Exercise and motor training in people with Parkinson's disease: a systematic review of participant characteristics, intervention delivery, retention rates, adherence, and adverse events in clinical trials (original) (raw)
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Parkinson's …, 2011
Both efficacy and clinical feasibility deserve consideration in translation of research outcomes. This study evaluated the feasibility of rehabilitation programs within the context of a large randomized controlled trial of physical therapy. Ambulant participants with Parkinson's disease (PD) (n = 210) were randomized into three groups: (1) progressive strength training (PST); (2) movement strategy training (MST); or (3) control ("life skills"). PST and MST included fall prevention education. Feasibility was evaluated in terms of safety, retention, adherence, and compliance measures. Time to first fall during the intervention phase did not differ across groups, and adverse effects were minimal. Retention was high; only eight participants withdrew during or after the intervention phase. Strong adherence (attendance > 80%) did not differ between groups (P = .435). Compliance in the therapy groups was high. All three programs proved feasible, suggesting they may be safely implemented for people with PD in community-based clinical practice.
Effect of Therapeutic Exercise on Motor Symptoms of Parkinson Disease: A Mini Review
Mediterranean Journal of Basic and Applied Sciences (MJBAS), 2019
This abstract discussed preamble of effects of therapeutic exercise on motor symptoms of Parkinson’s disease. By definition, Parkinson disease (PD) is a progressive chronic nervous system disease resulted from decrease in amount of dopamine production in substantia nigra. This is characterized by tremor at rest, abnormal gait pattern (Shuffling gait), bradykinesia and rigidity. Motor complication accompanied by motor symptom due to the loss of straiatal dopaminergic neuron. There are symptoms of motor complication of PD (Parkinson’s disease) which includes postural instability, rigidity, bradykinesia and shuffling gait pattern. The manifestation of the symptom affects quality of life and social interaction. PD has negative influence on patients and the caregiver. However, research has suggested that people suffering from motor complication of Parkinson disease are managed through therapeutic exercise intervention. Geriatrics categories have been found more with PD. Available studies in the literature indicate that therapeutic protocol has to focus on: cueing strategies, balance, cognitive movement strategies and improved physical capacity. Therapeutic motor training exercise for PD patients have been designed and evaluated but only specific training strategies tailored for each patient, may produce improvements in gait speed and stride length, decrease motor and balance symptoms and improve quality of life. Furthermore, therapeutic exercise such as balance and coordination training may improve muscle trophism and postural balance and strength. It seems reasonable to state that tailored therapeutic exercise is the physical activities that is structure, planned and repetitive and condition for any part of the body which is a valid tool to be included in the therapeutic program of PD patients, considering that this therapeutic exercise may alieviate the symptoms as well as the overall physical incapacity, reduce the risk of falls and injuries, and ultimately improve quality of life and social interaction
Parkinson's disease, 2012
Both efficacy and clinical feasibility deserve consideration in translation of research outcomes. This study evaluated the feasibility of rehabilitation programs within the context of a large randomized controlled trial of physical therapy. Ambulant participants with Parkinson's disease (PD) (n = 210) were randomized into three groups: (1) progressive strength training (PST); (2) movement strategy training (MST); or (3) control ("life skills"). PST and MST included fall prevention education. Feasibility was evaluated in terms of safety, retention, adherence, and compliance measures. Time to first fall during the intervention phase did not differ across groups, and adverse effects were minimal. Retention was high; only eight participants withdrew during or after the intervention phase. Strong adherence (attendance >80%) did not differ between groups (P = .435). Compliance in the therapy groups was high. All three programs proved feasible, suggesting they may be safe...
Movement Disorders, 2009
This randomized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson's disease. Participants were randomly assigned to a group that received movement strategy training or musculoskeletal exercises during 2 consecutive weeks of hospitalization. The primary outcome was disability as measured by the Unified Parkinson's Disease Rating Scale, UPDRS (motor and ADL components). Secondary outcomes were balance, walking speed, endurance, and quality of life. Assessments were carried out by blinded testers at baseline, after the 2 weeks of treatment and 3 months after discharge.
