Objectives-To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity; and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).Design-Cohort (prospective), randomized controlled trial.
Setting-University-based clinical and research facilities.Participants-Thirty people with PD, 3 years or more since diagnosis, with Hoehn and Yahr stage 1 or 2.Interventions-Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects completed 24 exercise sessions over 8 weeks and had 5 education classes over 8 weeks.
Main Outcome Measures-UnifiedParkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected, fast walking, and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period durations (CSP) in response to single-pulse TMS.Results-A small improvement in total and motor UPDRS was observed in all groups. Highintensity group subjects demonstrated postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
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Author ManuscriptArch Phys Med Rehabil. Author manuscript; available in PMC 2010 November 22.
Published in final edited form as:Arch Phys Med Rehabil.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript during sit-to-stand. Improvements in gait and sit-to-stand measures were not consistently observed in low-and zero-intensity groups. Importantly, the high-intensity group demonstrated lengthening in CSP.Conclusions-The findings suggest the dose-dependent benefits of exercise and that highintensity exercise can normalize corticomotor excitability in early PD.
KeywordsBasal ganglia; Central nervous system; Neuronal plasticity; Rehabilitation; Walking Both basic research and clinical studies suggest that high intensity (ie, high repetition, velocity, complexity) is a characteristic of exercise that may be important in promoting activitydependent neuroplasticity of the injured brain, includin...