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Exercise is safe and represents a cornerstone in PD rehabilitation, but exercise may have even more fundamental benefits that could change clinical practice. In PD, the existing knowledge base supports exercise as (1) a protective lifestyle factor preventing the disease (ie, primary prevention), (2) a potential disease-modifying therapy (ie, secondary prevention) and (3) an effective symptomatic treatment (ie, tertiary prevention). Based on current evidence, a paradigm shift is proposed, stating that exercise should be individually prescribed as medicine to persons with PD at an early disease stage, alongside conventional medical treatment.<\/jats:p>","DOI":"10.1136\/jnnp-2023-332974","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T13:25:51Z","timestamp":1709126751000},"page":"1077-1088","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":105,"title":["Exercise as medicine in Parkinson\u2019s disease"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8397-7527","authenticated-orcid":false,"given":"Martin","family":"Langeskov-Christensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Franz\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3233-0429","authenticated-orcid":false,"given":"Lars","family":"Gr\u00f8ndahl Hvid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik","family":"Dalgas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"2024101603401078000_95.11.1077.1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s00702-017-1686-y","article-title":"Epidemiology of Parkinson\u2019s disease","volume":"124","author":"Tysnes","year":"2017","journal-title":"J Neural Transm (Vienna)"},{"key":"2024101603401078000_95.11.1077.2","article-title":"Physical exercise for people with Parkinson\u2019s disease: a systematic review and network meta-analysis","volume":"1","author":"Ernst","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"2024101603401078000_95.11.1077.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2010.08.002"},{"key":"2024101603401078000_95.11.1077.4","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)00218-x"},{"key":"2024101603401078000_95.11.1077.5","unstructured":"World Health Organization . 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