyster Cult
Bad Moon Rising – Credence Clearwater Revival Everywhere – Fleetwood Mac |
| Resistance training | 2 sets of 10 – banded row and forward lunges
3-4 minute rest in between sets 2 sets of 10 – box squats and Pallof press 3-4 minute rest in between sets 2 sets of 10 –banded pull aparts and leg abduction 2-3 minute rest in between sets 2 sets of 10- toe raises and bretzels 2-3 minute rest in between sets |
White Wedding – Billy Idol
Welcome To The Jungle – Guns N’ Roses Kickstart My Heart – Motley Crue Sabotage – Bestie Boys Smells Like Teen Spirit – Nirvana Everlong – Foo Fighters Paint It, Black – The Rolling Stones Rooster- Alice In Chains Losing My Religion – R.E.M. Dancing In The Dark – Bruce Springsteen |
| Cool-down | Pec minor stretch (30 seconds each)
Soleus stretch (30 seconds each) Hip flexors (30 seconds each) |
Vienna – Billy Joel
Hotel California – Eagles Dreams – Fleetwood Mac Enjoy the Silence – Depeche Mode |
Step 5: Execute the routine. Make changes as necessary.
This program can be modified as time goes on to ensure the patient is optimizing their health outcomes. Experimenting with several exercises and adjusting your music playlist is a great way to find out what works best for the specific patient.
With no cure available, finding ways to slow PDD’s progression is crucial. Integrating exercise with our natural love for music creates an uplifting experience that helps tackles the tough challenges associated with PDD. Every note played and every beat followed can become a step toward resilience and joy, making the journey a bit more manageable.
Work With a Pro
At Stephen Fitness & Rehabilitation, we provide premium one on one personal training and exercise therapy in the comfort of home.
We prescribe and supervise exercise routines that are specifically designed for individuals with Parkinson’s Disease Dementia in London, Ontario.
Contact us to learn more about how we can help you or your parent(s) become stronger, more mobile and independent in the comfort of home!