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September 11, 2025 16 mins

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What if the future of Parkinson’s care was already taking shape — and it looked nothing like the rehab you know today? In this inspiring, research‑packed episode, we explore how AI, robotics, wearable tech, virtual and augmented reality, and breakthrough neuroscience are transforming exercise into a powerful, personalized therapy for Parkinson’s.

From boosting brain‑derived neurotrophic factor (BDNF) to harnessing the gut‑brain axis, you’ll discover how cutting‑edge science is unlocking new ways to protect the brain, improve movement, and enhance quality of life. Whether you’re newly diagnosed, a long‑time Parkinson’s warrior, or a care partner, this episode will leave you informed, empowered, and excited about what’s ahead.

In this episode, you’ll learn:

  • 🚀 How AI‑driven exercise prescriptions are being developed to adapt in real time to your symptoms and energy levels.
  • 🤖 The latest on robotic exoskeletons and assistive devices that retrain gait and balance.
  • 🥽 How VR and AR rehab can reduce freezing of gait, improve coordination, and make exercise fun.
  • ⌚ Why next‑gen wearables could predict “off” periods before they happen.
  • 🧠 The role of BDNF, motor learning, and biomarkers in slowing Parkinson’s progression.
  • 🦠 How exercise may influence the gut microbiome to reduce inflammation and protect neurons.
  • 📅 What to expect in the next 2–3 years, 5–10 years, and beyond in Parkinson’s exercise therapy.

This isn’t just about gadgets — it’s about living better, longer, and stronger with Parkinson’s.

💡 Stay connected & get free resources: Visit liveparkinsons.com to subscribe to the free monthly newsletter and access valuable tools like the Parkinson’s Symptom and Medication Tracker.

Support the mission: If you believe in helping people with Parkinson’s lead an exceptional quality of life, you can support the podcast and my work at ko-fi.com/liveparkinsons.

📖 Read my story & strategies: Discover my personal journey and proven approaches in my book Spectacular Life – 4 Essential Strategies for Living with Parkinson’s, available now on Amazon.

Support the show

Disclaimer: This podcast is for educational purposes only is not intended to treat or diagnose Parkinson's Disease. Please ensure that you are following the treatment plan developed by your doctor. Please ensure before starting anything new you get approval from your doctor. The information being provided is based on my own personal experiences and does not guarantee that it will benefit everyone.

Disclosure: I discuss and promote products in this podcast that pay me a small commission at no cost to you. I use the commissions to help support this podcast and my website Liveparkinsons.com. I make you aware of any affiliate links by adding AFFLIATE Link right beside the link. Thank you for supporting this podcast.

To help support the podcast please visit me on my Ko-fi page and buy a cup of coffee if you feel that I am providing information that is relevant and actionable to help you live a better quality of life.

Please visit me at Liveparkinsons.com

Get my book - Spectacular Life - 4 Essential Strategies for Living with Parkinson's - My Journey to Happiness

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Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Hello and welcome to Live Parkinson's Live an
Exceptional Life.
I'm your host, chrisKustenbader, and I've been
living an exceptional life withParkinson's for the past 15
years.
The mission of this podcast isto help as many people as
possible living with Parkinson'sto lead a great quality of life
.
Now, today, we're diving intothe future of exercise and
Parkinson's, where cutting edgescience meets hope and where

(00:32):
technology is rewriting therules of rehabilitation.
All right, I want you to closeyour eyes for a second, that is,
unless you're driving, in whichcase please don't.
But it's the year 2035.
You wake up, you slip into afeatherlight robotic suit that
syncs with your nervous system.
It senses your stiffness beforeyou do, it gently mobilizes

(00:55):
your joints and guides youthrough a workout tailored to
your brain's needs.
On that specific day, yourliving room morphs into a sunlit
Tuscan vineyard via augmentedreality, and your wearable
sensors stream real-time brainand movement data to your
neurologist.
Now here's the kicker Everystep you take is not just

