In individuals with Parkinson's disease who have orthostatic symptoms, which type of exercise should be avoided?

• A. Supine exercise
• B. High-intensity endurance training
• C. Resistance band training
• D. Aquatic therapy

Answer: (A)

When blood pressure regulation during positional changes is impaired, the body relies on gradual, controlled transitions to upright to keep BP stable. Exercising while lying flat minimizes the normal gravitational challenges that train the autonomic system to respond to standing. The risk is that after finishing a supine workout, getting up can trigger a sudden orthostatic drop, causing dizziness or fainting because the system hasn’t been practicing rapid adjustments to upright posture. So, to reduce the chance of problematic BP changes after exercise, supine (lying-down) exercise should be avoided in individuals with orthostatic symptoms. Other exercise modes can be used with careful pacing and positioning, but the key safety point is avoiding lying flat during activity.