An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease

Salgado, Sanjay; Williams, Nori; Kotian, Rima; Salgado, Miran

doi:10.3390/brainsci3010087

Cited by 33 publications

(19 citation statements)

References 88 publications

(110 reference statements)

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“…Their findings suggest that different ET modalities may preferentially improve different aspects of PD motor symptoms. A key clinical challenge is to understand how different ET parameters determine rehabilitative outcomes, so that rehabilitative regimens can be optimized for patients (Nieuwboer et al, 2009; Salgado et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

Recruitment of the prefrontal cortex and cerebellum in Parkinsonian rats following skilled aerobic exercise

Wang

Guo

Myers

et al. 2015

Neurobiology of Disease

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Exercise modality and complexity play a key role in determining neurorehabilitative outcome in Parkinson’s disease (PD). Exercise training (ET) that incorporates both motor skill training and aerobic exercise has been proposed to synergistically improve cognitive and automatic components of motor control in PD patients. Here we introduced such a skilled aerobic ET paradigm in a rat model of dopaminergic deafferentation. Rats with bilateral, intra-striatal 6-hydroxydopamine lesions were exposed to forced ET for 4 weeks, either on a simple running wheel (non-skilled aerobic exercise, NSAE) or on a complex wheel with irregularly spaced rungs (skilled aerobic exercise, SAE). Cerebral perfusion was mapped during horizontal treadmill walking or at rest using [14C]-iodoantipyrine 1 week after the completion of ET. Regional cerebral blood flow (rCBF) was quantified by autoradiography and analyzed in 3-dimensionally reconstructed brains by statistical parametric mapping. SAE compared to NSAE resulted in equal or greater recovery in motor deficits, as well as greater increases in rCBF during walking in the prelimbic area of the prefrontal cortex, broad areas of the somatosensory cortex, and the cerebellum. NSAE compared to SAE animals showed greater activation in the dorsal caudate-putamen and dorsal hippocampus. Seed correlation analysis revealed enhanced functional connectivity in SAE compared to NSAE animals between the prelimbic cortex and motor areas, as well as altered functional connectivity between midline cerebellum and sensorimotor regions. Our study provides the first evidence for functional brain reorganization following skilled aerobic exercise in Parkinsonian rats, and suggests that SAE compared to NSAE results in enhancement of prefrontal cortex- and cerebellum-mediated control of motor function.

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Section: Introductionmentioning

confidence: 99%

Recruitment of the prefrontal cortex and cerebellum in Parkinsonian rats following skilled aerobic exercise

Wang

Guo

Myers

et al. 2015

Neurobiology of Disease

View full text Add to dashboard Cite

show abstract

“…A plethora of evidence suggests that controlled aerobic exercise may improve gait, posture, mobility, and flexibility of PD patients [ 220 , 221 ]. Sometimes, voluntary physical exercise, or physiotherapy, can strengthen muscle activity, decrease muscular tonicity and rigidity, improve balance, minimize gait problems, and strengthen certain muscles in PD patients [ 222 ]. Even in severe cases of the disease, regular walking, gardening, and other physical activities have been shown to be beneficial, and may improve the ability of the brain to increase DA synthesis.…”

Section: Treatment Of Pdmentioning

confidence: 99%

Current understanding of the molecular mechanisms in Parkinson's disease: Targets for potential treatments

Maiti

Manna

Dunbar

2017

Transl Neurodegener

419

305

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Gradual degeneration and loss of dopaminergic neurons in the substantia nigra, pars compacta and subsequent reduction of dopamine levels in striatum are associated with motor deficits that characterize Parkinson’s disease (PD). In addition, half of the PD patients also exhibit frontostriatal-mediated executive dysfunction, including deficits in attention, short-term working memory, speed of mental processing, and impulsivity. The most commonly used treatments for PD are only partially or transiently effective and are available or applicable to a minority of patients. Because, these therapies neither restore the lost or degenerated dopaminergic neurons, nor prevent or delay the disease progression, the need for more effective therapeutics is critical. In this review, we provide a comprehensive overview of the current understanding of the molecular signaling pathways involved in PD, particularly within the context of how genetic and environmental factors contribute to the initiation and progression of this disease. The involvement of molecular chaperones, autophagy-lysosomal pathways, and proteasome systems in PD are also highlighted. In addition, emerging therapies, including pharmacological manipulations, surgical procedures, stem cell transplantation, gene therapy, as well as complementary, supportive and rehabilitation therapies to prevent or delay the progression of this complex disease are reviewed.

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“…Clinical and epidemiological studies have provided evidence supporting the conclusion that exercise has therapeutic value by reducing the symptoms and slowing disease progression (Ransmayr, 2011;Hou et al, 2017;Liu et al, 2019). Moderate to high-intensity aerobic exercises, such as treadmill walking or assisted cycling, are recommended for improved motor and cognitive function in Parkinson's disease (Ahlskog, 2011;Salgado et al, 2013;Evens and Clark, 2017). High-intensity treadmill exercise of 30 min at a target heart rate prevented Parkinson's disease progression, compared to moderate intensity and control (Schenkman et al, 2018).…”

Section: Body Warming In People With Neurodegenerative Diseases Evidementioning

confidence: 99%

Could Heat Therapy Be an Effective Treatment for Alzheimer’s and Parkinson’s Diseases? A Narrative Review

et al. 2020

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Neurodegenerative diseases involve the progressive deterioration of structures within the central nervous system responsible for motor control, cognition, and autonomic function. Alzheimer's disease and Parkinson's disease are among the most common neurodegenerative disease and have an increasing prevalence over the age of 50. Central in the pathophysiology of these neurodegenerative diseases is the loss of protein homeostasis, resulting in misfolding and aggregation of damaged proteins. An element of the protein homeostasis network that prevents the dysregulation associated with neurodegeneration is the role of molecular chaperones. Heat shock proteins (HSPs) are chaperones that regulate the aggregation and disaggregation of proteins in intracellular and extracellular spaces, and evidence supports their protective effect against protein aggregation common to neurodegenerative diseases. Consequently, upregulation of HSPs, such as HSP70, may be a target for therapeutic intervention for protection against neurodegeneration. A novel therapeutic intervention to increase the expression of HSP may be found in heat therapy and/or heat acclimation. In healthy populations, these interventions have been shown to increase HSP expression. Elevated HSP may have central therapeutic effects, preventing or reducing the toxicity of protein aggregation, and/or peripherally by enhancing neuromuscular function. Broader physiological responses to heat therapy have also been identified and include improvements in muscle function, cerebral blood flow, and markers of metabolic health. These outcomes may also have a significant benefit for people with neurodegenerative disease. While there is limited research into body warming in patient populations, regular passive heating (sauna bathing) has been associated with a reduced risk of developing neurodegenerative disease. Therefore, the emerging evidence is compelling and warrants further investigation of the potential benefits of heat acclimation and passive heat therapy for sufferers of neurodegenerative diseases.

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An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease

Cited by 33 publications

References 88 publications

Recruitment of the prefrontal cortex and cerebellum in Parkinsonian rats following skilled aerobic exercise

Recruitment of the prefrontal cortex and cerebellum in Parkinsonian rats following skilled aerobic exercise

Current understanding of the molecular mechanisms in Parkinson's disease: Targets for potential treatments

Could Heat Therapy Be an Effective Treatment for Alzheimer’s and Parkinson’s Diseases? A Narrative Review

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