Physical Therapy for at Least 6 Months Improves Motor Symptoms in Parkinson’s Patients: A Meta-Analysis

Effect of group virtual exercise on people with Parkinson's disease: A randomized controlled trial

BACKGROUND

For people with Parkinson's disease (PwPD), high-intensity exercise in individual or group format can improve function and quality of life (QoL). Individualized virtual exercise programs have been effective for people with PD, but the feasibility and impact of group exercise in the virtual format has not been investigated.

PURPOSE

To compare the effect of individual and group virtual exercise on functional mobility and QoL for PwPD.

METHODS

Twenty PwPD were randomized to individualized (n = 10) or group (n = 10) virtual exercise 2 times per week for 8 weeks. Exercises were multi-dimensional, and intensity was monitored with a wrist-worn heart rate (HR) monitor. Outcomes were assessed before and after the program, including standing balance, gait speed, gait endurance, motor function, QoL, and self-efficacy. Within-and between-group changes were analyzed using a mixed model analysis of variance (ANOVA) and nonparametric tests were used for analysis.

RESULTS

Participants attended over 75% of scheduled sessions. Within-group analysis showed statistically significant improvements in Five Times Sit-to-Stand (p < .01), mini-BESTest (p = .03), comfortable (p < .01) and fast gait speeds (p = .02), and gait endurance (p < .01) with large effect sizes (partial eta squared > 0.25). There were no statistically significant differences between groups on any outcomes (p > .09). In more than 70% of sessions, participants reached an exercise intensity ≥ 65% HR maximum.

CONCLUSION

This high-intensity, virtual exercise program was safe and effective at improving balance and functional mobility for community-dwelling PwPD in individual and group format. Virtual exercise programs, either in an individual or group format, can increase access to high-quality programs for PwPD.

Medical, surgical, and physical treatments for Parkinson's disease

Although dopamine replacement therapy remains a core component of Parkinson's disease treatment, the onset of motor fluctuations and dyskinetic movements might require a range of medical and surgical approaches from a multidisciplinary team, and important new approaches in the delivery of dopamine replacement are becoming available. The more challenging, wide range of non-motor symptoms can also have a major impact on the quality of life of a patient with Parkinson's disease, and requires careful multidisciplinary management using evidence-based knowledge, as well as appropriately tailored strategies according to the individual patient's needs. Disease-modifying therapies are urgently needed to prevent the development of the most disabling refractory symptoms, including gait and balance difficulties, cognitive impairment and dementia, and speech and swallowing impairments. In the third paper in this Series, we present the latest evidence supporting the optimal treatment of Parkinson's disease, and describe an expert approach to many aspects of treatment choice where an evidence base is insufficient.