(01:15):
keeping you fit.
It's actively protecting yourneurons, boosting brain
chemicals like BDNF, which we'lltalk a little bit about later,
and maybe even slowingParkinson's progression.
Now it sounds like sciencefiction, doesn't it?
Well, the truth is, much ofthis is already in clinical
trials.
You've probably heard me say itbefore, but exercise is

(01:37):
medicine.
But now the science is catchingup in a big way.
A 2023 review in the Journal ofNeurology, neurosurgery and
Psychiatry by LangoskavChristensen and colleagues
concluded that exercise can actas a primary prevention by
lowering the risk of developingParkinson's, as a secondary

(01:58):
prevention by slowing thedisease progression, and as a
tertiary prevention by helpingto improve symptoms.
And then there was a 2024meta-analysis in brain sciences
by Kegman et al that pulled datafrom five randomized controlled
trials, and what they found wasthat structured exercise
significantly increased serumBDNF.

(02:21):
Now, bdnf is the brain-derivedneurotropic factor, and think of
it this way it's your brain'sown growth fertilizer and it
improves your motor scores, yourwalking distance and your
balance.
Now you can tell I get boredpretty easily and sit around
looking up clinical studies, buttry to bear with me, all right.
So we're not talking aboutfeeling better after a workout.

(02:42):
We're talking about exercise aspotential neuroprotective
therapy.
Now, unlike pills, the sideeffects are mostly limited to
sore muscles.
And then maybe the occasionalawkward moment when your
smartwatch congratulates you fora workout.
That was actually just youchasing your dog through the
yard.
All right.
So let's talk about the techthat's making all this possible,

(03:05):
and let's start out with AI andwearable sensors.
Now, researchers are nowcombining wearable sensors with
artificial intelligence to trackand improve your movement.
So, for example, the ModyGravity Platform tested in the
2025 Journal of ClinicalMedicine study, uses inertial

(03:27):
sensors in a hypogravitytreadmill to collect precise
data movement.
So it's an AI model thatclassified Parkinsonian versus
healthy movement patterns with100% validation accuracy in a
pilot study.
That's pretty impressive.
Now, at the University ofIllinois, hernandez and
colleagues in 2024 showed thatlow-cost wearable sensors plus

(03:51):
deep learning improved detectionof motor impairments by 12%
over standard models.
And at the University ofMaryland, khalil in 2024, used a
single lower back sensor withmachine learning to distinguish
Parkinson's from control groupswith 92.6% accuracy.

(04:13):
All right, now let's talk alittle bit about robotic
exoskeletons.
These are pretty exciting.
Now.
These are devices like the XONRand Japan's HAL hybrid
assistive limb, and they'rebeing trialed for gait training.
Now, they don't just move yourlegs, they respond to your own
neural signals, helping youretrain your body and your brain

(04:36):
connection.
Now, early studies showed thatimproved stride length, reduced
freezing and better balance werethe results of using these new
exoskeleton technologies.
Now what's the benefit?
Well, these systems can deliverthousands of perfect,
repeatable steps in a session,something that's hard to achieve

(04:57):
by just using human therapistsalone.
All right, now let's take a stepinto the matrix in a good way,
and let's talk about virtualreality.
Now virtual reality is beingused to create immersive rehab
environments.
There was a 2023 study in theJournal of Neuroengineering and

(05:18):
Rehabilitation that found thatvirtual reality balance training
, improved gait and reduced fallrisk in Parkinson's patients.
So imagine walking along abeach, stepping over some
driftwood, while your brain isactually learning to adapt to
real-world obstacles.
So that's actually pretty cool.
So they can actually set upobstacles using the virtual

(05:41):
reality, and then you canpractice in a safe environment.
And then augmented reality itoverlays visual cues in your
real environment.
So there's devices like theQSTIM that's C-U-E-S-T-I-M, so
the QSTIM glasses.
What they do is they projectstepping stones on the floor to

(06:01):
help you overcome freezing ofgait.
So early trials have shownsignificant improvements in both
walking speed and reducefreezing episodes.
So the benefit of theseparticular tools virtual reality
and augmented reality are thatthey make rehab engaging,
gamified.
So if you're having a good time, you're more likely to

