Regular Brisk Walking Helps Parkinson's Patients Make Strides

July 03, 2014

Regular brisk walking may improve motor function, mood, tiredness, and fitness in patients with mild-to-moderate Parkinson's disease, a new study suggests.

"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 investigator Ergun Y. Uc, MD, University of Iowa in Iowa City told Medscape Medical News.

The study was published online July 2 in Neurology.

Although it is known that exercise in general improves fitness, fatigue, and mood, there are no established exercise programs for patients with Parkinson's disease.

"Our results suggest that patients with Parkinson's who do not have dementia, are able to walk independently without a cane or walker, and do not have heart or lung disease or other serious medical/orthopedic problem can safely follow the recommended exercise guidelines for healthy adults, which includes 150 minutes per week of moderate-intensity aerobic activity, and experience benefits," said Dr. Uc.

However, he cautioned that only preliminary conclusions can be drawn from this study.

"Without a control group, this phase 1/2 study cannot prove efficacy, but provides guidance on safety, tolerability, feasibility, and motor and nonmotor effect sizes for a future phase 3 study on aerobic exercise in Parkinson's," he said.

Real-Life Environment

For the study, the first 43 patients were randomized to continuous or interval training for 45 minute sessions 3 times a week for 6 months. Because preliminary analyses suggested higher musculoskeletal adverse events in the interval group and lack of difference between training methods in improving fitness, the next 17 participants were allocated to only continuous training.

Of the 60 participants, 81% completed the 6 months of exercise with a mean attendance of 83%. The average walking speed was about 2.9 miles per hour, and participants exercised at 47% of their heart rate reserve, which the researchers note is within the limits of moderate-intensity aerobic exercise.

There were no serious adverse events. Across all completers, improvements were seen in maximum oxygen consumption, gait speed, Unified Parkinson's Disease Rating Scale (UPDRS) sections I and III scores (particularly axial functions and rigidity), fatigue, depression, quality of life, and Flanker task scores.

There was no improvement in the activities of daily living scores or most cognitive measures, but Dr. Uc noted that the recruited patients were already performing well in these tests at baseline, so there was not much room for improvement.

He added that they did see an improvement in the Flanker task performance, which appears to be more sensitive to effects of exercise compared with other neuropsychological tests.

"Our intervention was conducted in a real-life environment and is likely to generalize to community dwelling, independently ambulating patients with Parkinson's disease without significant comorbidities," the investigators write.

They conclude that future research on exercise in Parkinson's disease should include longer-term and controlled studies testing the synergy of different physical training modalities, such aerobic exercise and resistance training, or combined physical and cognitive training.

Neurology. Published online July 2, 2014. Abstract

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