Document Detail


The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease.
MedLine Citation:
PMID:  18534554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).
DESIGN: Cohort (prospective), randomized controlled trial.
SETTING: University-based clinical and research facilities.
PARTICIPANTS: Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2.
INTERVENTIONS: Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks.
MAIN OUTCOME MEASURES: Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS.
RESULTS: A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP.
CONCLUSIONS: The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD.
Authors:
Beth E Fisher; Allan D Wu; George J Salem; Jooeun Song; Chien-Ho Janice Lin; Jeanine Yip; Steven Cen; James Gordon; Michael Jakowec; Giselle Petzinger
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-06-13
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  89     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-07-22     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1221-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089-9006, USA. bfisher@usc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Exercise Therapy*
Feasibility Studies
Female
Gait Disorders, Neurologic / rehabilitation
Humans
Male
Middle Aged
Motor Cortex / physiopathology*
Neuronal Plasticity / physiology
Parkinson Disease / physiopathology*,  radiotherapy*
Postural Balance / physiology
Prospective Studies
Task Performance and Analysis
Transcranial Magnetic Stimulation
Treatment Outcome
Walking
Grant Support
ID/Acronym/Agency:
K23 NS045764-01A1/NS/NINDS NIH HHS; K23-NS045764/NS/NINDS NIH HHS
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