(06:22):
participate and keep coming backto do it again, and they're
adaptable.
And another benefit is thatthey can be done at home.
All right, let's talk a littlebit now about wearable
technologies.
So, from smart watches toadvanced biosensors, wearables
are becoming mini health labs.
There's a watch out therecalled the PKG watch from Global

(06:45):
Kinetics.
That's FDA cleared forcontinuous movement monitoring.
Movement monitoring and whatthis watch does is it tracks
your tremor, bradykinesia anddyskinesia over days, helping
doctors fine-tune medicationtiming.
I think that's prettyfascinating.
Now some wearables nowintegrate with AI to predict
your off periods before theyhappen, giving you a heads up to

(07:08):
plan your daily activities.
So that way you'll kind of havea heads up and know when you
might be experiencing your offtimes.
All right, now let's move on andtalk about BDNF and some of the
breakthrough research that'sgoing on with BDNF, motor
learning and some biomarkers.
So let's geek out, if you will,with me for just a minute.

(07:29):
So BDNF again stands forbrain-derived neurotropic factor
and what it does?
It supports neuron growth andsurvival, and I need plenty of
that, that's for sure.
In a study in Frontiers inPhysiology by Paterno in 2024,
they found that higher intensityexercise correlated with

(07:50):
greater BDNF increases in peoplewith Parkinson's.
And then in another study intranslational neurodegeneration,
link these boosts to improvemotor scores as well.
So that's pretty impressive.
Now, in terms of motor learningresearch, motor learning
research has shown that thebrain can rewire itself through

(08:11):
targeted, repetitive practice,and we typically use that term
neuroplasticity so especiallywhen combined with real-time
feedback from sensors or virtualreality.
So you can use virtual realityand sensors, as well as motor
learning, to help rewire yourbrain, which I think is pretty
spectacular.

(08:31):
And then in terms of biomarkers, now these are think is pretty
spectacular.
And then, in terms ofbiomarkers, now these are the
holy grail.
These are blood tests orimaging that can track how
exercise impacts diseaseprogression.
And what scientists are doingis they're exploring
alpha-synuclein, which is aprotein that clumps in people
with Parkinson's.
So they're exploringalpha-synuclein assays and

(08:52):
advanced MRI to measureneuroplasticity changes.
All right, now here's wherethings get really interesting.
We'll talk a little bit aboutcombination therapies and the
gut-brain axis.
All right, we'll start off withcombination therapies.
Now trials are pairing exercisewith non-invasive brain
stimulation like TDSC or TMS toenhance motor learning.

(09:15):
Now the idea is to prime yourbrain so that it's more
receptive to the benefits ofexercise.
Now I need plenty of that.
My brain needs priming all thetime, I think.
So these trials that they'redoing are pretty fascinating in
that you're teaming exercisewith non-invasive brain
stimulation.

(09:36):
And then in terms of gut-brainaccess, which I've talked about
before, remember we havetrillions of bacteria, fungi,
living in our gut and we havewhat's called good and bad
bacteria, and they're involvedin our immune system as well as
communicating with our brain.
And in terms of the gut-brainaxis, there was a study

(09:58):
published by Zapanta in 2022 inphysical therapy, and they
suggested that exercise mayrestore gut microbiota diversity
, potentially reducingneuroinflammation, and
neuroinflammation is one of therisk factors that they believe
are involved in Parkinson's.
Now the Parkinson's Foundationnotes that people with PD often

(10:19):
have altered gut bacteriaprofiles and that by changing
that, we could help to influencethe symptoms.
So I think that's prettyfascinating that exercise might
help impact your gut flora andhelp you with your Parkinson's
symptoms.
All right, now let's talk alittle bit about the road ahead,

(10:40):
what's coming down the pike interms of exercise, and let's do
some time travel and look atwhat's in the pipeline in the
next two to three years, andthen we'll talk about what's
five to 10 years out and then 10plus years out All right.
So let's look at the next two tothree years, from 2025 to 2027.

