Effect of different types of exercises on psychological and cognitive features in people with Parkinson's disease: A randomized controlled trial

Abstract

Background: Parkinson's disease (PD) is a neurodegenerative and progressive disease marked by the presence of motor and non-motor symptoms, as psychological and cognitive impairment. Physical exercises have been prescribed as complementary therapy for PD, and the type of intervention and duration of the intervention should be taken into account. Objective: We aimed to compare the effect of different exercise modalities (functional mobility, multimodal and cognitive) and length (4 and 8 months) on psychological and cognition in people with PD. This study followed the CONSORT extension for non-pharmacological trials. Methods: In this randomized controlled trial, we assessed 107 participants between 2011 and 2013. At the end of 3 years, participants with PD (mild to moderate stages) who achieved the criteria were assessed considering 3 different groups of exercise: Multimodal (n = 38), Functional Mobility (n = 33) and Mental/Leisure (n = 36). All 3 interventions were performed for 32 weeks, twice a week, with 60 min for each session (64 sessions in total). Psychological and cognitive function were assessed at baseline and after 4 and 8 months. Results: The Functional Mobility and Mental/Leisure training had a potential effect on maintaining cognitive function (executive function, attention and work memory). The Multimodal training did not show a benefit for cognitive features and was not even able to delay the progressive decline in cognitive functions; however, this modality had a positive effect on physical stress after 8 months of exercise. Conclusions: An intervention that requires high complexity and specific activities, such as locomotor and cognitive exercise, provides a maintenance effect against the degeneration in cognition associated with the progression of PD and thus can delay the progressive decline in cognitive function in PD.

Management of psychiatric and cognitive complications in Parkinson’s disease

“…In addition, physical exercise interventions for cognition in PD encompass aerobic exercise, but also include resistance training, Tai Chi, dance, physical activity, and physical therapy with or without cognitive training 152153154170214215216229. Finally, although a recent Cochrane review suggested little benefit from combining memantine with ChEIs,230 these data included mainly AD patients and there are plans to specifically evaluate this approach in PDD (NIHR129175).…”

A Systematic Study into the Effects of Long-Term Multicomponent Training on the Cognitive Abilities of Older Adults with Neurodegenerative Disorders

“…The 14 studies incorporated in this SR included 1432 participants (Table 2). Of these studies, two were performed in subjects with AD (n = 301) [47][48][49], three studies were carried out with PD (n = 269) patients [50][51][52], and nine studies involved older adults with MCI (n = 862), [53][54][55][56][57][58][59]. The duration of the MEP intervention varied from 24 weeks [48] to 40 weeks [49].…”

“…Of these studies, two were performed in subjects with AD (n = 301) [47][48][49], three studies were carried out with PD (n = 269) patients [50][51][52], and nine studies involved older adults with MCI (n = 862), [53][54][55][56][57][58][59]. The duration of the MEP intervention varied from 24 weeks [48] to 40 weeks [49]. Interventions targeting the comparison or control group varied in content and format.…”

“…A total of two studies used a control group without an intervention [48]. Other interventions included a social intervention [47], Irish dance [51], functional mobility and mental leisure activities [50], and a home-based education intervention [49]. Considering this type of exercise, all selected studies presented a multicomponent intervention that met the initial criteria.…”

Citius, Fortius, Altius, Cognitus—Understanding Which Psychological and Cognitive Components Drive Physical Activity and Exercise Benefits in Parkinson Disease

“…Recent findings suggest that an important determinant for a beneficial outcome of physical activity is not just aerobic exercise with minimal cognitive demands but, first and foremost, cognitively enriched aerobic exercise (ie, with cognitive and motor skill component). In this regard, a randomized controlled trial 10 showed that a 32-week intervention requiring both complex locomotor and cognitive exercise can maintain executive features and delay the cognitive decline in PD. These findings are crucial considering that executive dysfunction is frequently present from the early stages of PD.…”