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Choi Y, Kim D, Kim SK. Effects of Physical Activity on Body Composition, Muscle Strength, and Physical Function in Old Age: Bibliometric and Meta-Analyses. Healthcare (Basel) 2024; 12:197. [PMID: 38255085 PMCID: PMC10815094 DOI: 10.3390/healthcare12020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVES Accumulating evidence suggests that physical activity (PA) is an efficient intervention to maintain functional capabilities and mitigate physiological changes in the older population. However, an attempt has yet to be made to comprehensively investigate the published landscape on the subject. METHODS This study had two aims. The first aim was to perform a bibliometric analysis for two keywords, "aging" and "PA", to analyze the research trend. Since "frailty" was the most noticeable co-occurring keyword with the two keywords, the second aim was to investigate the effects of PA, particularly, resistance training (RT), on frailty using a meta-analysis to provide a summary of the current evidence base. RESULTS The bibliometric analysis revealed that the number of publications on this research topic has gradually increased, highlighting the importance of understanding the role of PA in aging. The meta-analysis found that RT had significant beneficial effects on physical frailty factors, including handgrip strength, lower limb strength, balance, gait speed, and stair-climbing ability. CONCLUSION These findings demonstrate that RT is an effective intervention for improving physical function in frail populations; thus, it has important implications for the development of PA programs for older adults with frailty. Future research is warranted to explore the optimal dose, frequency, and duration of RT programs for older adults, as well as the potential benefits of combining RT with other forms of PA, such as aerobic or balance exercises.
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Affiliation(s)
- Yerim Choi
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea;
| | - Daekyoo Kim
- Department of Physical Education, Korea University, Seoul 02841, Republic of Korea;
| | - Seung Kyum Kim
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea;
- Department of Sports Science, Seoul National University of Science and Technology, Seoul 01811, Republic of Korea
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Corcos DM, Lamotte G, Luthra NS, McKee KE. Advice to People with Parkinson's in My Clinic: Exercise. JOURNAL OF PARKINSON'S DISEASE 2024; 14:609-617. [PMID: 38189710 PMCID: PMC11091645 DOI: 10.3233/jpd-230277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
There is compelling evidence that exercise must be part of main line therapy for people with Parkinson's disease. In this viewpoint, we outline the four key components of exercise: aerobic exercise, resistance exercise, flexibility exercise, and neuromotor exercises (posture, gait, balance, and agility) that can improve both motor and non-motor symptoms of the disease and, in the case of aerobic exercise, may delay the disease. We outline guidelines on how to change and optimize the exercise prescription at different stages of the disease.
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Affiliation(s)
- Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Guillaume Lamotte
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Nijee S. Luthra
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Kathleen E. McKee
- Neurosciences Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
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Bane A, Wilson L, Jumper J, Spindler L, Wyatt P, Willoughby D. Effects of Blood Flow Restriction Resistance Training on Autonomic and Endothelial Function in Persons with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:761-775. [PMID: 38701159 PMCID: PMC11191514 DOI: 10.3233/jpd-230259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/05/2024]
Abstract
Background Autonomic dysfunction precedes endothelial dysfunction in Parkinson's disease (PD) and causes blood pressure and circulation abnormalities that are highly disruptive to one's quality of life. While exercise interventions have proven helpful for motor symptoms of PD, improving associated non-motor symptoms is limited. Low-intensity resistance training with blood flow restriction (LIRT-BFR) improves autonomic dysfunction in non-PD patients and high-intensity resistance training (HIRT) is recommended for motor symptom improvements for people with PD (PwPD). Objective To determine the effects of LIRT-BFR and HIRT on homocysteine and autonomic and endothelial function in PwPD and to determine the hemodynamic loads during LIRT-BFR and HIRT in PwPD using a novel exercise protocol. Methods Thirty-eight PwPD were assigned LIRT-BFR, HIRT or to a control (CNTRL) group. The LIRT-BFR and HIRT groups exercised three days per week for four weeks. The LIRT-BFR protocol used 60% limb occlusion pressure (LOP) and performed three sets of 20 repetitions at 20% of the one-repetition maximum (1RM). The HIRT group performed three sets of eight repetitions at 80% 1RM. The CNTRL group was asked to continue their normal daily routines. Results LIRT-BFR significantly improved orthostatic hypotension (p = 0.026), homocysteine levels (p < 0.001), peripheral circulation (p = 0.003), supine blood pressure (p = 0.028) and heart rate variability (p = 0.041); LIRT-BFR improved homocysteine levels (p < 0.018), peripheral circulation (p = 0.005), supine blood pressure (p = 0.007) and heart rate variability (p = 0.047) more than HIRT; and hemodynamic loads for LIRT-BFR and HIRT were similar. Conclusions LIRT-BFR may be more effective than HIRT for autonomic and endothelial function improvements in PwPD and hemodynamic loads may be lessened in LIRT-BFR protocols using single-joint exercises with intermittent blood flow restriction. Further research is needed to determine if non-motor symptoms improve over time and if results are sustainable.
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Affiliation(s)
- Annie Bane
- Department of Kinesiology and Nutrition, Abilene Christian University, Abilene, TX, USA
| | - Lorraine Wilson
- Department of Kinesiology and Nutrition, Abilene Christian University, Abilene, TX, USA
| | - Jill Jumper
- Department of Physical Therapy, Hardin-Simmons University, Abilene, TX, USA
| | - Lindsay Spindler
- Department of Kinesiology, Health and Recreation, Hardin-Simmons University, Abilene, TX, USA
| | - Pricilla Wyatt
- Texas Tech University Health Science Center, Abilene, TX, USA
| | - Darryn Willoughby
- Physicians Assistant Program and the Exercise and Sport Science Department, University of Mary Hardin-Baylor, Belton, TX, USA
- School of Medicine, Baylor College of Medicine, Temple, TX, USA
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Mercer HM, Nair AM, Ridgel A, Piontkivska H. Alterations in RNA editing in skeletal muscle following exercise training in individuals with Parkinson's disease. PLoS One 2023; 18:e0287078. [PMID: 38134032 PMCID: PMC10745226 DOI: 10.1371/journal.pone.0287078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/01/2023] [Indexed: 12/24/2023] Open
Abstract
Parkinson's Disease (PD) is the second most common neurodegenerative disease behind Alzheimer's Disease, currently affecting more than 10 million people worldwide and 1.5 times more males than females. The progression of PD results in the loss of function due to neurodegeneration and neuroinflammation. The etiology of PD is multifactorial, including both genetic and environmental origins. Here we explored changes in RNA editing, specifically editing through the actions of the Adenosine Deaminases Acting on RNA (ADARs), in the progression of PD. Analysis of ADAR editing of skeletal muscle transcriptomes from PD patients and controls, including those that engaged in a rehabilitative exercise training program revealed significant differences in ADAR editing patterns based on age, disease status, and following rehabilitative exercise. Further, deleterious editing events in protein coding regions were identified in multiple genes with known associations to PD pathogenesis. Our findings of differential ADAR editing complement findings of changes in transcriptional networks identified by a recent study and offer insights into dynamic ADAR editing changes associated with PD pathogenesis.
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Affiliation(s)
- Heather Milliken Mercer
- Department of Biological Sciences, Kent State University, Kent, OH, United States of America
- Department of Biological and Environmental Sciences, University of Mount Union, Alliance, OH, United States of America
- Healthy Communities Research Institute, Kent State University, Kent, OH, United States of America
| | - Aiswarya Mukundan Nair
- Department of Biological Sciences, Kent State University, Kent, OH, United States of America
| | - Angela Ridgel
- School of Health Sciences, Kent State University, Kent, OH, United States of America
- Brain Health Research Institute, Kent State University, Kent, OH, United States of America
- Healthy Communities Research Institute, Kent State University, Kent, OH, United States of America
| | - Helen Piontkivska
- Department of Biological Sciences, Kent State University, Kent, OH, United States of America
- Brain Health Research Institute, Kent State University, Kent, OH, United States of America
- Healthy Communities Research Institute, Kent State University, Kent, OH, United States of America
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Law NY, Li JX, Zhu Q, Nantel J. Effects of a biomechanical-based Tai Chi program on gait and posture in people with Parkinson's disease: study protocol for a randomized controlled trial. Trials 2023; 24:241. [PMID: 37386473 DOI: 10.1186/s13063-023-07146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 02/08/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is associated with changes in gait and posture, which increases the rate of falls and injuries in this population. Tai Chi (TC) training enhances the movement capacity of patients with PD. However, the understanding of the effect of TC training on gait and postural stability in PD is lacking. This study aims to examine the effect of biomechanical-based TC training on dynamic postural stability and its relationship with walking performance. METHODS/DESIGN A single-blind, randomized control trial of 40 individuals with early-stage PD was conducted (Hoehn and Yahr stages 1 to 3). Patients with PD will be randomly assigned to either the TC or control group. The TC group will participate in a biomechanical-based TC training program that is formed based on the movement analysis of TC and will be practiced thrice a week for 12 weeks. The control group will be required to engage in at least 60 min of regular physical activity (PA) on their own for three times per week for 12 weeks. The primary and secondary outcomes will be assessed at baseline and at 6 and 12 weeks after commencing the study protocol. The primary outcome measures will include dynamic postural stability indicated by the center of mass and center of pressure separation distance and clearance distance of the heel and toe measured during fixed-obstacle crossing. The secondary measures are gait speed, cadence, step length during level surface walking (simple task), and fixed-obstacle crossing (challenging task). The Unified Parkinson's Disease Rating Scale, single leg-stance test with eyes open and closed, and three cognitive scores (Stroop Test, Trail Making Test Part B, and the Wisconsin Card Sorting Test) were also employed. DISCUSSION This protocol could lead to the development of a biomechanics TC training program for the improvement of gait and postural stability among individuals with PD. The program could enhance the understanding of the effect of TC training on gait and postural stability and could help improve or preserve the postural stability, self-confidence, and active participation in social activities of the participants, thus enhancing their overall quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04644367. Registered on 25 November 2020.
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Affiliation(s)
- Nok-Yeung Law
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Jing Xian Li
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Qingguang Zhu
- Research Institute of Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Julie Nantel
- Schools of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Hortobágyi T, Vetrovsky T, Brach JS, van Haren M, Volesky K, Radaelli R, Lopez P, Granacher U. Effects of Exercise Training on Muscle Quality in Older Individuals: A Systematic Scoping Review with Meta-Analyses. SPORTS MEDICINE - OPEN 2023; 9:41. [PMID: 37278947 DOI: 10.1186/s40798-023-00585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND The quantity and quality of skeletal muscle are important determinants of daily function and metabolic health. Various forms of physical exercise can improve muscle function, but this effect can be inconsistent and has not been systematically examined across the health-neurological disease continuum. The purpose of this systematic scoping review with meta-analyses was to determine the effects and potential moderators of exercise training on morphological and neuromuscular muscle quality (MMQ, NMQ) in healthy older individuals. In addition and in the form of a scoping review, we examined the effects of exercise training on NMQ and MMQ in individuals with neurological conditions. METHODS A systematic literature search was performed in the electronic databases Medline, Embase, and Web of Science. Randomized controlled trials were included that examined the effects of exercise training on muscle quality (MQ) in older individuals with and without neurological conditions. Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. RESULTS Thirty studies (n = 1494, 34% females) in healthy older individuals and no studies in individuals with neurological conditions were eligible for inclusion. Exercise training had small effects on MMQ (g = 0.21, 95% confidence interval [CI]: 0.03-0.40, p = 0.029). Heterogeneity was low (median I2 = 16%). Training and demographic variables did not moderate the effects of exercise on MMQ. There was no association between changes in MMQ and changes in functional outcomes. Exercise training improved NMQ (g = 0.68, 95% CI 0.35-1.01, p < 0.000) across all studies, in particular in higher-functioning older individuals (g = 0.72, 95% CI 0.38-1.06, p < 0.001), in lower extremity muscles (g = 0.74, 95% CI 0.35-1.13, p = 0.001), and after resistance training (g = 0.91; 95% CI 0.42-1.41, p = 0.001). Heterogeneity was very high (median I2 = 79%). Of the training and demographic variables, only resistance training moderated the exercise-effects on NMQ. High- versus low-intensity exercise moderated the exercise-effects on NMQ, but these effects were considered unreliable due to a low number of studies at high intensity. There was no association between changes in NMQ and changes in functional outcomes. CONCLUSION Exercise training has small effects on MMQ and medium-large effects on NMQ in healthy older individuals. There was no association between improvements in MQ and increases in muscle strength, mobility, and balance. Information on dose-response relations following training is currently lacking. There is a critical gap in muscle quality data for older individuals with lower function and neurological conditions after exercise training. Health practitioners should use resistance training to improve muscle function in older individuals. Well-designed studies are needed to examine the relevance of exercise training-induced changes in MQ in daily function in older individuals, especially to those with lower function and neurological conditions.