(11:02):
And we'll start off with AIdriven personalized exercise
prescriptions.
Say what AI platforms are goingto be able to analyze your
movement data, symptom patternsand even biomarker results to
create daily exercise plans thatare tailored to meet your needs
.
So imagine an app that noticesyour gait slightly off today and

(11:24):
it swaps your planned cyclingsession for targeted balance
drills.
I think that's really cool.
So you might go to the gymthinking you're going to do one
thing, but the app is able toread your movements and your
symptoms and suggest somethingelse.
Next up is wider adoption ofboth virtual reality and
augmented reality rehab at homeThings like virtual reality

(11:46):
boxing programs that can adaptto tremor patterns, and then
augmented reality glasses thatare able to project stepping
cues to help you overcomefreezing.
So this makes therapy engaging,accessible and fun.
And then, third, in the nexttwo to three years, you're going
to see wearables that are goingto be able to predict off
periods.
So you're going to have smartdevices that will forecast when

(12:10):
symptoms will worsen, andthey're going to be able to give
you a heads up to adjust yourmedication or help you plan your
activities, so think of it as aweather forecast for your motor
symptoms.
I think that's really awesomeNow, five to 10 years out, from
2030 to 2035,.
One of the things they're goingto have is affordable home use
robotic gait trainers.

(12:31):
They're compact, cost-effectivedevices that bring clinical
level gait therapy right intoyour home.
So you strap in, you walk andyou let the robot guide your
perfect stride.
And then next up is biomarkerguided exercise programs, and
what these are is exerciseprescriptions based on

(12:53):
measurable biological indicatorslike BDNF levels or
alpha-synuclein concentrations.
Your workout could befine-tuned, really based just on
a simple blood test.
And then, finally, gutmicrobiome profiling integrated
into rehab.
So stool sample analysis tounderstand your gut bacteria,

(13:16):
and then they're going to pairthat with an exercise plan, with
dietary tweaks or probioticsfor optimal gut health.
All the things that they'reworking on.
It's really fascinating.
And then in 10 plus years, wherewe're talking 2035 and beyond,
they're going to have a fullyimmersible AI adaptive exercise
ecosystem.

(13:36):
These are smart rehab roomsthat adapt lighting, sound,
visuals and exercise equipmentin real time based on your brain
and your body signals.
That's actually prettyfascinating.
And then you're going to havereal-time brain imaging feedback
during your exercise workouts.
So there's going to be portablebrain monitoring that's going

(13:56):
to allow you to show how yourmotor cortex responds to each
type of exercise, letting youand your therapist fine-tune in
the moment while you'reexercising.
And then, third, is large-scaleproof of disease-modifying
effects.
There's decade-long globaltrials that are going to confirm
that exercise is one of thekeys to helping you slow the

(14:20):
progression of the disease.
So that's a quick overview ofsome of the things that are
coming down the exercise pikeand helping you live your best
life with Parkinson's.
So really, the future ofexercise and Parkinson's is
going to be about moving smarter, not just moving more.
It's going to be about blendinghuman determination with some
of these tools like AI, roboticsand biology to not just manage

(14:45):
symptoms, but to really to helpto change the trajectory of the
disease.
Now all this technology isexciting trajectory of the
disease.
Now, all this technology isexciting.
The science is promising, butthe real magic that's you
Showing up, moving and believingin a better tomorrow is going
to help in the long run.
So it's important that you stayconsistent with your exercise

(15:09):
program and that you show up andgive it your best shot Now.
For more information, pleasevisit my website,
liveparkinsonscom, and subscribeto the free monthly newsletter
where I keep you updated on allthe latest research, clinical
trials, webinars and seminarsthat are going on, and there's

(15:29):
also valuable free resourceslike the Parkinson's Medication
and Symptom Tracker, as well asnine balance exercises to help
you improve your balance withParkinson's.
And then, in addition, if youwant to support my mission to
help as many people as possibleliving with Parkinson's and to
help keep the program going,please consider visiting my

(15:52):
Ko-fi page at ko-ficom slashliveparkinsons and donating to
help support the mission.
I want to thank you again forlistening and remember stay
strong, stay healthy and liveyour best life with Parkinson's.
I have faith in you and I hopeyou have faith in yourself.
See you again next time andhave a great week.
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