Exercise Therapies for Parkinson's Disease: A Systematic Review and Meta-Analysis
Recently, rehabilitative exercise therapies have been described as an important method of overcoming the limitations of the conventional therapies for Parkinson’s disease. The present study aimed to evaluate efficacy and safety of exercise therapies for Parkinson’s disease. Randomized controlled trials that evaluated exercise therapies in patients with Parkinson’s disease until December 2016 were searched for in five electronic databases: PubMed, CENTRAL, EMBASE, OASIS, and CNKI. Eighteen studies (1,144 patients) were included. The overall methodological quality was not high. Patients who underwent exercise therapies exhibited statistically significant improvements in the total UPDRS, UPDRS II and III, Berg Balance Scale, preferred walking speed, and Timed Up and Go Test compared to patients who underwent nonexercise therapies. In comparison to patients who performed regular activity, patients who underwent exercise therapies exhibited statistically significant improvements in the total UPDRS, UPDRS II, and UPDRS III. Exercise therapies were found to be relatively safe. Exercise therapies might promote improvements in the motor symptoms of Parkinson’s disease. However, due to the small number of randomized controlled trials and methodological limitations, we are unable to draw concrete conclusions. Therefore, further studies with better designs will be needed.
Effects of Exercise-based Management on Motor Symptoms in Parkinsonamp Disease - A Meta-analysis
Journal of the College of Physicians and Surgeons Pakistan
Parkinson's disease (PD) is the second most common neurological illness after Alzheimer's disease. According to research, medication alone can give palliative alleviation; however, freezing of gait (FOG) and balance can be treated with physical therapy. This meta-analysis aims to bridge gaps about exercise-based therapy's impact on balance and FOG in patients with PD. Google Scholar, CINHAL, Medline, PubMed, and PEDro were searched for 2016-2021 citations using the PIOD paradigm. Pooled effect size mean and SD were analysed using a fixed and random effects model. A total of 21 trials were included in this review, with SMD=0.60 and p=0.0007 utilising BBS. The pooled analysis revealed statistically significant impacts on exercise-based management in the experimental group. With SMD=0.87 and p<0.00001 using Mini-BESTest, the pooled analysis revealed that exercise-based management was also effective on balance in the experimental group. The fixed effect model of FOG in terms of SMD was used to draw the pooled effects of FOG in terms of SMD and FOG in terms of SMD (0.21; 95 percent CI-0.01 to 0.44; p=0.06). According to this research, several physiotherapy approaches such as exergaming, gamepad systems, virtual reality, gait exercises, and core training, help Parkinson's patients regain balance and FOG.
Long-term Group Exercise for People With Parkinson's Disease
Journal of Neurologic Physical Therapy, 2011
Background and Purpose: Aerobic and strengthening exercises have been shown to benefit people with Parkinson's disease (PD) on the basis of highly structured, short-term, clinical protocols. This study extended previous research by investigating feasibility of an ongoing, community-based, group exercise program for people with PD on the basis of short-term (10 weeks) and long-term (14 months) data. Methods: Twenty people with PD (Hoehn and Yahr stages I to III) participated in at least one of four 10-week sessions. Classes were held twice weekly for 1 hour and included strength, flexibility, and balance and walking exercises. Evaluations were done 1.5 hours after medication intake 1 week before and 1 week after each session. Gait speed, 6-Minute Walk test (6MWT), "Timed Up and Go" test, and grip strength were used to assess physical function. Analysis of short-term results were based on 18 participants (2 dropped out prior to posttest), and long-term results were based on 8 participants who started in the first session continued through the 14-month period. Results: Attendance rates were moderate to high (73% overall). No injuries were reported. Wilcoxon signed ranks tests based on each participant's first 10-week session demonstrated significant improvements in 6MWT, and grip strength. Long-term participants showed significant improvements in grip strength, and a trend toward improved 6MWT. Gait speed and Timed Up and Go test did not change significantly in the short or long terms. Discussion/Conclusions: Our community-based group exercise program was safe, feasible, and appears to be effective. While some