Sabine investigated how physical activity can be used as an intervention for people with Parkinson's disease (Parkinson Association | Dutch summary). Previous research showed that a certain way of moving, intensive aerobic exercise (i.e. exercises that require a high level of oxygen consumption from the muscles), can help to reduce motor complaints caused by Parkinson's disease (van der Kolk 2019).

She first looked at the existing literature in which endurance training in the above form was investigated as an exercise intervention for people with Parkinson's disease. Endurance training appears to improve endurance and possibly reduce motor complaints caused by Parkinson's disease. However, additional research is needed to make this evidence even stronger. It should also be investigated whether these positive effects are permanent and whether positive effects can also be measured on non-motor symptoms of Parkinson's disease (Schootemeijer 2020).

Effect of exercise

That is why Sabine looked at the effect of exercise on complaints of the autonomic nervous system. For example, people with Parkinson's disease often experience changes in blood pressure, which can cause dizziness and lightheadedness and increase the risk of falling. This study showed that people with more autonomic complaints had a lower maximum heart rate. Physically more active people had a better heart rate recovery and a higher maximum oxygen uptake. Future research should strengthen these findings and show whether exercise also has a long-term positive effect on these complaints.

It is important for drawing up an exercise program to map out which motivators and barriers patients experience to start exercising. Sabine investigated this in the following studies (Schootemeijer 2022, 2023). It turned out that social contact, knowledge about the importance of exercise and support from the social environment and from professionals were important motivators to start exercising. Non-motor complaints, such as fatigue, depression and fear of falling, were mentioned as barriers. In people who already had Parkinson's disease, the motivators were the same, but the barriers differed. She also stressed that because her research shows that motivators and barriers can be so broad and personal, it is important to motivate people with Parkinson's to exercise and continue to exercise in a way that suits them.

Stimulating exercise with an app

Finally, in a pilot study she investigated how you can stimulate physical activity in people with Parkinson's disease (Schootemeijer 2023, 2025). An application (STEPWISE) was used for this, which people can use on their smartphone and which motivates people with Parkinson's to exercise more. The app measures how active someone is by measuring how many steps someone takes.
The aim of this study is to test user-friendliness. Participants used the app for a month. They found the app user-friendly and had moved more when they used the app.

These findings are encouraging and show that apps can be used effectively to get people with Parkinson's to move more. A follow-up study has already started where the application is being tested in a larger group of people with Parkinson's disease, and where the app is being used for a longer period of time. This study will also look at the effects on the physical fitness and motor and non-motor functioning of people with Parkinson's disease. 452 people will participate in the study and they will complete the study in 2026.

Bike Labyrinth also has an application for a phone or tablet. With Bike Labyrinth Club you can easily discover the world by bike from your own familiar environment. For people with Parkinson's disease who suffer from freezing of gait, cycling on an exercise bike can be a good alternative to exercise (Snijders 2012).