Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease
(note: we suggest reading the article in full if available to you, for specific parameters, etc., prior to reading the main takeaways!)
- Background information regarding Parkinson’s Disease (PD) and effects of exercise:
- In 1999, van Praag et al. showed that the adult brain following exercise showed an increase in neurogenesis
- Multiple clinical studies have shown the significant benefit of exercise on a variety of neurological disorders
- There is a benefit of motor symptoms with treadmill training, resistance training, biking, tai chi, tango, boxing, and most recently the Lee Silverman Voice Therapy BIG (LSVT BIG) ProgramÂ
- LSVT BIG program increases proprioception through increasing amplitude together with sustained attention and cognitive involvement, focusing on specific movements
- LSVT BIG can only be administered by a certified therapist (remember this with your language when documenting in your daily notes!)
- Effects of LSVT BIG on non motor symptoms have not been extensively studied
- Objective of the study was to compare the effect of the LSVT program vs. a standard exercise program (treadmill and seated trunk and limb exercises) on both motor and non-motor symptoms of PD
- 11 participants with early-mid stage PD in a double-blinded randomized control study
- Were between 30-90 y/o
- On stable medication for at least 28 days prior to study
- No change in medication allowed for 4 monthsÂ
- Clinically stable and able to participate in LSVT BIG programÂ
- Both groups received 16, 1 hour sessions with a Physical Therapist over a 4 week period of time
- 5 participants in the standard exercise group:
- 30 minutes of treadmill training (at 75% of max heart rate)
- 30 minutes of exercise, consisting of: theraband arm swings, trunk side flexion, marching in place, buttoning/unbuttoning, theraband rowing, trunk rotations with reaching, cone stacking, finger tapping, marching in place with arm swings, seated arm swings, finger to nose (See article for specific BORG intensity levels and time frames for each exercise. We love how it lists specific exercises! Keep an eye out for videos to come!)
- 6 participants in the LSVT BIG exercise group:
- Large amplitude functional movements with emphasis on high concentration and effort over course of 1 hour session
- How did they assess outcomes?
- Unified Parkinson’s Disease Rating Scale (UPDRS)
- Beck Depression Inventory (BDI)
- Beck Anxiety Inventory (BAI)
- Modified Fatigue Impact Scale (MFIS)
- Assessments were made at weeks: 4, 12, 24
- Conclusion:Â
- The study showed that significant positive effects were noted in both the exercise group and LSVT BIG program on both motor and non-motor symptomsÂ
- Positive results lasted for 6 months in both groups following the last day of therapy
- General exercise was just as effective as LSVT BIG protocol
- Why is this important?:Â
- The results prove that general exercise may be just as effective as LSVT BIG therapy on symptoms associated with PD that are unable to tolerate or access an outpatient LSVT certified therapist
- May be able to better create specific exercise programs based off of evidence from this study
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Resource:Â
Khashayar Dashtipour, Eric Johnson, Camellia Kani, Kayvan Kani, Ehsan Hadi, Mark Ghamsary, Shant Pezeshkian, Jack J. Chen, "Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease", Parkinson’s Disease, vol. 2015, Article ID 586378, 5 pages, 2015. https://doi.org/10.1155/2015/586378Â
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