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Affiliation(s)
- Tibor Hortobágyi
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Pecs, Hungary
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, The Netherlands
- Institute of Sport Research, Sports University of Tirana, Tirana, Albania
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martijn van Haren
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, The Netherlands
| | - Krystof Volesky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Regis Radaelli
- Faculty of Human Kinetics, CIPER, University of Lisboa, Cruz Quebrada, Dafundo, Portugal
| | - Pedro Lopez
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany.
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Pechstein AE, Gollie JM, Keyser RE, Guccione AA. Walking Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training. J Neurol Phys Ther 2023; 47:99-111. [PMID: 36538418 DOI: 10.1097/npt.0000000000000423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Poor walking endurance in Parkinson disease (PD) may be attributable to both bioenergetic and biomechanical factors, but locomotor training methods addressing both these factors simultaneously are understudied. Our objective was to examine the effects of overground locomotor training (OLT) on walking endurance in individuals with mild-to-moderate PD, and to further explore potential cardiorespiratory contributions. METHODS A single-arm, longitudinal design was used to examine the effects of 24 biweekly sessions of OLT in people with mild-to-moderate PD (n = 12). Walking endurance was measured as total distance walked during a 10-minute walk test (10minWT). Oxygen uptake (V˙ o2 ) on-kinetic profiles were determined using a monoexponential function. Perceived fatigability was assessed following the 10minWT using a self-report scale. Magnitude of change in primary outcomes was assessed using Cohen's d and adjusted for sample size (Cohen's d(unbiased) ). RESULTS Participants executed 3036 (297) steps and maintained 65.5% (8%) age-predicted heart rate maximum in a typical session lasting 56.9 (2.5) minutes. Medium effects in total distance walked-885.9 (157.2) versus 969.5 (140.9); Cohen's d(unbiased) = 0.54-and phase II time constant of the V˙ o2 on-kinetic profile-33.7 (12.3) versus 25.9 (15.3); Cohen's d(unbiased) = 0.54-were observed alongside trivial effects for perceived fatigability-4.7 (1.4) versus 4.8 (1.5); Cohen's d(unbiased) = 0.11-following OLT. DISCUSSION AND CONCLUSIONS These preliminary findings may demonstrate the potential for moderate-intensity OLT to improve walking endurance and enhance cardiorespiratory adjustments to walking activity in adults with mild-to-moderate PD.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A407 ).
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Affiliation(s)
- Andrew E Pechstein
- Department of Rehabilitation Science, George Mason University, Fairfax, Virginia (A.E.P., J.M.G., R.E.K., A.A.G.); Department of Physical Therapy, University of Delaware, Newark (A.E.P.); and Research Service, Veterans Affairs Medical Center, Washington, District of Columbia (J.M.G.)
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Stone WJ, Tolusso DV, Duchette C, Malone G, Dolan A. Eccentric resistance training with neurological conditions: A meta analysis. Gait Posture 2023; 100:14-26. [PMID: 36463713 DOI: 10.1016/j.gaitpost.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND People with neurological conditions are exposed to muscle wasting resulting in reduced strength and endurance. Both deficiencies negatively impact gait and balance, each of which can be benefited by strengthening exercises. Unfortunately, people with neurological conditions often do not have the ability to perform traditional weight training as their endurance and strength fail to meet the minimum threshold for improvement. An alternative to traditional, full range of motion lifting is eccentric resistance training (ERT). RESEARCH QUESTION The current systematic review and meta-analysis sought to evaluate the efficacy of ERT against conventional therapeutic modalities or weightlifting on walking speed, Timed Up and Go (TUG), and maximum voluntary isometric contraction (MVIC) in individuals with neurological conditions. METHODS Web of Science, PubMed, and Academic Search Complete were searched until September 1, 2020, followed by a manual search on December 3, 2021. Publications were included if they were peer reviewed, available in English, consisted of a pre-specified neurological disorder, involved human subjects, had an eccentric and "traditional" therapy; and reported at least one of the outcome measures at both pre- and post-intervention. RESULTS Thirteen studies of human subjects (n = 297) and 47 standardized mean differences (SMD) were included in the multilevel model analysis. The analysis revealed a small, albeit non-significant effect on performance (TUG, MVIC, walking speed) when comparing traditional therapies and ERT (SMD: 0.136; 96; 95 % CI: -0.0002, 0.050). SIGNIFICANCE There appears to be no difference between ERT and traditional therapy or weightlifting on measured outcomes. In this way, ERT is as effective as traditional therapeutics and full range of motion weightlifting to improve movement in clinical populations. Practitioners working with populations with neurological conditions may consider supplementing or replacing traditional strengthening activities with ERT as clients can complete greater volumes of work with lower metabolic demand.
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Affiliation(s)
- Whitley J Stone
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, USA.
| | - Danilo V Tolusso
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, USA
| | - Catie Duchette
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, USA; Alabama College of Osteopathic Medicine, USA
| | - Grant Malone
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, USA
| | - Angie Dolan
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, USA; Doctor of Physical Therapy Program, Hanover College, USA
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Le Sant G, Lecharte T, Goreau V, Nordez A, Gross R, Cattagni T. Motor performance, motor impairments, and quality of life after eccentric resistance training in neurological populations: A systematic review and meta-analyses. NeuroRehabilitation 2023; 53:33-50. [PMID: 37424484 DOI: 10.3233/nre-230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Many overlapping factors impair motor performance and quality of life in neurological patients. Eccentric resistance training (ET) has potential benefits for improving motor performance and treating motor impairments better than some traditional rehabilitation approaches. OBJECTIVE To estimate the effect of ET in neurological settings. METHODS Seven databases were reviewed up to May 2022 according to PRSIMA guidelines to find randomized clinical trials involving adults with a neurological condition, who underwent ET as set by the American College of Sports Medicine. Motor performance (main outcome) was assessed as strength, power and capacities during activity. Secondary outcomes (impairments) were muscle structure, flexibility, muscle activity, tone, tremor, balance and fatigue. Tertiary outcomes were risk of fall, and self-reports of quality of life. RESULTS Ten trials were included, assessed using Risk of Bias 2.0 tool, and used to compute meta-analyses. Effective effects in favour of ET were found for strength and power, but not for capacities during activity. Mixed results were found for secondary and tertiary outcomes. CONCLUSION ET may be a promising intervention to better improve strength/power in neurological patients. More studies are needed to improve the quality of evidence underlying changes responsible for these results.
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Affiliation(s)
- Guillaume Le Sant
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
- School of Physiotherapy, IFM3, R, Saint-Sébastien-sur-Loire, France
| | - Thomas Lecharte
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
| | - Valentin Goreau
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
- School of Physiotherapy, IFM3, R, Saint-Sébastien-sur-Loire, France
| | - Antoine Nordez
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
- Institut Universitaire de France (IUF), Paris, France
| | - Raphaël Gross
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
| | - Thomas Cattagni
- Movement - Interactions - Performance (MIP), CHU Nantes, University of Nantes, Nantes, France
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Assessing the Effect of 12 Weeks of Pilates and Aquatic Exercise on Muscle Strength and Range of Motion in Patients with Mild to Moderate Parkinson’s Disease. Asian J Sports Med 2022. [DOI: 10.5812/asjsm-123190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Parkinson's disease is a chronic, progressive and degenerative disorder of the central nervous system with four main symptoms of bradykinesia, tremor, muscular rigidity, and postural instability. Objectives: The effect of 12 weeks of Pilates and aquatic exercise on muscle strength and range of motion (ROM) in male patients with Parkinson's disease was assessed in this article. Methods: In this quasi-experimental study, 25 male patients reporting to Al-Zahra Hospital, Isfahan, were selected randomly and grouped in Pilates (n = 7), Aquatic exercise (n = 10), and Control (n = 8). The experimental groups received 1-hour sessions of training three times a week for 12 weeks. Muscle strength and ROM of each patient was measured through the Biodex Isokinetic System 3 before entering the study and after the final assigned session. Results: Pilates and Aquatic exercise groups had a significant improvement in ROM, while no significant difference was observed in the control group. Muscle strength and ROM increased significantly in the experimental groups compared to the control group (P < 0.05). The effect of Pilates on muscle strength was not significant (P < 0.05). Conclusions: Non-pharmacological modalities could be contributive in the patients with Parkinson's disease recovery and lead to significant improvements in their physiological parameters of muscle strength and ROM. Next to the pharmacological treatments, patients could benefit from inexpensive and readily available options like Pilates and aquatic exercises to alleviate the disease symptoms. Further studies should be run to reveal the aforementioned and plausible benefits of these complementary activities.
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Effect of Long-term Exercise Therapy on Motor Symptoms in Parkinson Disease Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2022; 101:905-912. [PMID: 35695530 DOI: 10.1097/phm.0000000000002052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aims of the study were to assess the effectiveness of long-term exercise therapy (≥12 wks) for patients with Parkinson disease and to derive specific suggestions on how the motor symptom improvements can be optimized by exercise type and exercise dose. DESIGN The PubMed, Web of Science, Cochrane Central Register, Embase, Scopus, and CNKI databases were searched up to January 2021 for randomized controlled trials focusing on the effects of long-term exercise for Parkinson disease. Two researchers independently evaluated the quality of papers using the PEDro scale. Twenty-six studies with a total of 1243 participants were included. RESULTS Tai Chi, resistance training, and dance provide significant improvements in physical function and functional mobility. Furthermore, Tai Chi and dance result in balance benefits. However, walking capacity outcomes did not improve after Tai Chi and resistance training but did improve after dance. With an increase in the intervention duration or length of each session, the effect sizes of exercise on these outcomes increased; higher benefits of exercise on these outcomes were observed at a frequency of 2 times/wk. CONCLUSIONS Long-term exercise therapy is an effective treatment for improving motor symptoms, with dance being an ideal exercise choice. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES Upon completion of this article, the reader should be able to: (1) Recognize that long-term exercise slows clinical progression of motor symptoms in patients with Parkinson disease; (2) Acquire knowledge regarding the effectiveness of long-term exercise therapy on motor symptoms in Parkinson disease; and (3) Incorporate specific suggestions on dose-response relationships of different exercise therapy on motor symptoms in Parkinson disease. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Inskip MJ, Mavros Y, Sachdev PS, Hausdorff JM, Hillel I, Singh MAF. Promoting independence in Lewy body dementia through exercise: the PRIDE study. BMC Geriatr 2022; 22:650. [PMID: 35945508 PMCID: PMC9361699 DOI: 10.1186/s12877-022-03347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Lewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-intensity exercise are effective in other neurological cohorts but have been scarcely evaluated in LBD. Methods The Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomised, non-blinded, crossover pilot trial involving older adults with LBD consisting of a baseline assessment, an 8-week wait-list, and an 8-week exercise intervention. The aims of this study were to evaluate the determinants of the primary outcome functional independence, as measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, and the feasibility and preliminary efficacy of an exercise intervention on this outcome. Additionally, important clinical characteristics were evaluated to explore associations and treatment targets. The exercise intervention was supervised, clinic-based, high-intensity progressive resistance training (PRT), challenging balance, and functional exercises, 3 days/week. Results Nine participants completed the baseline cross-sectional study, of which five had a diagnosis of Parkinson’s disease dementia (PDD), and four dementia with Lewy Bodies (DLB). Six completed the exercise intervention (three PDD, three DLB). The cohort was diverse, ranging from mild to severe dementia and living in various residential settings. Greater functional independence at baseline was significantly associated with better physical function, balance, cognition, quality of life, muscle mass ratio, walking endurance, faster walking speed and cadence, and lower dementia severity (p < 0.05). Participants declined by clinically meaningful amounts in functional independence, cognition, physical function, muscle mass, and weight over the wait-list period (p < 0.05). Following exercise, participants improved by clinically meaningful amounts in functional independence, cognition, physical function, and strength (p < 0.05). Progressive, high intensity exercise was well-tolerated (> 80% adherence), and only one minor exercise-related adverse event occurred. Conclusions PRIDE is the first exercise trial conducted specifically within individuals diagnosed with LBD, and provides important insight for the design of larger, randomized trials for further evaluation of progressive, high-intensity exercise as a valuable treatment in LBD. Trial registration The PRIDE trial protocol has previously been prospectively registered (08/04/2016, ANZCTR: ACTRN12616000466448). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03347-2.
