Effects of exercise on gait and motor imagery in people with Parkinson disease and freezing of gait

Myers, Peter S.; McNeely, Marie E.; Pickett, Kristen A.; Duncan, Ryan P.; Earhart, Gammon M.

doi:10.1016/j.parkreldis.2018.05.006

Cited by 40 publications

(47 citation statements)

References 28 publications

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“…Pohl et al comparing speed-dependent treadmill training, limited progressive treadmill training, conventional gait training, and non-intervention controls, found that treadmill training significantly improved gait parameters compared to both controls and conventional gait training (149). However, Myers et al found that, while treadmill therapy, tango dance, and guided stretching all improved walking velocity and stride length, there was no difference between the three groups (150). Sale et al found that robot-assisted walking, but not traditional treadmill training, improved gait velocity and stride length, though this result conflicts with all other such studies (151).…”

Section: Effect Of Training On Pigdmentioning

confidence: 99%

Motor Learning Deficits in Parkinson's Disease (PD) and Their Effect on Training Response in Gait and Balance: A Narrative Review

2019

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Parkinson's disease (PD) is a neurological disorder traditionally associated with degeneration of the dopaminergic neurons within the substantia nigra, which results in bradykinesia, rigidity, tremor, and postural instability and gait disability (PIGD). The disorder has also been implicated in degradation of motor learning. While individuals with PD are able to learn, certain aspects of learning, especially automatic responses to feedback, are faulty, resulting in a reliance on feedforward systems of movement learning and control. Because of this, patients with PD may require more training to achieve and retain motor learning and may require additional sensory information or motor guidance in order to facilitate this learning. Furthermore, they may be unable to maintain these gains in environments and situations in which conscious effort is divided (such as dual-tasking). These shortcomings in motor learning could play a large part in degenerative gait and balance symptoms often seen in the disease, as patients are unable to adapt to gradual sensory and motor degradation. Research has shown that physical and exercise therapy can help patients with PD to adapt new feedforward strategies to partially counteract these symptoms. In particular, balance, treadmill, resistance, and repeated perturbation training therapies have been shown to improve motor patterns in PD. However, much research is still needed to determine which of these therapies best alleviates which symptoms of PIGD, the needed dose and intensity of these therapies, and long-term retention effects. The benefits of such technologies as augmented feedback, motorized perturbations, virtual reality, and weight-bearing assistance are also of interest. This narrative review will evaluate the effect of PD on motor learning and the effect of motor learning deficits on response to physical therapy and training programs, focusing specifically on features related to PIGD. Potential methods to strengthen therapeutic effects will be discussed.

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Section: Effect Of Training On Pigdmentioning

confidence: 99%

Motor Learning Deficits in Parkinson's Disease (PD) and Their Effect on Training Response in Gait and Balance: A Narrative Review

2019

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“…The effects of exercise interventions on brain function in freezers are equivocal, as 1 study demonstrated increased BOLD activation in frontal-parietal areas after 4 weeks of exercise, 13 whereas another study failed to demonstrate changes in brain activation after a 12-week exercise intervention. 14 No study has investigated the effects of exercise intervention on MLR activation and gait initiation (APAs) in freezers. Thus, as abnormal APAs and dysfunction in cognitive inhibition are associated with FOG 5,7 and linked to impairments in MLR, we hypothesized that exercise interventions aiming to improve these aspects could increase MLR activation and decrease FOG severity.…”

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confidence: 99%

A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait

et al. 2020

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Background Exercises with motor complexity induce neuroplasticity in individuals with Parkinson's disease (PD), but its effects on freezing of gait are unknown. The objective of this study was to verify if adapted resistance training with instability — exercises with motor complexity will be more effective than traditional motor rehabilitation — exercises without motor complexity in improving freezing‐of‐gait severity, outcomes linked to freezing of gait, and brain function. Methods Freezers were randomized either to the adapted resistance training with instability group (n = 17) or to the active control group (traditional motor rehabilitation, n = 15). Both training groups performed exercises 3 times a week for 12 weeks. The primary outcome was the New Freezing of Gait Questionnaire. Secondary outcomes were freezing of gait ratio (turning task), cognitive inhibition (Stroop‐III test), motor signs (Unified Parkinson's Disease Rating Scale part‐III [UPDRS‐III]), quality of life (PD Questionnaire 39), anticipatory postural adjustment (leg‐lifting task) and brain activation during a functional magnetic resonance imaging protocol of simulated anticipatory postural adjustment task. Outcomes were evaluated before and after interventions. Results Only adapted resistance training with instability improved all the outcomes (P < 0.05). Adapted resistance training with instability was more effective than traditional motor rehabilitation (in improving freezing‐of‐gait ratio, motor signs, quality of life, anticipatory postural adjustment amplitude, and brain activation; P < 0.05). Our results are clinically relevant because improvement in the New Freezing of Gait Questionnaire (−4.4 points) and UPDRS‐III (−7.4 points) scores exceeded the minimally detectable change (traditional motor rehabilitation group data) and the moderate clinically important difference suggested for PD, respectively. The changes in mesencephalic locomotor region activation and in anticipatory postural adjustment amplitude explained the changes in New Freezing of Gait Questionnaire scores and in freezing‐of‐gait ratio following adapted resistance training with instability, respectively. Conclusions Adapted resistance training with instability is able to cause significant clinical improvement and brain plasticity in freezers. © 2020 International Parkinson and Movement Disorder Society

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“…We also calculated the levodopa equivalent daily dose (LEDD). The wearing-off (WO) phenomenon was the shortening therapeutic effect of levodopa and it was assessed by a 9-item Wearing-off Questionnaire (WOQ-9) [21, 22]. The phenomenon of freezing of gait (FOG) was characterized by brief episodes of inability to step or by small shuffling steps, and it was evaluated by the New Freezing of Gait Questionnaire (NFOG-Q) [23, 24].…”

Section: Methodsmentioning

confidence: 99%

Gastrointestinal Dysfunctions Are Associated withIL-10Variants in Parkinson’s Disease

Liang

Pan

et al. 2018

Parkinson's Disease

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Inflammation has been demonstrated to be involved in Parkinson's disease (PD) pathogenesis. There were evidences that the disturbance of the protective function of IL-10 gene contributed to PD. In our study, haplotype analyses were conducted of IL-10 rs1800871 and rs1800872 on 371 PD patients. Because the two SNPs exposed significant linkage disequilibrium demonstrated by Haploview software, we included 177 carriers of both rs1800871 and rs1800872 and 190 noncarriers in clinical phenotype analyses. As to nonmotor symptoms, the score of the gastrointestinal dysfunction domain in Nonmotor Symptom Scale (NMSS) was lower in the carrier group of both SNPs than in the noncarrier group in PD patients (SC: −0.198, p : 023). Other nonmotor symptoms reflected by relevant rating scales showed negative results. As to comorbidity, no significant statistical significance was observed between the two SNPs and Charlson Comorbidity Index (CCI). In conclusion, we found less severe gastrointestinal dysfunctions of both IL-10 rs1800871 and rs1800872 carriers than noncarriers in PD.

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Effects of exercise on gait and motor imagery in people with Parkinson disease and freezing of gait

Cited by 40 publications

References 28 publications

Motor Learning Deficits in Parkinson's Disease (PD) and Their Effect on Training Response in Gait and Balance: A Narrative Review

Motor Learning Deficits in Parkinson's Disease (PD) and Their Effect on Training Response in Gait and Balance: A Narrative Review

A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait

Gastrointestinal Dysfunctions Are Associated withIL-10Variants in Parkinson’s Disease

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