A two‐year randomized controlled trial of progressive resistance exercise for Parkinson's disease

Abstract

Background The effects of progressive resistance exercise (PRE) on the motor signs of Parkinson’s disease have not been studied in controlled trials. Our aim was to compare 6, 12, 18, and 24 month outcomes of patients with Parkinson’s disease who received PRE to a stretching, balance, and strengthening exercise program. Methods We conducted a randomized controlled trial between September 2007 and July 2011. Pairs of patients, matched by sex and off-medication Unified Parkinson’s Disease Rating Scale, motor subscale (UPDRS-III), were randomly assigned to the interventions with a 1:1 allocation ratio. The PRE group performed a weight lifting program. The Modified Fitness Counts (mFC) group performed a stretching, balance, and strengthening exercise program. Patients exercised two days per week for 24 months at a gym. A personal trainer directed both weekly sessions for the first six months and one weekly session after six months. The primary outcome was the off-medication UPDRS-III score. Patients were followed for 24 months at six-month intervals. Results Of 51 patients, 20 in PRE and 18 in mFC completed the trial. At 24 months, the mean off-medication UPDRS-III score decreased more with PRE than with mFC (mean difference: - 7·3 points; 95% CI: -11·3 to -3·6; P < 0·001). The PRE group had ten adverse events. The mFC group had seven adverse events. Conclusions PRE demonstrated a statistically and clinically significant reduction in UPDRS-III scores compared to mFC and is recommended as a useful adjunct therapy to improve Parkinsonian motor signs.

Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

“…The decreased work and power generation observed in the early stages of PD suggest the need for early interventions that improve the muscular performance of these individuals. Recently, Corcos et al 32 observed improve in muscular strength and a 7.3 points decrease in UPDRS-III scores, which is a moderate clinically important change, after a 24-month progressive resistance exercise program (PRE). PRE progressively increased the resistance over time and each repetition lasted 6-9 seconds, that is, at slow speeds 32 .…”

“…Recently, Corcos et al 32 observed improve in muscular strength and a 7.3 points decrease in UPDRS-III scores, which is a moderate clinically important change, after a 24-month progressive resistance exercise program (PRE). PRE progressively increased the resistance over time and each repetition lasted 6-9 seconds, that is, at slow speeds 32 . The authors hypothesized that PRE may lead to experience-dependent plasticity in the basal ganglia and corticomotor pathways, which could contribute to improving signs and motor performance.…”

Yoga Versus Resistance Training in Mild to Moderate Severity Parkinson’s Disease: A 12-Week Pilot Study

“…While specific elements of effective interventions have been described, there is no published consensus guideline regarding what type of intervention is the most beneficial form of regular physical activity in PD [21]. Resistance training has been shown to be beneficial in PD, and since there is no consensus regarding what type of intervention is most beneficial in PD, it serves as an appropriate comparison [22,23]. In this current study, we aimed to explore the feasibility of a yoga intervention in patients with PD both in a busy urban setting and a suburban setting, as well as to collect pilot data on preliminary efficacy compared to traditional resistance training to support a future larger scale efficacy study.…”

Effects of Nordic walking on Parkinson’s disease: a systematic review of randomized clinical trials

“…The combination of motor and non-motor manifestations (e.g., depression, apathy and dementia) interferes with the individual's level of disability, and these factors negatively influence quality of life (QOL), which leads to isolation and low participation in social activities 6,7 . Distinct exercise modalities improve the symptoms of PD [8][9][10][11][12] . Exercise promotes plasticity of the central nervous system (CNS) 13 ; improves balance, gait, physical function and quality of life 8,9,14 , delays cognitive impairment 15,16 , dementia 17,18 , depression 19,20 ; and slows the progression of PD 21 .…”