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Affiliation(s)
- Michael J Inskip
- Sport and Exercise Science, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia. .,Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Yorgi Mavros
- Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW, Australia
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Maria A Fiatarone Singh
- Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,Hebrew SeniorLife, Boston, MA, USA
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13
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Karpodini CC, Dinas PC, Angelopoulou E, Wyon MA, Haas AN, Bougiesi M, Papageorgiou SG, Koutedakis Y. Rhythmic cueing, dance, resistance training, and Parkinson's disease: A systematic review and meta-analysis. Front Neurol 2022; 13:875178. [PMID: 36034281 PMCID: PMC9413961 DOI: 10.3389/fneur.2022.875178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of the present systematic review and meta-analysis was to synthesize evidence associated with the functional and clinical effectiveness of rhythmic cueing, dance, or resistance training (RT) on motor and non-motor parameters in Parkinson's Disease patients, and to provide a comparative perspective not offered by existing systematic reviews. Methodology Eligibility criteria for selecting studies retained no restrictions in methodological design and included interventions of rhythmic cueing, dance, RT, and measurements of motor and non-motor parameters. Animal studies, reviews, editorials, conferences, magazines, and gray literature articles were excluded. Two independent investigators searched Cochrane Library, Medline, PubMed, and SPORTDiscus from the date of their inception until 1 June 2021. The ROBINS-I tool was employed for the non-randomized controlled trials, and the updated for Risk of Bias 2 tool of Cochrane Library used for randomized controlled trials. For meta-analyses, the RevMan 5.4.13 software was used. For incompatible meta-analysis studies, a narrative data synthesis was conducted. Results A total of 49 studies included in the systematic review involving 3767 PD participants. Meta-analyses revealed that rhythmic cueing training assists gait velocity (p = 0.01), stride length (p = 0.01), and motor symptoms (p = 0.03). Similarly, dance training benefits stride length (p = 0.05), lower extremity function-TUG (p = 0.01), and motor symptoms (p = 0.01), whilst RT improves lower extremity function-TUG (p = 0.01), quality of life (p = 0.01), knee flexion (p = 0.02), and leg press (p = 0.01). Subgroup analyses have shown non-significant differences in gait velocity (p = 0.26), stride length (p = 0.80), functional mobility-TUG (p = 0.74), motor symptoms-UPDRS-III (p = 0.46), and quality of life-PDQ39 (p = 0.44). Conclusion Rhythmic cueing, dance, or RT positively affect the examined outcomes, with rhythmic cueing to be associated with three outcomes (Gait, Stride, and UPDRS-III), dance with three outcomes (TUG, Stride, and UPDRS-III), and RT with two outcomes (TUG and PDQ-39). Subgroup analyses confirmed the beneficial effects of these forms of exercise. Clinicians should entertain the idea of more holistic exercise protocols aiming at improving PD manifestations.International Prospective Register of systematic reviews (PROSPERO) (registration number: CRD42020212380).
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Affiliation(s)
- Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Petros C. Dinas
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Efthalia Angelopoulou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Matthew A. Wyon
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Aline Nogueira Haas
- School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maria Bougiesi
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Sokratis G. Papageorgiou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Yiannis Koutedakis
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
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14
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Zhou X, Zhao P, Guo X, Wang J, Wang R. Effectiveness of aerobic and resistance training on the motor symptoms in Parkinson's disease: Systematic review and network meta-analysis. Front Aging Neurosci 2022; 14:935176. [PMID: 35978948 PMCID: PMC9376630 DOI: 10.3389/fnagi.2022.935176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background/objectives Aerobic and resistance training are common complementary therapies to improve motor symptoms in people with Parkinson's disease (PD), and there is still a lack of advice on which intensity and period of aerobic or resistance training is more appropriate for people with PD. Therefore, a network meta-analysis was conducted to assess the comparative efficacy of aerobic and resistance training of different intensities and cycles on motor symptoms in patients with Parkinson's disease. Methods Based on several biomedical databases, a search strategy system was conducted to retrieve randomized controlled trials (RCTs) without language restrictions. A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of aerobic and resistance training on Parkinson's patients. What's more, a range of analyses and assessments, such as routine meta-analyses and risk of bias, were performed as well. Results Twenty trials with 719 patients evaluating 18 different therapies were identified. Through the Unified Parkinson's Disease Motor Rating Scale, (UPDRS III); 6-minute walk test, (6MWT); 10-meter walk test, (TWM); and time up and go (TUG) and Quality of Life Scale-39 (PDQ-39), to explore the effects of different intensity resistance and aerobic exercise on PD. As a result, short period high intensity resistance movement (standard mean difference (SMD) = -0.95, 95% confidence interval (CI) -1.68 to -0.22) had significantly decreased the Unified Parkinson's Disease Motor Rating Scale (UPDRS III). Short period high intensity resistance exercise showed similar superiority in other indices; also, aerobic and resistance training of different cycle intensities produced some efficacy in PD patients, both in direct and indirect comparisons. Conclusion For patients with moderate to mild Parkinson's symptoms, short periods high intensity resistance training may provide complementary therapy for PD, and aerobic or resistance training of varying intensity and periodicity may be recommended as exercise prescription for PD patients. However, more large scale and high quality clinical trials are needed to confirm the effectiveness of this exercise therapy in the future. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022324824.
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Affiliation(s)
- Xiao Zhou
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Peng Zhao
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Xuanhui Guo
- College of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Jialin Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Ruirui Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
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15
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Khobkhun F, Hollands M, Tretriluxana J, Srivanitchapoom P, Richards J, Ajjimaporn A. Benefits of task-specific movement program on en bloc turning in Parkinson's disease: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 27:e1963. [PMID: 35717662 DOI: 10.1002/pri.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 12/15/2021] [Accepted: 06/05/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION En bloc turning highlights a lack of rotational intersegmental coordination, which commonly impacts turning ability in people with Parkinson's disease (PD). Whilst this turning deficit responds fairly well to medical treatment, it may be further mitigated by performing specific exercise training. Thus, the present study aimed to examine the effects of a 4-week exercise program, which focused on task-specific movements (TSM program) on turning ability and clinical outcomes in people with PD. METHODS Twenty-two adults (67 ± 6 years) with early-to-mid-stage idiopathic PD were randomly assigned to an experimental group (EG; n = 11) or a control group (CG; n = 11). The exercise group (EG) group received a 60-min per session TSM program for 4 weeks (a total of 15 sessions), while the CG group performed their routine rehabilitation program (a total of 12 sessions). Inertial measurement units were used to measure turning kinematics including; onset latency of body segments and stepping characteristics. Clinical outcomes included the Unified Parkinson's Disease Rating Scale (UPDRS), functional reach test (FRT), and fall efficacy scale international (FES-I). Assessments were conducted at baseline and after 4 weeks. RESULTS In the EG, turning kinematics, UPDRS scores, FRT, and FES-I scale, were improved at the end of the 4-week program compared with the CG (all p < 0.05). IMPACT STATEMENT A 4-week TSM program could be a promising alternative rehabilitation program for improving "en bloc" turns and clinical outcomes in PD patients.
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Affiliation(s)
- Fuengfa Khobkhun
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand.,Brain and Behaviour Lab, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Mark Hollands
- Brain and Behaviour Lab, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jarugool Tretriluxana
- Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Prachaya Srivanitchapoom
- Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jim Richards
- Allied Health Research Unit, School of Sport and Health Sciences, University of Central Lancashire, Preston, UK
| | - Amornpan Ajjimaporn
- College of Sports Science and Technology, Mahidol University, Nakhon Pathom, Thailand
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16
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Tian J, Kang Y, Liu P, Yu H. Effect of Physical Activity on Depression in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116849. [PMID: 35682432 PMCID: PMC9180645 DOI: 10.3390/ijerph19116849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide, and approximately 50% of PD patients suffer from depression. We aim to determine the effects of physical activity on depression in PD patients and to provide scientific evidence-based exercise prescriptions for PD patients. A systematic review was conducted by searching PubMed, Embase, Cochrane Library, and PsycInfo until February 2022 for randomized controlled trial (RCT) studies published in English. The primary outcome was a score on a depression scale. A total of 14 RCTs involving 516 patients with PD were included in this study. The results of the meta-analysis showed that physical activity had a moderate and significant improvement in depression in PD patients (SMD = −0.60; 95% CI = −0.79 to −0.41; p < 0.00001). Subgroup analysis indicated that resistance exercise for 60−90 min more than 4 times per week for up to 12 weeks had a significant effect on PD patients who have had the disease for more than 5 years. Meta-regression showed that intervention type, intervention time, intervention frequency, intervention period, age, and disease duration were not sources of heterogeneity. Physical activity may reduce depression in PD patients. However, other larger sample sizes and high-quality studies are needed to validate these effects in the future.
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Affiliation(s)
- Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Yujie Kang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Peifeng Liu
- Department of Physical Education, Central South University, Changsha 410083, China;
| | - Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
- Correspondence:
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17
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Ferrazzoli D, Ortelli P, Iansek R, Volpe D. Rehabilitation in movement disorders: From basic mechanisms to clinical strategies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:341-355. [PMID: 35034747 DOI: 10.1016/b978-0-12-819410-2.00019-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Movement disorders encompass a variety of conditions affecting the nervous system at multiple levels. The pathologic processes underlying movement disorders alter the normal neural functions and could lead to aberrant neuroplastic changes and to clinical phenomenology that is not expressed only through mere motor symptoms. Given this complexity, the responsiveness to pharmacologic and surgical therapies is often disappointing. Growing evidence supports the efficacy of neurorehabilitation for the treatment of movement disorders. Specific form of training involving both goal-based practice and aerobic training could drive and modulate neuroplasticity in order to restore the circuitries dysfunctions and to achieve behavioral gains. This chapter provides an overview of the alterations expressed in some movement disorders in terms of clinical signs and symptoms and plasticity, and suggests which ones and why tailored rehabilitation strategies should be adopted for the management of the different movement disorders.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Paola Ortelli
- Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy; Department of Parkinson's Disease, Fresco Parkinson Center, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital-Gravedona ed Uniti, Como, Italy
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, National Parkinson Foundation Center of Excellence, Monash Health, Cheltenham, VIC, Australia; School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Daniele Volpe
- Department of Rehabilitation, Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
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18
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Harper SA, Thompson BJ. Potential Benefits of a Minimal Dose Eccentric Resistance Training Paradigm to Combat Sarcopenia and Age-Related Muscle and Physical Function Deficits in Older Adults. Front Physiol 2021; 12:790034. [PMID: 34916963 PMCID: PMC8669760 DOI: 10.3389/fphys.2021.790034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
The ability of older adults to perform activities of daily living is often limited by the ability to generate high mechanical outputs. Therefore, assessing and developing maximal neuromuscular capacity is essential for determining age-related risk for functional decline as well as the effectiveness of therapeutic interventions. Interventions designed to enhance neuromuscular capacities underpinning maximal mechanical outputs could positively impact functional performance in daily life. Unfortunately, < 10% of older adults meet the current resistance training guidelines. It has recently been proposed that a more “minimal dose” RT model may help engage a greater proportion of older adults, so that they may realize the benefits of RT. Eccentric exercise offers some promising qualities for such an approach due to its efficiency in overloading contractions that can induce substantial neuromuscular adaptations. When used in a minimal dose RT paradigm, eccentric-based RT may be a particularly promising approach for older adults that can efficiently improve muscle mass, strength, and functional performance. One approach that may lead to improved neuromuscular function capacities and overall health is through heightened exercise tolerance which would favor greater exercise participation in older adult populations. Therefore, our perspective article will discuss the implications of using a minimal dose, submaximal (i.e., low intensity) multi-joint eccentric resistance training paradigm as a potentially effective, and yet currently underutilized, means to efficiently improve neuromuscular capacities and function for older adults.
