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Friday, August 1, 2014

Can Aerobic Exercise Improve Quality of Life for Patients with Parkinson’s Disease?

by Rebecca Hiscott

Aerobic exercise can help Parkinson’s disease (PD) patients improve fitness, motor function, fatigue, mood, executive control, and quality of life, according to a new preliminary study published in the July 29 issue of Neurology.


“The results of our study suggest that walking may provide a safe and easily accessible way of improving the symptoms of Parkinson’s disease and improve quality of life,” study author Ergun Y. Uc, MD, associate professor of neurology at  the University of Iowa and the Veterans Affairs Medical Center of Iowa City, said in a news release.

The phase 1/2 randomized trial compared the effects of individual versus group exercise settings and different fitness training regimens in 60 patients with mild to moderate PD. During the first two years of the study, 43 participants between the ages of 50 and 80 years were required to participate in aerobic walking three times per week for a 45-minute session. They were assigned to one of four groups: an individual or group setting and either a continuous, moderate aerobic walking regime, or an interval training regime where they alternated between low and vigorous intensity walking. They wore electronic heart rate and walking speed monitors, and filled out diaries for each session.

In the third year of the study, the researchers eliminated the interval training group amid concerns for participants’ safety.  Seventeen PD patients were then assigned to an individual exercise regime consisting of moderate, continuous walking. “Despite theoretical advantages of interval training and group setting, continuous training in individual setting provided equivalent fitness gains with better retention, adherence, and safety,” the authors wrote.

Participants’ average walking speed was about 2.9 miles per hour, and they exercised at an average 46.8 percent of their heart rate reserve (HRR), which qualifies as moderate intensity aerobic exercise.

The researchers looked at the participants’ oxygen uptake to measure changes in aerobic fitness, and administered a battery of tests to measure changes in cognitive function. Parkinsonism was measured using the Unified Parkinson’s Disease Rating Scale (UPDRS), which tracks PD progression and impairment through interviews and clinical observation. Quality of life was assessed according to the Fatigue Severity Scale, the Geriatric Depression Scale, and the PD Quality of Life Scale.

Overall, they found that walking at a brisk pace improved PD patients’ motor function and mood by 15 percent and their attention/response control scores by 14 percent. In addition, they observed that the participants had reduced tiredness (by 11 percent)  and increased their aerobic fitness and gait speed by seven percent. Participants improved on tests of motor function by an average of 2.8 points, which is considered clinically significant. These improvements “could not be explained by changes in dopaminergic medications during the intervention period,” the authors concluded.

 “People with mild-moderate Parkinson’s who do not have dementia and are able to walk independently without a cane or walker can safely follow the recommended exercise guidelines for healthy adults, which includes 150 minutes per week of moderate intensity aerobic exercise, and experience benefits,” Dr. Uc said.

            He added that the results would need to be confirmed in a phase 3 randomized study with a control group.

For more information about the impact of exercise on PD patients, browse our archives here: