Researchers from the University of Maryland School of Medicine and the Baltimore VA Medical Center have published results of a randomized, controlled trial showing that physical activity, including walking on a treadmill and stretching and resistance exercise, appears to improve gait speed, muscle strength and fitness for patients with Parkinson’s disease (PD). Study results are published Nov. 6, 2012, in the online edition of Archives of Neurology, a publication of the Journal of the American Medical Association (JAMA).
“People with Parkinson’s often see a serious decline in their quality of life when they begin to have trouble with walking, so many patients ask what kind exercise they should be doing to help them maintain their mobility and independence. Our research shows that treadmill walking and stretching and resistance training are effective in improving mobility, strength and fitness,” says Lisa Shulman, MD, principal investigator and professor of neurology at the University of Maryland School of Medicine.
“We also found that lower intensity treadmill walking, which most people with Parkinson’s can do, was actually more effective than the higher intensity treadmill exercise,” adds Dr. Shulman, who is the Eugenia Brin Professor in Parkinson’s Disease and Movement Disorders at the University of Maryland School of Medicine.
The researchers, who received funding from the Michael J. Fox Foundation, compared 67 people with Parkinson’s disease who were randomly assigned to one of three exercise groups: walking on a treadmill at low intensity for 50 minutes, higher-intensity treadmill training to improve cardiovascular fitness for 30 minutes, and using weights (leg presses, extensions and curls) and stretching exercises to improve muscle strength and range of motion. Participants exercised three times a week for three months under the supervision of exercise physiologists at the Baltimore VA Medical Center.
“When we tested the participants, all three groups showed improvement, but low-intensity exercise (performed for 50 minutes three times a week) was the best in terms of helping participants to improve their mobility,” notes Dr. Shulman, who is also co-director of the Maryland Parkinson’s Disease and Movement Disorders Center at the University of Maryland Medical Center.
The University of Maryland investigators found improved cardiovascular fitness in both the higher- and lower-intensity treadmill exercise groups. However, only the stretching and resistance exercises improved muscle strength (16 percent increase) compared to when the participants started.
One key measurement was distance covered during a six-minute walk, where all three types of exercisers showed improvement compared to their baseline measurement: lower-intensity treadmill exercise (12 percent increase), stretching and resistance exercises (9 percent increase), and higher-intensity treadmill exercises (6 percent increase).
“We are encouraged to see that the lower-intensity treadmill exercise, which is feasible for most Parkinson’s patients, proved to have the greatest benefit for mobility while also improving cardiovascular fitness,” says Dr. Shulman.
“This study by University of Maryland School of Medicine faculty provides a very practical, real-life option for doctors and patients. The research builds a strong foundation, opening the possibility for future investigation, such as comparing different combinations of exercise or looking at the potential benefit of a longer training session,” says E. Albert Reece, MD, PhD, MBA, vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and dean of the University of Maryland School of Medicine.
In fact, the University of Maryland School of Medicine team is already exploring the possibilities of exercise with a new study looking at the benefits of exercise on memory and cognitive ability in Parkinson’s patients.
Parkinson’s disease affects about one million people in the United States and Canada. Most people begin to develop symptoms in their late 50s or early 60s, although it can occur in younger people. Parkinson’s disease affects the brain’s ability to produce dopamine, the neurotransmitter involved in the communication between the brain cells for motor control. Physical symptoms include tremor, muscle rigidity, slowness of movement and gait impairment. There are also non-motor symptoms such as changes in cognitive function, sleep disturbance and depressed mood.
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