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Affiliation(s)
- Sara A Harper
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States.,Sorenson Legacy Foundation Center for Clinical Excellence, Dennis Dolny Movement Research Clinic, Utah State University, Logan, UT, United States
| | - Brennan J Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States.,Sorenson Legacy Foundation Center for Clinical Excellence, Dennis Dolny Movement Research Clinic, Utah State University, Logan, UT, United States
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19
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Walsh JA, McAndrew DJ, Henness DJ, Shemmell J, Cuicuri D, Stapley PJ. A Semi-recumbent Eccentric Cycle Ergometer Instrumented to Isolate Lower Limb Muscle Contractions to the Appropriate Phase of the Pedal Cycle. Front Physiol 2021; 12:756805. [PMID: 34912239 PMCID: PMC8667581 DOI: 10.3389/fphys.2021.756805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Eccentric (ECC) cycling is used in rehabilitation and sports conditioning settings. We present the construction and mode of operation of a custom-built semi-recumbent ECC cycle designed to limit the production of lower limb muscle activity to the phase of the pedal cycle known to produce ECC contractions. A commercially available semi-recumbent frame and seat (Monarch, 837E Semi-recumbent Bike, Sweden) were used to assemble the ergometer. An electrical drive train system was constructed using individual direct drive servo motors. To avoid active muscle activation occurring during the non-ECC pedaling phase of cycling, a “trip” mechanism was integrated into the drivetrain system using a servo-driven regenerative braking mechanism based on the monitoring of the voltage produced over and above a predetermined threshold produced by the motors. The servo drive internal (DC bus) voltage is recorded and internally monitored during opposing (OPP) and non-opposing (N-OPP) phases of the pedal cycle. To demonstrate that the cycle functions as desired and stops or “trips” when it is supposed to, we present average (of 5 trials) muscle activation patterns of the principal lower limb muscles for regular ECC pedal cycles in comparison with one pedal cycle during which the muscles activated outside the desired phase of the cycle for a sample participant. This semi-recumbent ECC cycle ergometer has the capacity to limit the occurrence of muscle contraction only to the ECC phase of cycling. It can be used to target that mode of muscle contraction more precisely in rehabilitation or training studies.
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Affiliation(s)
- Joel A Walsh
- Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Darryl J McAndrew
- Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Douglas J Henness
- Electrical Workshop, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Jonathan Shemmell
- Neuromotor Adaptation Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Dominic Cuicuri
- Electrical Workshop, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Paul J Stapley
- Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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20
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Carroll LM, Morris ME, O'Connor WT, Clifford AM. Is Aquatic Therapy Optimally Prescribed for Parkinson's Disease? A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSONS DISEASE 2021; 10:59-76. [PMID: 31815701 DOI: 10.3233/jpd-191784] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Aquatic therapy offers an alternative physiotherapy approach to managing the motor and non-motor symptoms associated with Parkinson's disease (PD). OBJECTIVE This review examined exercise prescription for aquatic therapy in PD and evaluated if aquatic therapy is as effective as land-based physiotherapy for improving movement, disability and wellbeing in people living with PD. METHODS A systematic search of eight databases was conducted to identify suitable randomized controlled trials from inception until August 2019. Aquatic therapy prescription data and outcomes of interest included gait, balance, motor disability, mobility, falls, mood, cognitive function and health related quality of life data was extracted and synthesised. A meta-analysis was performed where appropriate. RESULTS Fourteen studies involving 472 participants (Hoehn & Yahr scale I-IV) met the inclusion criteria. Eight were of modest quality, scoring 70-80% on the PEDro scale. Seven studies were included in the meta-analysis. Exercise prescription was highly variable and often insufficiently dosed. Similar gains were shown for aquatic therapy and land exercises for balance, motor disability or quality of life. A statistically significant difference was found for mobility as measured using the TUG (-1.5 s, 95 % CI -2.68 to -0.32; p = 0.01, I2 = 13%), in favor of aquatic therapy. CONCLUSION Aquatic therapy had positive outcomes for gait, balance and mobility that were comparable to land-based physiotherapy in the early stages of PD. The optimal dosage, content and duration of aquatic interventions for PD could not be confirmed in this meta-analysis. Many trials appeared to be under-dosed and therapy duration was low, ranging from 3-11 weeks.
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Affiliation(s)
- Louise M Carroll
- School of Allied Health, Faculty of Education and Health Sciences, Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Meg E Morris
- Healthscope & La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - William T O'Connor
- Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Amanda M Clifford
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
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21
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Braz de Oliveira MP, Maria Dos Reis L, Pereira ND. Effect of Resistance Exercise on Body Structure and Function, Activity, and Participation in Individuals With Parkinson Disease: A Systematic Review. Arch Phys Med Rehabil 2021; 102:1998-2011. [PMID: 33587899 DOI: 10.1016/j.apmr.2021.01.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of resistance exercise (RE) on body structure and function, activity, and participation in individuals with Parkinson Disease (PD) in the mild to moderate stages. DATA SOURCES Medline, Embase, Web of Science, The Cochrane Library, Lilacs, and PEDro were searched from inception until June 2020 using the terms "Parkinson Disease," "Exercise," "Resistance Training," "Muscle Strength," "Cardiorespiratory Fitness," "Postural Balance," "Gait," and "Quality of Life." STUDY SELECTION We included studies conducted in individuals with PD involving RE compared with a control group. Two independent reviewers performed the selection process based on titles, abstracts, and full-text reading. In total, 270 individuals with PD were included from 10 selected studies. DATA EXTRACTION Two reviewers independently extracted characteristics related to participants, intervention and control types, and results. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the Grading of Recommendation, Assessment, Development, and Evaluations approach. DATA SYNTHESIS The level of evidence for body structure and function was low and without effect for lower limb muscle strength; very low and with effect for upper limb muscle strength, cardiorespiratory fitness, and postural balance; and very low and without effect for flexibility after RE training. For activity, the evidence was very low and with effect for gait and very low and without effect for mobility. For participation (ie, quality of life) the evidence was very low and without effect. CONCLUSIONS Although the level of evidence was low to very low, RE was shown to promote improvements in body structure and function (upper limb muscle strength, cardiovascular function, postural balance) and activity (gait). In contrast, RE did not significantly improve participation (quality of life). However, based on the present findings, the practice of RE can be recommended for individuals with PD in the mild to moderate stages.
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Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Physiotherapy Department, Healthy Aging Research Laboratory, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Luciana Maria Dos Reis
- Physiotherapy Department, Neurofunctional Physiotherapy Laboratory, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Natalia Duarte Pereira
- Physiotherapy Department, Research Group in Functionality and Technological Innovation in NeuroRehabilitation, Federal University of São Carlos, São Carlos, SP, Brazil
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22
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Chamberlain-Carter J, Jackson J. Does resistance training reduce falls and improve quality of life in people with Parkinson’s disease using strength training exercise programmes? PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2020.1814123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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Li X, He J, Yun J, Qin H. Lower Limb Resistance Training in Individuals With Parkinson's Disease: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Neurol 2020; 11:591605. [PMID: 33281732 PMCID: PMC7691593 DOI: 10.3389/fneur.2020.591605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/07/2020] [Indexed: 01/20/2023] Open
Abstract
Objective: Initial randomized controlled trials (RCTs) and recently released systematic reviews have identified resistance training (RT) as a modality to manage motor symptoms and improve physical functioning in individuals with Parkinson's disease (PD), although the effects are inconsistent. Therefore, we conducted an updated meta-analysis to reassess the evidence of the relationship. Methods: We performed a systematic search of studies reporting the effects of RT in PD available through major electronic databases (PubMed, Medline, Embase, Ovid, Cochrane Library, CNKI, Wanfang) through 20 July 2020. Eligible RCTs were screened based on established inclusion criteria. We extracted data on the indicators of leg strength, balance, gait capacity, and quality of life (QoL) of lower limbs. Random and fixed effects models were used for the analysis of standard mean differences (SMD) or mean differences (MD) with their 95% confidence intervals (CI). Results: Thirty-one papers from 25 independent trials compromising 1,239 subjects were selected for eligibility in this systematic review and meta-analysis. Summarized data indicated that the leg strength increased statistically significant in PD patients (SMD = 0.79, 95% CI 0.3, 1.27, P = 0.001), the balance capability was improved statistically significant in PD patients (SMD = 0.34, 95% CI 0.01, 0.66, P = 0.04), and QoL statistically significantly improved (MD = −7.22, 95% CI −12.05, −2.39, P = 0.003). For gait performance, four indicators were measured, the results as follows: fast gait velocity (MD = 0.14, 95% CI 0.06, 0.23, P = 0.001), Timed-up-and-go-test (TUG, MD = −1.17, 95% CI −2.27, −0.08, P = 0.04) and Freezing of Gait Questionnaire (FOG-Q, MD = −1.74, 95% CI −3.18, −0.3, P = 0.02) were improved statistically significant across trials, while there were no statistically significant improvement in stride length (MD = −0.05, 95% CI −0.12, 0.02, P = 0.15) in PD patients. Conclusions: Lower limb RT has positive effects during rehabilitation in individuals with PD in leg strength, QoL, and improve gait performance to a certain extent. RT also could improve balance capacity of patients, although a wide variety of tools were used, and further study is needed to confirm these findings.
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Affiliation(s)
- Xiaoyan Li
- Department of Endocrinology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jie He
- Department of Respiratory and Critical Care Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jie Yun
- Nursing Department of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hua Qin
- Department of Endocrinology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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24
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Barreto RV, de Lima LCR, Denadai BS. Moving forward with backward pedaling: a review on eccentric cycling. Eur J Appl Physiol 2020; 121:381-407. [PMID: 33180156 DOI: 10.1007/s00421-020-04548-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/31/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE There is a profound gap in the understanding of the eccentric cycling intensity continuum, which prevents accurate exercise prescription based on desired physiological responses. This may underestimate the applicability of eccentric cycling for different training purposes. Thus, we aimed to summarize recent research findings and screen for possible new approaches in the prescription and investigation of eccentric cycling. METHOD A search for the most relevant and state-of-the-art literature on eccentric cycling was conducted on the PubMed database. Literature from reference lists was also included when relevant. RESULTS Transversal studies present comparisons between physiological responses to eccentric and concentric cycling, performed at the same absolute power output or metabolic load. Longitudinal studies evaluate responses to eccentric cycling training by comparing them with concentric cycling and resistance training outcomes. Only one study investigated maximal eccentric cycling capacity and there are no investigations on physiological thresholds and/or exercise intensity domains during eccentric cycling. No study investigated different protocols of eccentric cycling training and the chronic effects of different load configurations. CONCLUSION Describing physiological responses to eccentric cycling based on its maximal exercise capacity may be a better way to understand it. The available evidence indicates that clinical populations may benefit from improvements in aerobic power/capacity, exercise tolerance, strength and muscle mass, while healthy and trained individuals may require different eccentric cycling training approaches to benefit from similar improvements. There is limited evidence regarding the mechanisms of acute physiological and chronic adaptive responses to eccentric cycling.
