Effects of a formal exercise program on Parkinson's disease: A pilot study using a delayed start design

Abstract

Introduction Parkinson’s Disease (PD) is a progressive neurodegenerative disease. Increasing evidence shows that physical exercise is beneficial for motor and non-motor symptoms of PD, and animal models suggest that it may help slow progression of disease. Methods Using a randomized delayed-start design, 31 patients were randomized to an early start group (ESG) or a delayed start group (DSG) exercise program. The ESG underwent a rigorous formal group exercise program for 1 h, three days/week, for 48 weeks (November 2011–October 2012). The DSG participated in this identical exercise program from weeks 24–48. Outcome measures included the Unified Parkinson’s Disease Rating Scale (UPDRS), Walking Test (get-up-and-go), Tinetti Mobility Test, PDQ-39 Questionnaire, and the Beck Depression Inventory. Results There was minimal attrition in this study, with only one patient dropping out. Results did not show improvement in total UPDRS scores with early exercise. At week 48, the mean change from baseline total UPDRS score was 6.33 in the ESG versus 5.13 in the DSG (p = 0.58). However, patients randomized to the ESG scored significantly better on the Beck Depression Inventory, with a mean improvement of 1.07 points relative to those in the DSG (p = 0.04). Conclusions The findings demonstrate that long-term, group exercise programs are feasible in the Parkinson’s disease population, with excellent adherence and minimal drop out. While the outcome measures used in our study did not provide strong evidence that exercise has a neuroprotective effect on motor function, earlier participation in a group exercise program had a significant effect on symptoms of depression.

Exercise alters resting-state functional connectivity of motor circuits in parkinsonian rats

“…Indeed, work suggests that exercise in early Parkinson’s disease can elevate striatal dopamine D2 receptor binding potential and normalize corticomotor excitability (Fisher, et al, 2013, Fisher, et al, 2008). Furthermore, a recent study by Park et al reported a greater efficacy for early versus delayed exercise intervention with regards to depressive symptoms, though not for ratings on the Unified Parkinson’s Disease Rating Scale (UPDRS) (Park, et al, 2014). Our animal model was more relevant to early stage than late stage PD.…”

The Effects of Exercise on People with Parkinson’s Disease—Review

“…Substantial improvement in depressive symptoms has been noticed in case of a group of patients that started with exercise earlier than another group [43]. The importance of this discovery lies in the fact that mood can often have a more decisive impact on quality of life with PD than the physical disorder itself.…”

Outcome Measurement in Neurodegenerative Disease: Attributes, Applications & Interpretation

“…Such studies encompass a range of randomized controlled trials including, for example, pharmaceutical trials [50,51], surgical trials [52,53], nonpharmaceutical therapy trials [54,55] and clinical practice trials [56,57]. Additionally, the measure has been extensively used in descriptive surveys including, for example, studies relating to mood [58,59], nutrition [60,61], exercise [62,63] and personality style [64,65].…”