Regular physical exercise has been shown to delay and alleviate neurodegenerative diseases. Yet, optimum physical exercise conditions that provide neuronal protection and exercise-related factors remain poorly understood. Here, we create an Acoustic Gym on a chip through the surface acoustic wave (SAW) microfluidic technology to precisely control the duration and intensity of swimming exercise of model organisms. We find that precisely dosed swimming exercise enabled by acoustic streaming decreases neuronal loss in two different neurodegenerative disease models of Caenorhabditis elegans, a Parkinson's disease model and a tauopathy model. These findings highlight the importance of optimum exercise conditions for effective neuronal protection, a key characteristic of healthy aging in the elderly population. This SAW device also paves avenues for screening for compounds that can enhance or replace the beneficial effects of exercise and for identifying drug targets for treating neurodegenerative diseases.