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Affiliation(s)
- Renan Vieira Barreto
- Human Performance Laboratory, Department of Physical Education, São Paulo State University, Rio Claro, São Paulo, Brazil
| | | | - Benedito Sérgio Denadai
- Human Performance Laboratory, Department of Physical Education, São Paulo State University, Rio Claro, São Paulo, Brazil.
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Nielsen C, Siersma V, Ghaziani E, Beyer N, Magnusson SP, Couppé C. Health-Related Quality of Life and Physical Function in Individuals with Parkinson's Disease after a Multidisciplinary Rehabilitation Regimen-A Prospective Cohort Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207668. [PMID: 33096677 PMCID: PMC7589165 DOI: 10.3390/ijerph17207668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/20/2022]
Abstract
Parkinson’s disease (PD) is a neurodegenerative disease and a multidisciplinary approach to rehabilitation has been suggested as the best clinical practice. However, very few studies have investigated the long-term effects of a multidisciplinary rehabilitation approach, particularly regarding whether this can slow the progression of PD. The purpose was to investigate the short- and long-term effect of a 2-week multidisciplinary rehabilitation regimen on the PD-related decline in health-related quality of life (HRQOL), mobility, and muscle function. Individuals with PD (IPD) participated in a 2-week inpatient multidisciplinary rehabilitation regimen that focused on improving HRQOL, mobility, and muscle function. Data from the primary outcome: HRQOL (Parkinson’s Disease Questionnaire 39, PDQ-39), secondary outcomes: handgrip strength, Timed-up and Go (TUG), Hospital Anxiety and Depression Scale (HADS), and Falls Efficacy Scale-International (FES-I) were compared at pre-visitation, before and after the 2-week regimen, and again at 4 and 10 months follow-up. In total, 224 patients with PD were included. There were short-term improvements in all outcomes. PDQ-39 was maintained at the same level as pre-visitation after 10 months follow-up. A 2-week multidisciplinary rehabilitation regimen improved short-term mobility, muscle function, and HRQOL in individuals with Parkinson’s disease. HRQOL was maintained after 10 months demonstrating long-term effects.
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Affiliation(s)
- Christina Nielsen
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-2095-2588
| | - Volkert Siersma
- Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark;
| | - Emma Ghaziani
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
| | - Nina Beyer
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
| | - S. Peter Magnusson
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
| | - Christian Couppé
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
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26
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Progressive muscle-strength protocol for the functionality of upper limbs and quality of life in individuals with Parkinson's disease: Pilot study. Complement Ther Med 2020; 52:102432. [PMID: 32951706 DOI: 10.1016/j.ctim.2020.102432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/06/2020] [Accepted: 05/06/2020] [Indexed: 11/22/2022] Open
Abstract
The effects of physical-therapy intervention on the motor function of upper limbs and the quality of life in patients with Parkinson's disease (PD) are not fully understood. We evaluated the effects of a progressive muscle-strengthening protocol for upper limbs on the functionality and quality of life. Patients were divided into two groups: Intervention (n = 6) and Control (n = 7). Assessment tools used were: Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire, Nine-Hole Peg Test (9HPT), Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA), 10-Repetition Maximum (10-RM) and handgrip dynamometer, which were applied pre- and post-intervention, with follow-up for one month after the last training session. Only, the Intervention group (post-intervention) showed significant statistical differences, with the following outcomes: UPDRS III (p = 0.042); 9HPT, right (p = 0.028) and left side (p = 0.028); TEMPA for total right side (p = 0.028), left side (p = 0.028) and total bilateral tasks (p = 0.028); TEMPA task 2 - open a jar and take a spoonful of coffee (p = 0.028), task 3 - pick up a pitcher and pour water into a glass for right (p = 0.046) and left side (p = 0.028), task 5 - write on an envelope and stick on a stamp (p = 0.028), and task 6 - shuffle and deal playing cards (p = 0.028). We observed significant statistical differences between groups (post-intervention) for TEMPA task 6 (p = 0.032), total right side (p = 0.032), and total bilateral tasks (p = 0.032). An increase in the maximum load in the post-intervention stage, based on the 10-RM test, was observed on the right (p = 0.003) and left (p = 0.007) sides. Our results showed an improvement in upper-limb functionality in PD patients submitted to progressive muscle-strength training, although not in quality of life.
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Endo Y, Nourmahnad A, Sinha I. Optimizing Skeletal Muscle Anabolic Response to Resistance Training in Aging. Front Physiol 2020; 11:874. [PMID: 32792984 PMCID: PMC7390896 DOI: 10.3389/fphys.2020.00874] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022] Open
Abstract
Loss of muscle mass and strength with aging, also termed sarcopenia, results in a loss of mobility and independence. Exercise, particularly resistance training, has proven to be beneficial in counteracting the aging-associated loss of skeletal muscle mass and function. However, the anabolic response to exercise in old age is not as robust, with blunted improvements in muscle size, strength, and function in comparison to younger individuals. This review provides an overview of several physiological changes which may contribute to age-related loss of muscle mass and decreased anabolism in response to resistance training in the elderly. Additionally, the following supplemental therapies with potential to synergize with resistance training to increase muscle mass are discussed: nutrition, creatine, anti-inflammatory drugs, testosterone, and growth hormone (GH). Although these interventions hold some promise, further research is necessary to optimize the response to exercise in elderly patients.
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Affiliation(s)
- Yori Endo
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Atousa Nourmahnad
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Indranil Sinha
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Harvard Department of Stem Cell and Regenerative Biology, Harvard Stem Cell Institute, Cambridge, MA, United States
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28
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Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review. PARKINSONS DISEASE 2020; 2020:9748091. [PMID: 32566123 PMCID: PMC7270996 DOI: 10.1155/2020/9748091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/09/2020] [Indexed: 11/26/2022]
Abstract
Parkinson disease (PD) is a chronic neurodegenerative condition that leads to progressive disability. PD-related reductions in muscle strength have been reported to be associated with lower functional performance and balance confidence with an increased risk of falls. Progressive resistance training (PRT) improves strength, balance, and functional abilities. This umbrella review examines the efficacy of PRT regarding muscular strength in PD patients. The PubMed, PEDro, Scopus, and Cochrane Library databases were searched from January 2009 to August 2019 for systematic reviews and meta-analyses conducted in English. The populations included had diagnoses of PD and consisted of males and females aged >18 years old. Outcomes measured were muscle strength and enhanced physical function. Eight papers (six systematic reviews and meta-analyses and two systematic reviews) were considered relevant for qualitative analysis. In six of the eight studies, the reported severity of PD was mild to moderate. Each study analyzed how PRT elicited positive effects on muscle strength in PD patients, suggesting 10 weeks on average of progressive resistance exercises for the upper and lower limbs two to three times per week. However, none of the studies considered the postworkout follow-up, and there was no detailed evidence about the value of PRT in preventing falls. The possibility of PRT exercises being effective for increasing muscle strength in patients with PD, but without comorbidities or severe disability, is discussed. Overall, this review suggests that PRT should be included in rehabilitation programs for PD patients, in combination with balance training for postural control and other types of exercise, in order to preserve cardiorespiratory fitness and improve endurance in daily life activities.
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29
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Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CKY, Choi KC, Chan HYL. Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol 2020; 76:755-763. [PMID: 30958514 DOI: 10.1001/jamaneurol.2019.0534] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Clinical practice guidelines support exercise for patients with Parkinson disease (PD), but to our knowledge, no randomized clinical trials have tested whether yoga is superior to conventional physical exercises for stress and symptom management. Objective To compare the effects of a mindfulness yoga program vs stretching and resistance training exercise (SRTE) on psychological distress, physical health, spiritual well-being, and health-related quality of life (HRQOL) in patients with mild-to-moderate PD. Design, Setting, and Participants An assessor-masked, randomized clinical trial using the intention-to-treat principle was conducted at 4 community rehabilitation centers in Hong Kong between December 1, 2016, and May 31, 2017. A total of 187 adults (aged ≥18 years) with a clinical diagnosis of idiopathic PD who were able to stand unaided and walk with or without an assistive device were enrolled via convenience sampling. Eligible participants were randomized 1:1 to mindfulness yoga or SRTE. Interventions Mindfulness yoga was delivered in 90-minute groups and SRTE were delivered in 60-minute groups for 8 weeks. Main Outcomes and Measures Primary outcomes included anxiety and depressive symptoms assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes included severity of motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Part III motor score), mobility, spiritual well-being in terms of perceived hardship and equanimity, and HRQOL. Assessments were done at baseline, 8 weeks (T1), and 20 weeks (T2). Results The 138 participants included 65 men (47.1%) with a mean (SD) age of 63.7 (8.7) years and a mean (SD) MDS-UPDRS score of 33.3 (15.3). Generalized estimating equation analyses revealed that the yoga group had significantly better improvement in outcomes than the SRTE group, particularly for anxiety (time-by-group interaction, T1: β, -1.79 [95% CI, -2.85 to -0.69; P = .001]; T2: β, -2.05 [95% CI, -3.02 to -1.08; P < .001]), depression (T1: β, -2.75 [95% CI, -3.17 to -1.35; P < .001]); T2: β, -2.75 [95% CI, -3.71 to -1.79; P < .001]), perceived hardship (T1: β, -0.92 [95% CI, -1.25 to -0.61; P < .001]; T2: β, -0.76 [95% CI, -1.12 to -0.40; P < .001]), perceived equanimity (T1: β, 1.11 [95% CI, 0.79-1.42; P < .001]; T2: β, 1.19 [95% CI, 0.82-1.56; P < .001]), and disease-specific HRQOL (T1: β, -7.77 [95% CI, -11.61 to -4.38; P < .001]; T2: β, -7.99 [95% CI, -11.61 to -4.38; P < .001]). Conclusions and Relevance Among patients with mild-to-moderate PD, the mindfulness yoga program was found to be as effective as SRTE in improving motor dysfunction and mobility, with the additional benefits of a reduction in anxiety and depressive symptoms and an increase in spiritual well-being and HRQOL. Trial Registration Centre for Clinical Research and Biostatistics identifier: CUHK_CCRB00522.
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Affiliation(s)
- Jojo Y Y Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jackie C Y Kwan
- The Hong Kong Society for Rehabilitation, Hong Kong Special Administrative Region
| | - M Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Center for Prevention of Dementia, Gerald Choa Neuroscience Centre, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Claire K Y Lau
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Special Administration Region
| | - K C Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Helen Y L Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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30
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Rahmati Z, Behzadipour S, Schouten AC, Taghizadeh G, Firoozbakhsh K. Postural control learning dynamics in Parkinson's disease: early improvement with plateau in stability, and continuous progression in flexibility and mobility. Biomed Eng Online 2020; 19:29. [PMID: 32393271 PMCID: PMC7216342 DOI: 10.1186/s12938-020-00776-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022] Open
Abstract
Background Balance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program, are poorly understood. Objectives We investigated the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and novel model-based measures. Methods Twenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point. The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures. Results Mobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first 3 to 4 weeks of training, and reached a plateau for the rest of the training. Conclusions The progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continue to improve during the balance training.
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Affiliation(s)
- Zahra Rahmati
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran.,Djawad Movafaghian Research Center in Neurorehab Technologies, Sharif University of Technology, Tehran, Iran
| | - Saeed Behzadipour
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran. .,Djawad Movafaghian Research Center in Neurorehab Technologies, Sharif University of Technology, Tehran, Iran.
| | - Alfred C Schouten
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Ferrazzoli D, Ortelli P, Cucca A, Bakdounes L, Canesi M, Volpe D. Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson's disease. Neurodegener Dis Manag 2020; 10:41-55. [PMID: 32039653 DOI: 10.2217/nmt-2019-0025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) results in a complex deterioration of motor behavior. Effective pharmacological or surgical treatments addressing the whole spectrum of both motor and cognitive symptoms are lacking. The cumulative functional impairment may have devastating socio-economic consequences on both patients and caregivers. Comprehensive models of care based on multidisciplinary approaches may succeed in better addressing the overall complexity of PD. Neurorehabilitation is a highly promising non-pharmacological intervention for managing PD. The scientific rationale beyond rehabilitation and its practical applicability remain to be established. In the present perspective, we aim to discuss the current evidence supporting integrated motor-cognitive and aerobic rehabilitation approaches for patients with PD while suggesting a practical framework to optimize this intervention in the next future.
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Affiliation(s)
- Davide Ferrazzoli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Paola Ortelli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy.,The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY 10017, USA
| | - Leila Bakdounes
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
| | - Margherita Canesi
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
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32
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Vieira de Moraes Filho A, Chaves SN, Martins WR, Tolentino GP, de Cássia Pereira Pinto Homem R, Landim de Farias G, Fischer BL, Oliveira JA, Pereira SKA, Vidal SE, Mota MR, Moreno Lima R, Jacó de Oliveira R. Progressive Resistance Training Improves Bradykinesia, Motor Symptoms and Functional Performance in Patients with Parkinson's Disease. Clin Interv Aging 2020; 15:87-95. [PMID: 32158202 PMCID: PMC6986410 DOI: 10.2147/cia.s231359] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/13/2019] [Indexed: 01/08/2023] Open
Abstract
Purpose Bradykinesia and muscle weaknesses are common symptoms of Parkinson’s Disease (PD) and are associated with impaired functional performance, increased risk of falls, and reduced quality of life. Recent studies have pointed to progressive resistance training (PRT) as an effective method to control and reduce these symptoms, increasing possibilities to treat the disease. However, few studies have focused on assessing the PRT effects in the short-term. Therefore, the present study aimed to assess the short-term PRT effects on people with PD, in order to offer new parameters for a better understanding of its effects, so as an adequation and PRT use as a complementary therapy. Patients and Methods Forty individuals diagnosed with PD from stage 1 to 3 on the Hoehn and Yahr scale took part on the study and were allocated into 2 groups; Training Group (TG) performed a 9-week RT program twice a week, and the Control Group (CG) attended disease lectures. Bradykinesia UPDRS subscale (BSS), knee extensors isokinetic strength, Ten Meters Walk Test (TMW), Timed Up&Go Test (TUG) and 30-Second Chair Stand (T30) were measured before and after the intervention period. Statistical significance was set at p ≤ 0.05. Results Significant time was noted by the group interaction for all functional tests (TUG, T30, and TWM; all p < 0.01) and BSS (p < 0.01). Post hoc analyses revealed that these differences were driven by significant improvements in these dependent variables (all p < 0.01) while the CG remained unchanged (all p > 0.05). Moreover, TUG, T30, TWM, and BSS were significantly different between TG and CG in the post-training assessments (all p < 0.01). Isokinetic muscle strength was slightly increased in the TG (2.4%) and decreased in the CG (−2.2%), but statistical analyses did not reach significance for interaction but only a trend (p = 0.12). Conclusion The results indicate that 9 weeks of PRT reduces bradykinesia and improves functional performance in patients with mild to moderate PD. These findings reinforce this mode of exercise as an important component of public health promotion programs for PD.
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Affiliation(s)
| | - Sandro Nobre Chaves
- College of Physical Education, University of Brasilia, Brasilia, Brazil.,Integrated Colleges IESGO, Formosa, Goias, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Ricardo Jacó de Oliveira
- College of Health Sciences, University of Brasilia, Brasilia, Brazil.,College of Physical Education, University of Brasilia, Brasilia, Brazil
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33
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Morris ME, Ellis TD, Jazayeri D, Heng H, Thomson A, Balasundaram AP, Slade SC. Boxing for Parkinson's Disease: Has Implementation Accelerated Beyond Current Evidence? Front Neurol 2019; 10:1222. [PMID: 31866923 PMCID: PMC6904341 DOI: 10.3389/fneur.2019.01222] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/04/2019] [Indexed: 01/23/2023] Open
Abstract
Background: Exercise and physical activity are argued to promote neural plasticity in Parkinson's disease (PD), with potential to slow disease progression. Boxing for PD is rapidly growing in popularity. Objectives: (i) To evaluate evidence on benefits and risks of boxing exercises for people living with PD and (ii) to appraise websites for evidence of global implementation of this intervention. Data Sources: We searched AMED, CINAHL, Cochrane, EMBASE, EMCARE, Health and Medical Collection via ProQuest, MEDLINE, and PEDro electronic databases for the research literature. Websites were also searched for evidence of successful implementation of boxing for PD. Study Selection: Published research and websites were considered if they reported data on adults with PD and boxing as an intervention. Data Extraction: For the literature review, two reviewers independently extracted data on study characteristics and intervention content. Risk of bias was assessed with the PEDro scale and Joanna Briggs Checklist. We conducted a quality appraisal of websites using the QUality Evaluation Scoring Tool (QUEST). Data Synthesis: Two studies, with a total of 37 participants, met the review eligibility criteria for the literature review. Risk of bias was low in these trials. Balance confidence, mobility, and quality of life were reported to improve with community-based boxing training programs delivered in 24-36 sessions over 12 weeks. PD medications were not always documented and some elements of the boxing interventions were incompletely reported against the CERT (Consensus on Exercise Reporting Template). Nine websites advocating boxing programs for PD were also evaluated. The QUEST analysis showed low-level quality, and little scientific evidence verifying findings, despite positive reports. Limitations: In the published literature, findings were limited due to the small number of included studies and participants. Websites were numerous yet often lacked verifiable data. Conclusions: Despite the recent growth in the popularity of boxing for PD and some positive findings, there is limited evidence of efficacy. Risks and disease-specific modifications have not been reported. Safety guidelines and health professional training are key considerations for implementation.
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Affiliation(s)
- Meg E. Morris
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Healthscope North Eastern Centre, Ivanhoe, VIC, Australia
| | - Terry D. Ellis
- Center for Neurorehabilitation, Boston University College of Health and Rehabilitation Sciences, Sargent College, Boston, MA, United States
| | - Dana Jazayeri
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Healthscope North Eastern Centre, Ivanhoe, VIC, Australia
| | - Hazel Heng
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Andrea Thomson
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Arun Prasad Balasundaram
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Susan C. Slade
- La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- Healthscope North Eastern Centre, Ivanhoe, VIC, Australia
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Cherup NP, Buskard AN, Strand KL, Roberson KB, Michiels ER, Kuhn JE, Lopez FA, Signorile JF. Power vs strength training to improve muscular strength, power, balance and functional movement in individuals diagnosed with Parkinson's disease. Exp Gerontol 2019; 128:110740. [DOI: 10.1016/j.exger.2019.110740] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
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35
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Inskip M, Mavros Y, Sachdev PS, Fiatarone Singh MA. Promoting independence in Lewy body dementia through exercise (PRIDE) study: Protocol for a pilot study. Contemp Clin Trials Commun 2019; 16:100466. [PMID: 31701040 PMCID: PMC6831670 DOI: 10.1016/j.conctc.2019.100466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background Lewy Body dementia (LBD) is the second most prevalent neurodegenerative dementia. This form of dementia is notable for an aggressive disease course consisting of a combination of cognitive, Parkinsonian, affective, and physiological symptoms that significantly increase morbidity and mortality, and decrease life expectancy in this population compared to more common dementias. Additionally, those diagnosed with LBD are often excluded from trials evaluating exercise in similar diseases such as Alzheimer's disease or Parkinson's disease due to the complexity and concurrency of motor and cognitive symptoms. Consequently, there is scarce research evaluating the effect of exercise on individuals with LBD. Methods The PRomoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial is a novel non-randomised, crossover pilot study consisting of an 8-week wait-list usual care period, followed by an 8-week exercise intervention targeting progressive resistance and balance training. The trial aim is to evaluate the effect of exercise on the primary outcome of functional independence and secondary outcomes including cognitive, physical, psychosocial and quality of life measures in people living with LBD and their caregivers. The intervention involves 3 supervised 1-h sessions per week (24 sessions in total) administered by an Accredited Exercise Physiologist in a clinical facility at the University of Sydney in Lidcombe, Australia. Discussion The PRIDE study is the first controlled trial to evaluate a robust exercise intervention within a LBD cohort and will provide crucial information required to inform robust future clinical trials. Trial registration Australia and New Zealand Trial Register (ANZCTR): ACTRN12616000466448; Key words: Lewy body; dementia; exercise; anabolic; functional independence.
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Affiliation(s)
- Michael Inskip
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
- Corresponding author. Office K220, The University of Sydney, Faculty of Health Sciences, Cumberland Campus, Lidcombe, NSW, 2141, Australia.
| | - Yorgi Mavros
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, NSW, 2031, Australia
| | - Maria A. Fiatarone Singh
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
- The University of Sydney, Sydney Medical School, Sydney, 2006, Australia
- Hebrew SeniorLife, Roslindale, MA, 02131, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, 02155, USA
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36
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Gladstone E, Narad ME, Hussain F, Quatman-Yates CC, Hugentobler J, Wade SL, Gubanich PJ, Kurowski BG. Neurocognitive and Quality of Life Improvements Associated With Aerobic Training for Individuals With Persistent Symptoms After Mild Traumatic Brain Injury: Secondary Outcome Analysis of a Pilot Randomized Clinical Trial. Front Neurol 2019; 10:1002. [PMID: 31620073 PMCID: PMC6759771 DOI: 10.3389/fneur.2019.01002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 09/02/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: To report secondary neurocognitive and quality of life outcomes for a pilot randomized clinical trial (RCT) of aerobic training for management of prolonged symptoms after a mild traumatic brain injury (mTBI) in adolescents. Setting: Outpatient research setting. Participants: Thirty adolescents between the ages of 12 and 17 years who sustained a mTBI and had between 4 and 16 weeks of persistent post-concussive symptoms. Design: Secondary outcome analysis of a partially masked RCT of sub-symptom exacerbation aerobic training compared with a full-body stretching program highlighting cognitive and quality of life outcomes. Main Measures: The secondary outcomes assessed included neurocognitive changes in fluid and crystallized age-adjusted cognition using the National Institutes of Health (NIH) toolbox and self and parent-reported total quality of life using the Pediatric Quality of Life Inventory. Results: Twenty-two percent of eligible participants enrolled in the trial. General linear models did not reveal statistically significant differences between groups. Within group analyses using paired t-tests demonstrated improvement in age-adjusted fluid cognition [t (13) = 3.39, p = 0.005, Cohen's d = 0.61] and crystallized cognition [t (13) = 2.63, p = 0.02, Cohen's d = 0.70] within the aerobic training group but no significant improvement within the stretching group. Paired t-tests demonstrated significant improvement in both self-reported and parent-reported total quality of life measures in the aerobic training group [self-report t (13) = 3.51, p = 0.004, Cohen's d = 0.94; parent-report t (13) = 6.5, p < 0.0001, Cohen's d = 1.80] and the stretching group [self-report t (14) = 4.20, p = 0.0009, Cohen's d = 1.08; parent-report t (14) = 4.06, p = 0.0012, Cohen's d = 1.045]. Conclusion: Quality of life improved significantly in both the aerobic exercise and stretching groups; however, this study suggests that only sub-symptom exacerbation aerobic training was potentially beneficial for neurocognitive recovery, particularly the fluid cognition subset in the NIH Toolbox. Limited sample size and variation in outcomes measures limited ability to detect between group differences. Future research should focus on developing larger studies to determine optimal timing post-injury and intensity of active rehabilitation to facilitate neurocognitive recovery and improve quality of life after mTBI. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02035579.
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Affiliation(s)
- Emily Gladstone
- Department of Physical Medicine and Rehabilitation, MetroHealth and Case Western Reserve College of Medicine, Cleveland, OH, United States
| | - Megan E Narad
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Fadhil Hussain
- College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Catherine C Quatman-Yates
- Division of Occupational Therapy and Physical Therapy, Department of Physical Therapy, Cincinnati Children's Hospital Medical Center, The Ohio State University, Columbus, OH, United States.,Division of Physical Therapy, Sports Medicine Research Institute, and Chronic Brain Injury Program, Columbus, OH, United States
| | - Jason Hugentobler
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Shari L Wade
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Paul J Gubanich
- Division of Sports Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University College of Medicine, Cincinnati, OH, United States.,Department of Internal Medicine, University College of Medicine, Cincinnati, OH, United States
| | - Brad G Kurowski
- Division of Pediatric Rehabilitation Medicine, Departments of Pediatrics and Neurology and Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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37
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de Lima TA, Ferreira-Moraes R, Alves WMGDC, Alves TGG, Pimentel CP, Sousa EC, Abrahin O, Cortinhas-Alves EA. Resistance training reduces depressive symptoms in elderly people with Parkinson disease: A controlled randomized study. Scand J Med Sci Sports 2019; 29:1957-1967. [PMID: 31357229 DOI: 10.1111/sms.13528] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/04/2019] [Accepted: 07/26/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Depression affects up to 40% of individuals with Parkinson's disease (PD). PURPOSE To assess resistance training effects on the depressive symptoms of elderly PD patients. STUDY DESIGN A randomized control study. METHODS Thirty-three patients (aged ≥ 60 years) were randomly divided into two groups: (a) control group: n = 16 and (b) resistance training group (RTG): n = 17. All patients with Parkinson's disease (stage 1-3 on the Hoehn and Yahr scale). The RTG, in addition to maintaining their pharmacological treatments, performed 20 weeks of resistance training. The control group maintained their pharmacological treatments. Depressive symptoms, quality of life, unified Parkinson's Disease scale, and functional capacity were evaluated in both groups. RESULTS The RTG presented a significant reduction (P < .05) of depressive symptoms (pre = 17.9 ± 8 score; post = 10.3 ± 6 score; effect size: -0.48), improved quality of life (pre = 40.3 ± 21.1 score; post = 30.2 ± 16.8 score; effect size: -0.26), and improved UPDRS (pre = 64 ± 34.6 score; post = 49.1 ± 24.1 score; effect size: -0.24). No significant changes in the control group regarding depressive symptoms (pre = 18.7 ± 5.4 score; post = 19.4 ± 5.2 score; effect size: 0.07), quality of life (pre = 39 ± 16.1 score; post = 40.6 ± 15.6 score; effect size: 0.05), and UPDRS (pre = 61.1 ± 24.3 score; post = 64.9 ± 23.4 score; effect size: 0.08) after 20 weeks. CONCLUSION Resistance training reduces depressive symptoms and improves the quality of life and functionality of elderly with PD.
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Affiliation(s)
- Tiago Alencar de Lima
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil.,Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Renilson Ferreira-Moraes
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil.,Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Wilson Mateus Gomes da Costa Alves
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil.,Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Thiago Gonçalves Gibson Alves
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil.,Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Clebson Pantoja Pimentel
- Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Evitom Corrêa Sousa
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Odilon Abrahin
- Laboratório de Exercício Resistido e Saúde, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
| | - Erik Artur Cortinhas-Alves
- Laboratório de Bioquímica do Exercício, Centro de Ciências Biológicas e da Saúde III, Universidade do Estado do Pará, Belém, Brasil
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Abstract
Parkinson's disease is the second most common neurodegenerative disease with a prevalence rate of 1-2 per 1000 of the population worldwide. Pharmacological management is the mainstay of treatment. Despite optimal medication, motor impairment particularly balance and gait impairment persist leading to various degree of disability and reduced quality-of-life. The present review describes motor impairment including postural impairment, gait dysfunction, reduced muscle strength and aerobic capacity and falls. Physical therapy and complementary exercises have been proven to improve motor performance and functional mobility. Evidence on the efficacy of physical therapy and complementary exercises is presented in this review. These exercises include gait training with cues, gait training with treadmill, Nordic walking, brisk walking, balance training, virtual reality interventions, Tai Chi and dance. All these treatment interventions produce short-term beneficial effects and some interventions demonstrate long-term benefit. Gait training with treadmill enhance walking performance and the effects sustain for 3-6 months. Balance training improves balance, function and reduces fall rate, and these effects carry over to at least 12 months after training ended. Sustained Tai Chi for 6 months, dance therapy for 12 months, progressive resistive training for 24 months alleviates the PD motor symptoms, suggesting that they could slow down PD progression. Based on this evidence, individuals with PD are encouraged to sustain their training in order to improve/maintain their physical ability and to combat the progression of PD.
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Affiliation(s)
- Margaret K Y Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Irene S K Wong-Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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39
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Combs-Miller SA, Moore ES. Predictors of outcomes in exercisers with Parkinson disease: A two-year longitudinal cohort study. NeuroRehabilitation 2019; 44:425-432. [DOI: 10.3233/nre-182641] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Stephanie A. Combs-Miller
- University of Indianapolis, Krannert School of Physical Therapy, Interprofessional Health and Aging Studies, Indianapolis, IN, USA
| | - Elizabeth S. Moore
- University of Indianapolis, Krannert School of Physical Therapy, Interprofessional Health and Aging Studies, Indianapolis, IN, USA
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40
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Leal LC, Abrahin O, Rodrigues RP, da Silva MC, Araújo AP, de Sousa EC, Pimentel CP, Cortinhas-Alves EA. Low-volume resistance training improves the functional capacity of older individuals with Parkinson's disease. Geriatr Gerontol Int 2019; 19:635-640. [PMID: 31037806 DOI: 10.1111/ggi.13682] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/02/2019] [Accepted: 04/10/2019] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the effects of low-volume resistance training on the physical and functional capacity of older patients with Parkinson's disease. METHODS A total of 54 patients (aged ≥60 years) were randomly divided into two groups: (i) a control group comprising 13 men and 14 women; and (ii) a resistance training group with 14 men and 13 women. The resistance training group, in addition to maintaining their pharmacological treatments, carried out 6 months of resistance training twice a week, whereas the control group maintained their pharmacological treatments. Handgrip strength, flexibility, aerobic endurance, gait speed and balance were assessed in both groups. RESULTS After 6 months, patient functionality in the control group was reduced, whereas patients who carried out low training volumes showed significantly improved flexibility (Pre × Post: P = 0.008), aerobic resistance (Pre × Post: P = 0.006), gait speed (Pre × Post: P = 0.006) and balance (Pre × Post: P = 0.043). Significant improvement (P = 0.042) was also observed in right handgrip strength in the resistance training group. CONCLUSIONS The results of the present study showed that low-volume resistance training improves the physical capacity of older people with Parkinson's disease. Therefore, we suggest that resistance training be a central component in exercise programs for patients with Parkinson's disease. Geriatr Gerontol Int 2019; 19: 635-640.
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Affiliation(s)
- Leon Cp Leal
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil.,Department of Physical Education, Resistance Exercise and Health Laboratory, Pará State University, Belém, Brazil
| | - Odilon Abrahin
- Department of Physical Education, Resistance Exercise and Health Laboratory, Pará State University, Belém, Brazil
| | - Rejane P Rodrigues
- Department of Physical Education, Resistance Exercise and Health Laboratory, Pará State University, Belém, Brazil
| | - Maria Cr da Silva
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil
| | - Ana Pm Araújo
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil
| | - Evitom C de Sousa
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil.,Department of Physical Education, Resistance Exercise and Health Laboratory, Pará State University, Belém, Brazil
| | - Clebson P Pimentel
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil
| | - Erik A Cortinhas-Alves
- Department of Physical Education, Exercise Biochemistry Laboratory, Pará State University, Belém, Brazil.,Department of Physical Education, Resistance Exercise and Health Laboratory, Pará State University, Belém, Brazil
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41
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Oreel TH, Borsboom D, Epskamp S, Hartog ID, Netjes JE, Nieuwkerk PT, Henriques JP, Scherer-Rath M, van Laarhoven HW, Sprangers MA. The dynamics in health-related quality of life of patients with stable coronary artery disease were revealed: a network analysis. J Clin Epidemiol 2019; 107:116-123. [DOI: 10.1016/j.jclinepi.2018.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/12/2018] [Accepted: 11/27/2018] [Indexed: 12/20/2022]
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42
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Al-Jarrah MD, Erekat NS. Treadmill exercise training could attenuate the upregulation of Interleukin-1 beta and tumor necrosis factor alpha in the skeletal muscle of mouse model of chronic/progressive Parkinson disease. NeuroRehabilitation 2019; 43:501-507. [DOI: 10.3233/nre-182492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Muhammed D. Al-Jarrah
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour S. Erekat
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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43
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Lai B, Bond K, Kim Y, Barstow B, Jovanov E, Bickel CS. Exploring the uptake and implementation of tele-monitored home-exercise programmes in adults with Parkinson's disease: A mixed-methods pilot study. J Telemed Telecare 2018; 26:53-63. [PMID: 30134777 DOI: 10.1177/1357633x18794315] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with Parkinson's disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants' perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson's disease. METHODS Twenty adults with Parkinson's disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach's supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. RESULTS Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. CONCLUSION Findings demonstrate that adults with Parkinson's disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.
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Affiliation(s)
- Byron Lai
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Kristina Bond
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Yumi Kim
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Beth Barstow
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - Emil Jovanov
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
| | - C Scott Bickel
- Electrical & Computer Engineering University of Alabama at Birmingham, USA
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44
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Stone WJ, Stevens SL, Fuller DK, Caputo JL. Strength and Step Activity After Eccentric Resistance Training in Those With Incomplete Spinal Cord Injuries. Top Spinal Cord Inj Rehabil 2018; 24:343-352. [PMID: 30459497 PMCID: PMC6241222 DOI: 10.1310/sci17-00052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Individuals with spinal cord injuries (SCIs) often experience general weakness in the lower extremities that undermines daily step activity. Objective: To investigate the efficacy of eccentrically biased resistance training on lower extremity strength and physical activity of individuals with spinal injuries. Methods: Individuals with long-standing incomplete SCIs (N = 11) capable of completing a 10-meter walk assessment were included. All participants who completed the familiarization period finished the training. Individuals trained two times per week for 12 weeks on a lower body eccentric resistance training machine. It was hypothesized that the outcome variables (eccentric strength, isometric strength, and daily step physical activity) would improve as a result of the training intervention. Results: Eccentric strength [F(1.27, 12.71) = 8.42, MSE = 1738.35, H-F p = .009] and isometric strength [F(1.97, 19.77) = 7.10, MSE = 11.29, H-F p = .005] improved as a result of the training while daily step activity remained unchanged [F(2.00, 18.00) = 2.73, MSE = 216,836.78, H-F p = .092]. Conclusions: Eccentric resistance training improves eccentric and isometric strength. These physiological adaptations may translate to improved gait mechanics, but further study is required to identify this potential crossover effect.
