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Delaying PD Symptom Progression With High-Intensity Exercise

December 13, 2017

Older and middle-aged adults in the early stages of Parkinson disease (PD) may be able to delay the progression of common PD motor symptoms with frequent and vigorous treadmill exercise.

In addition, while past research has suggested that high-intensity endurance activities may protect against PD, it was theorized that intense activity may be too stressful for people with a neurodegenerative disease. But this new study found that it was safe for those with PD.

These findings are based on results of a phase 2 randomized trial from May 1, 2012, through November 30, 2015, that followed participants for 6 months. Participants were individuals from outpatients and community-based clinics who had been diagnosed with Hoehn and Yahr stages 1 or 2 PD and were not taking medication.

A total of 384 volunteers were screened by phone; 128 were randomly assigned to one of three groups: high-intensity exercise, moderate-intensity exercise, or control group). Those in the high-intensity group exercised 4 days per week at 80%-85% max heart rate; in the moderate-intensity group for 4 days per week at 60%-65% heart rate; or wait-list control for 6 months.

According to researchers: “A total of 128 patients were included in the study (mean age, 64 [9] years; age range, 40-80 years; 73 [57.0%] male; and 108 [84.4%] non-Hispanic white). The mean change in Unified Parkinson’s Disease Rating Scale motor score in the high-intensity group was 0.3 (95% CI, −1.7 to 2.3) compared with 3.2 (95% CI, 1.4 to 5.1) in the usual care group (P  = .03). The high-intensity group, but not the moderate-intensity group, reached the predefined nonfutility threshold compared with the control group” (JAMA Neurol. Published online December 11, 2017. doi:10.1001/jamaneurol.2017.3517).

“If you have Parkinson’s disease and you want to delay the progression of your symptoms, you should exercise three times a week with your heart rate between 80 to 85 percent maximum. It’s that simple,” said Daniel Corcos, the study’s senior author and a professor of physical therapy at Northwestern University in a news release (Rush University Medical Center press release. December 13, 2017).

Larger, longer phase 3 randomized trials will need to be conducted to confirm these findings, however, and to determine if the effects can last for more than a few months.—Amanda Del Signore

For more articles like this, visit the Parkinson Disease Resource Center

For more Annals of Long-Term Care articles, visit the homepage

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