Ask Dr. Victoria Holiday what she prescribes a newly diagnosed Parkinson’s patient, and medication is only half the answer. The other half is movement. Dr. Holiday, a board-certified neurologist at UofL Health’s Brain and Spine Institute and Clinical Director of the Deep Brain Stimulation Program, sat down with National Parkinson’s Institute CEO Eric Richardson and Vice President Erika Ganong for a recent episode of the NPI Parkinson’s Podcast. The conversation covered two things she cares about deeply: mentoring the next generation of physicians through NPI’s Buddy Program, and the science that keeps proving what a lot of us in this community already suspected: that exercise isn’t just helpful for Parkinson’s; it’s essential.
Teaching Future Doctors to See the Whole Patient
Dr. Holiday has been part of NPI’s Parkinson’s Buddy Program since she joined the University of Louisville faculty eight years ago. The idea is simple: pair a first-year medical student with someone living with Parkinson’s disease and let them learn what a textbook can’t teach.
She’s clear that the program isn’t a recruiting pipeline for neurology, even though some students do end up going that direction. What matters more, she says, is that every future doctor, whatever they end up specializing in, walks away understanding what it actually means to manage a chronic disease that isn’t going away. The demand this year says a lot. Every participant living with Parkinson’s got matched with two student buddies instead of one, and organizers still had to turn away roughly twenty students who wanted in. Some of these relationships stick. One longtime buddy named Bob has stayed connected to every student he’s ever been paired with, showing up to their weddings, watching their kids grow up.
Exercise as a Prescription
This was the heart of the episode. Dr. Holiday made the case, backed by real data, that exercise belongs in the treatment plan from day one. It’s not just about strength and balance, though those matter. She pointed to the symptoms people don’t talk about as much, constipation, a voice that’s gotten quieter, shortness of breath, cognitive fog. Better posture and stronger lungs, it turns out, are directly tied to whether someone can be heard across a room.
She cited a study that followed over 1,000 Parkinson’s patients for two years. The ones who exercised 150 minutes a week showed significantly less disease progression than those who didn’t, likely because exercise fights inflammation in the body and brain. Her baseline recommendation: three to four days a week of aerobic activity, at least 30 minutes each, two to three days of strength training, and regular flexibility work. She also flagged something newer called neuromotor exercise, movement paired with a mental task, like reacting to colored lights or building something while staying active, that challenges the body and brain at the same time. And she was clear, nobody is too far along or too limited to benefit. Even patients who can no longer walk have shown improvement through passive movement, whether that’s a caregiver-assisted stretch or a motorized pedal bike.
Medication and Exercise Aren’t Competing, They’re a Team
Here’s where Dr. Holiday pushed back on a mindset she sees a lot: patients trying to white-knuckle their way through symptoms without proper medication. It doesn’t work, and she said so plainly. She calls Parkinson’s medication “gas in the tank.” Without enough dopamine, muscles fatigue fast, no matter how hard someone is trying. Rigidity and bradykinesia respond well to treatment, and patients who are properly medicated get far more out of every workout. For those still hesitant to start medication, she’s found that showing them their own performance, on it versus off it, tends to make the decision for them.
The Social Piece Matters Too
Dr. Holiday and the NPI team also talked about isolation and what COVID took from this community. She referenced a 2023 study out of Japan showing that social isolation during the pandemic affected Parkinson’s progression independent of exercise, hitting cognition, mood, and behavior hard. It’s part of why group classes, Rock Steady Boxing, dance, and pickleball tend to outperform working out alone at home. There’s built-in accountability, and there’s something about doing this alongside other people living with the same disease that’s hard to replicate solo. For anyone still trying to make home workouts stick, Dr. Holiday’s advice is simple: claim a specific space for it, and pair it with something you already do, like standing up and moving every time your favorite show is on.
The audio podcast is on Apple, Spotify and other platforms, with a concept video posted on YouTube where you can listen and read along.
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