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Affiliation(s)
- Whitley J. Stone
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, Missouri
| | - Sandra L. Stevens
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, Tennessee
| | - Dana K. Fuller
- Department of Psychology, Middle Tennessee State University, Murfreesboro, Tennessee
| | - Jennifer L. Caputo
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, Tennessee
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45
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Alomari MA, Khalil H, Khabour OF, Wood R. Cardiovascular function is related to neuromuscular performance in Parkinson's disease. Neurodegener Dis Manag 2018; 8:243-255. [DOI: 10.2217/nmt-2017-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The current study examined the relationship of handgrip, leg and arm neuromuscular performance with cardiovascular function in patients with Parkinson's disease (PD). Materials & methods: Blood pressure, vascular measures and handgrip, shoulder and leg neuromuscular performance were obtained in PD persons and healthy controls. Results: The data reveal that muscular and cardiovascular functions are altered (p < 0.05) in PD. Most importantly, regression indicates that altered central and peripheral cardiovascular function measures demonstrate a moderately strong relationship (p < 0.05) with deteriorated handgrip (R2-range = 0.196–0.257), shoulder (R2-range = 0.146–0.289) and leg (R2-range = 0.19–0.35) neuromuscular performance in PD. Conclusion: These results suggest that deteriorated neuromuscular performance and cardiovascular function are related in PD. Future studies are needed to determine that developing muscular strength might contribute to improving cardiovascular function in PD.
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Affiliation(s)
- Mahmoud A Alomari
- Department of Rehabilitation Sciences, Division of Physical Therapy, Jordan University of Science & Technology, Irbid, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science & Technology, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Science, Jordan University of Science & Technology, Irbid, Jordan
| | - Robert Wood
- Department of Kinesiology & Dance, New Mexico State University, Las Cruces, NM, 88003, USA
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Al-Jarrah MD, Erekat NS. Parkinson disease-induced upregulation of apoptotic mediators could be attenuated in the skeletal muscle following chronic exercise training. NeuroRehabilitation 2018; 41:823-830. [PMID: 29254117 DOI: 10.3233/nre-172196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND We have shown elevated levels of p53 and active caspase-3 in gastrocnemius skeletal muscle with Parkinson's disease (PD). The main aim of this study is to examine the impact of endurance exercise training on the expression of p53 and active caspase-3 in the skeletal muscle of mouse with induced Parkinsonism. METHODS Sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD) groups were formed; each consisting of 10 randomly selected normal albino mice. Chronic Parkinson disease was induced in the SPD and EPD animals using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the gastrocnemius muscle in each animal group. RESULTS Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD gastrocnemius skeletal muscle following endurance exercise training. CONCLUSION Our present data suggest that chronic exercise training reduced Parkinson disease-induced upregulation of p53 and active caspase-3 in gastrocnemius skeletal muscle. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD skeletal muscle abnormalities.
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Affiliation(s)
- Muhammed D Al-Jarrah
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, JUST, Irbid, Jordan
| | - Nour S Erekat
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
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47
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Afshari M, Yang A, Bega D. Motivators and Barriers to Exercise in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2018; 7:703-711. [PMID: 29103050 DOI: 10.3233/jpd-171173] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite evidence for the benefits of exercise in Parkinson's disease (PD), many patients remain sedentary for undefined reasons. OBJECTIVE To compare exercise habits, perceptions about exercise, and barriers to exercise in 'low' (<3 h/week) and 'high' (≥3 h/week) exercisers with PD. METHODS A 48-item survey was administered to PD patients at an outpatient academic center. Chi-squared tests were used to compare the percentage differences between low- and high-exercisers with two-sided tests and a significant level of 0.05. RESULTS 243 surveys were collected over three months; 28 were excluded due to incomplete data, leaving 215 to be analyzed. 49.3% reported 'low'-exercise and 50.7% reported 'high'-exercise. High-exercisers participated in higher intensity exercise regimens (83.4% versus 32.1%, p≤0.001). High-exercisers were more likely to start exercising after being diagnosed (54.2% versus 27.8%, p < 0.001), whereas low-exercisers were more likely to reduce their amount of exercise (40.2% versus 15.9%, p < 0.001). Low-exercisers required more motivating factors. Both groups benefited from having a significant other or a personal trainer motivate them, and both were more likely to exercise if their neurologist encouraged them. Low-exercisers reported twice as many barriers as high-exercisers (p = 0.001). Barriers that were significantly more common in low-exercisers were: lacking someone to motivate them (33.3% versus 10.5%, p < 0.001), fatigue (20.8% versus 15.2%, p = 0.005), and depression (16.7% versus 7.6%, p = 0.045). CONCLUSIONS There are significant differences between people with PD who exercise regularly and those who do not in terms of motivators and barriers. These findings should be considered when tailoring recommendations for PD patients to encourage exercise, and in designing future interventions.
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Affiliation(s)
- Mitra Afshari
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Neurology, University of California, San Francisco, CA, USA
| | - Amy Yang
- Biostatics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Danny Bega
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Ferrazzoli D, Ortelli P, Madeo G, Giladi N, Petzinger GM, Frazzitta G. Basal ganglia and beyond: The interplay between motor and cognitive aspects in Parkinson's disease rehabilitation. Neurosci Biobehav Rev 2018; 90:294-308. [PMID: 29733882 DOI: 10.1016/j.neubiorev.2018.05.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/28/2018] [Accepted: 05/03/2018] [Indexed: 02/08/2023]
Abstract
Parkinson's disease (PD) is characterized by motor and cognitive dysfunctions, affecting the motor behaviour. We summarize evidence that the interplay between motor and cognitive approaches is crucial in PD rehabilitation. Rehabilitation is complementary to pharmacological therapy and effective in reducing the PD disturbances, probably acting by inducing neuroplastic effects. The motor behaviour results from a complex integration between cortical and subcortical areas, underlying the motor, cognitive and motivational aspects of movement. The close interplay amongst these areas makes possible to learn, control and express habitual-automatic actions, which are dysfunctional in PD. The physiopathology of PD could be considered the base for the development of effective rehabilitation treatments. As the volitional action control is spared in early-medium stages of disease, rehabilitative approaches engaging cognition permit to achieve motor benefits and appear to be the most effective for PD. We will point out data supporting the relevance of targeting both motor and cognitive aspects in PD rehabilitation. Finally, we will discuss the role of cognitive engagement in motor rehabilitation for PD.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Via Pelascini, 3, Gravedona ed Uniti, 22015, Como, Italy.
| | - Paola Ortelli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Via Pelascini, 3, Gravedona ed Uniti, 22015, Como, Italy.
| | - Graziella Madeo
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Via Pelascini, 3, Gravedona ed Uniti, 22015, Como, Italy.
| | - Nir Giladi
- Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Centre, Sieratzki Chair in Neurology, Sackler School of Medicine, Sagol School for Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
| | - Giselle M Petzinger
- Department of Neurology, University of Southern California, Los Angeles, CA, 90033, United States; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, 90033, United States.
| | - Giuseppe Frazzitta
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Via Pelascini, 3, Gravedona ed Uniti, 22015, Como, Italy.
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49
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Oliveira de Carvalho A, Filho ASS, Murillo-Rodriguez E, Rocha NB, Carta MG, Machado S. Physical Exercise For Parkinson's Disease: Clinical And Experimental Evidence. Clin Pract Epidemiol Ment Health 2018; 14:89-98. [PMID: 29785199 PMCID: PMC5897963 DOI: 10.2174/1745017901814010089] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/23/2018] [Accepted: 03/08/2018] [Indexed: 01/03/2023]
Abstract
Background: National projections about the increase in the elderly population over 60 years bring with it an increase in the number of people affected by Parkinson's Disease (PD), making it an important public health problem. Therefore, the establishment of effective strategies for intervention in people with PD needs to be more clearly investigated. Objective:
The study aimed to report the effectiveness of exercise on functional capacity and neurobiological mechanisms in people with PD. Methods: This study is a critical review of the literature. Results: The progressive death of dopaminergic neurons in the substantia nigra is described as one of the main physiological mechanisms manifested before PD, directly interfering with motor behavior. However, PD is not only related to motor symptoms, but also to cognitive, autonomic, and mood impairments. Such effects may be attenuated by pharmacological influence, but also evidence suggests that the implementation of regular physical exercise programs may exhibit potential benefits over PD. The synthesis and expression of monoaminergic neurotransmitters can act positively on motor disorders, as well as directly or indirectly influence the neuronal plasticity of the brain, restoring neuronal pathways previously affected. Conclusion: Physical exercise contributes effectively to the treatment of PD, and can play a preventive and maintenance role of physical fitness and mental health.
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Affiliation(s)
- Alessandro Oliveira de Carvalho
- Institute of Psichiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.,Castelo Branco University, Rio de Janeiro, Brazil
| | - Alberto Souza Sá Filho
- Institute of Psichiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.,Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil.,Physical Education Department, Faculty of Unidas de Campinas (FacUNICAMPS), Goiânia, GO, Brazil
| | - Eric Murillo-Rodriguez
- Politechnique Institute of Porto, Healthy School, Porto, Portugal.,Intercontinental Neuroscience Research Group, Yucatán, Mexico
| | - Nuno Barbosa Rocha
- Politechnique Institute of Porto, Healthy School, Porto, Portugal.,Intercontinental Neuroscience Research Group, Yucatán, Mexico
| | - Mauro Giovanni Carta
- Laboratorio de Neurociencias Moleculares e Integrativas Escuela de Medicina, División Ciencias de la Salud Universidad Anáhuac Mayab, Yucatán, Mexico
| | - Sergio Machado
- Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil.,Laboratory of Panic and Respiration, Institute of Psichiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil.,Intercontinental Neuroscience Research Group, Yucatán, Mexico
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50
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Silva-Batista C, Corcos DM, Barroso R, David FJ, Kanegusuku H, Forjaz C, DE Mello MT, Roschel H, Tricoli V, Ugrinowitsch C. Instability Resistance Training Improves Neuromuscular Outcome in Parkinson's Disease. Med Sci Sports Exerc 2017; 49:652-660. [PMID: 27851668 DOI: 10.1249/mss.0000000000001159] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study compared the effects of resistance training (RT) and RT with instability (RTI) on neuromuscular and total training volume (TTV) outcomes obtained as part of the Instability Resistance Training Trial in Parkinson's disease. It also used a linear multiple regression (forward stepwise method) to identify the contribution of neuromuscular outcomes to previously published improvements in the timed-up-and-go test and the Unified Parkinson's Disease Rating Scale, motor subscale score. METHODS Thirty-nine patients with moderate to severe Parkinson's disease were randomly assigned to three groups: control (C), RT, and RTI. RT and RTI groups performed resistance exercises twice a week for 12 wk, and only the RTI group used unstable devices to perform resistance exercises. The following neuromuscular outcomes were assessed: quadriceps muscle cross-sectional area, root mean square and mean spike frequency of electromyographic signal, peak torque, rate of torque development, and half relaxation time of the knee extensors and plantarflexors during maximum ballistic voluntary isometric contractions. TTV was calculated for lower limb exercises. RESULTS From pre- to posttraining, RTI improved all of the neuromuscular outcomes (P < 0.05) except half relaxation time of the knee extensors (P = 0.068), despite the lower TTV than RT (P < 0.05). RTI was more effective than RT in increasing the root mean square values of vastus medialis, mean spike frequency of gastrocnemius medialis, and rate of torque development of plantarflexors (P < 0.05). Stepwise regression identified the changes in mean spike frequency of gastrocnemius medialis as the best predictor of improvements in timed-up-and-go test (R = 0.58, P = 0.002) and on-medication Unified Parkinson's Disease Rating Scale, motor subscale scores (R = 0.40, P = 0.020). CONCLUSION RTI optimizes neuromuscular adaptations, which partially explains mobility and motor sign improvements in patients with Parkinson's disease.
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Affiliation(s)
- Carla Silva-Batista
- 1Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, BRAZIL; 2Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL; 3Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; 4Department of Sport Sciences, State University of Campinas, Campinas, BRAZIL; 5Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, BRAZIL; and 6Center for Psychobiology and Exercise Studies, Federal University of São Paulo, São Paulo, BRAZIL
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