Cardiorespiratory fitness is improved with physical activity.
One meta-analysis and a systematic review and meta-analysis showed that variety of different physical activities all improve cardiorespiratory fitness safely in early Parkinson’s by improving VO2 max and reducing breathlessness and BP, including aerobic training, treadmill, stationary bike, cycling, walking, jogging, resistance training and Qigong . Another systematic review reviewed the effects of aerobic training on cardiopulmonary function in PD patients in seven studies. This study reported an improvement of V02 peak, decrease in breathlessness, increase maximum workload tolerated, reduce BP and increase test duration of the CPET test carried out. However, two studies reported a decrease rather than an increase in V02 max training. Most of the studies included in the review used similar intensities and frequencies recommended by the World Health Organization in 2010 (WHO) (30–45 minutes of moderate intensity, three times per week) . The types of activities included in this study included walking overground, treadmill walking and stationary cycling  It is worth noting that the World Health Organisation has issued updated guidelines on recommendations for physical activity and recommends at least at least 75-150 minutes of vigorous intensity physical activity a week in 2020 for adults (18-64 years old) .
Quality of Evidence
B – This is based on two good systematic reviews and one meta-analysis.
Strength of Recommendation
1 – These activities are found to be feasible and safe and there is no evidence of deterioration in any outcomes.
Physical activity helps improve cardiorespiratory fitness in People with Parkinson’s when performed 3 times a week for at least 30 mins.
 Uhrbrand et al. Parkinson’s disease and intensive exercise therapy – a systematic review and meta-analysis of randomized controlled trials. J Neurol Sci. 2015;353(1-2):9-19. doi: 10.1016/j.jns.2015.04.004. Epub 2015 Apr 14.
 Global recommendations on physical activity for health. World Health Organisation. 1 January 2010
 Aburub et al. Cardiopulmonary Function and Aerobic Exercise in Pakinson’s : A systematic review of the Literature 2020 Aug: 7(6): 599-606
 WHO guidelines on physical activity and sedentary behaviour. World Health Organisation 25 November 2020