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Palmieri JL, Jones L, Schenkman M, Deutsch JE. Bicycling for Rehabilitation of Persons With Parkinson Disease: A Scoping Review. J Neurol Phys Ther 2024; 48:125-139. [PMID: 38693613 PMCID: PMC11196205 DOI: 10.1097/npt.0000000000000466] [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] [Indexed: 05/03/2024]
Abstract
BACKGROUND AND PURPOSE Exercise is beneficial for persons with Parkinson disease (PwPD). The overarching purpose of this scoping review was to provide guidance to clinicians and scientists regarding current evidence for bicycling exercise for PwPD. A scoping review was conducted to examine the heterogeneous literature on stationary bicycling for PwPD to reduce motor symptoms and body function structure impairments, improve activities and motor performance, and reduce disease severity. METHODS The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. PubMed, CINAHL, and PEDro were searched from inception to January 23, 2023. Articles reporting original data on relevant outcome measures were included. Search results were screened and articles were extracted. Data were analyzed quantitatively with percentages of significant and clinically meaningful findings and qualitatively to extract themes. RESULTS Bicycling was categorized using bicycle types (assisted, nonassisted) and training modes (speed, aerobic, force). A high percentage of the 34 studies showed statistical significance for reducing motor symptoms (83%), body function structure impairments (78%), disease severity (82%), and improving activities (gait 72%, balance 60%). Clinically meaningful findings were achieved in 71% of the studies for reduction in disease severity and in 50% for improving gait. DISCUSSION AND CONCLUSIONS The literature on bicycling for PwPD has evolved from speed to aerobic studies. The terminology describing types of bicycling was simplified. Of all the outcomes reported, reduction of disease severity achieved the highest frequency of clinical meaningful improvements. Bicycling was comparable with other forms of aerobic training for walking speed and endurance. Opportunities for translation to practice and research are presented.
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Affiliation(s)
- John L Palmieri
- Rivers Lab, Department of Rehabilitation & Movement Sciences (J.L.P., L.J., J.E.D.), Rutgers School of Health Professions, Newark, New Jersey; Rutgers School of Graduate Studies (J.L.P., J.E.D.), New Brunswick, New Jersey; Rutgers New Jersey Medical School (J.L.P.), Newark; and University of Colorado Anschutz Medical Campus (M.S.), Aurora
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Daniels RJ, Grenet D, Knight CA. Impaired performance of rapid grip in people with Parkinson's disease and motor segmentation. Hum Mov Sci 2024; 95:103201. [PMID: 38507858 DOI: 10.1016/j.humov.2024.103201] [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] [Received: 08/23/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
Bradykinesia, or slow movement, is a defining symptom of Parkinson's disease (PD), but the underlying neuromechanical deficits that lead to this slowness remain unclear. People with PD often have impaired rates of motor output accompanied by disruptions in neuromuscular excitation, causing abnormal, segmented, force-time curves. Previous investigations using single-joint models indicate that agonist electromyogram (EMG) silent periods cause motor segmentation. It is unknown whether motor segmentation is evident in more anatomically complex and ecologically important tasks, such as handgrip tasks. Aim 1 was to determine how handgrip rates of force change compare between people with PD and healthy young and older adults. Aim 2 was to determine whether motor segmentation is present in handgrip force and EMG measures in people with PD. Subjects performed rapid isometric handgrip pulses to 20-60% of their maximal voluntary contraction force while EMG was collected from the grip flexors and extensors. Dependent variables included the time to 90% peak force, the peak rate of force development, the duration above 90% of peak force, the number of segments in the force-time curve, the number of EMG bursts, time to relaxation from 90% of peak force, and the peak rate of force relaxation. People with PD had longer durations and lower rates of force change than young and older adults. Six of 22 people with PD had motor segmentation. People with PD had more EMG bursts compared to healthy adults and the number of EMG bursts covaried with the number of segments. Thus, control of rapid movement in Parkinson's disease can be studied using isometric handgrip. People with PD have impaired rate control compared to healthy adults and motor segmentation can be studied in handgrip.
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Affiliation(s)
- Rebecca J Daniels
- Department of Kinesiology and Applied Physiology, University of Delaware, 211AC The Tower at STAR, 100 Discovery Blvd, Newark, DE, USA.
| | - David Grenet
- Department of Psychology, Concordia University, 7141 Sherbrooke St. W, Montreal, QC H4B 1R6, Canada.
| | - Christopher A Knight
- Department of Kinesiology and Applied Physiology, University of Delaware, 344 The Tower at STAR, 100 Discovery Blvd, Newark, DE, USA.
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Harpham C, Gunn H, Marsden J, Connolly L. The feasibility, safety, physiological and clinical effects of high-intensity interval training for people with Parkinson's: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:497-523. [PMID: 36607555 DOI: 10.1007/s40520-022-02330-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Exercise is important for people with Parkinson's (PwP), with high-intensity interval training (HIIT) proposed as a feasible and effective exercise modality. However, no literature synthesis for PwP has been undertaken. OBJECTIVES To evaluate the feasibility, safety, physiological and clinical effects of HIIT for PwP. METHODS Systematic searches of Medline, Embase, CINAHL, Web of Science, and Google Scholar were undertaken. Studies that included ≥ 2 weeks of HIIT for PwP and reported sufficient detail for full quality assessment were eligible. Quality was assessed with the TESTEX scale or the Downs and Black tool according to study design. Feasibility and safety data, physiological and clinical outcomes were extracted. Meta-analyses explored the pooled effects of HIIT on VO2peak/max compared to moderate-intensity continuous exercise (MICE) and usual care. RESULTS Eleven articles were identified (seven controlled/comparator studies and four single group) including 117 HIIT participants predominantly of mild-to-moderate disease severity. HIIT programmes were professionally supervised and between 6 weeks and 24 months. Overall, study quality was deemed to be moderate to good. Following screening, nine studies reported 90-100% programme completion; however, only one was > 12 weeks in duration. Adverse events were uncommon. HIIT improved VO2peak/max compared to usual care, but not to MICE. Increased brain-derived neurotrophic factor (BDNF) and improved motor symptoms were also reported. CONCLUSION Up to 12 weeks of supervised HIIT appears to be feasible and safe for some people with mild-to-moderate disease severity. HIIT improves cardiorespiratory fitness and may increase BDNF and improve motor symptoms in PwP. Future studies should explore safe ways to facilitate access and long-term adherence.
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Affiliation(s)
- Conrad Harpham
- School of Health Professions, University of Plymouth, Devon, UK.
| | - Hilary Gunn
- School of Health Professions, University of Plymouth, Devon, UK
| | | | - Luke Connolly
- School of Health Professions, University of Plymouth, Devon, UK
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Tiihonen M, Westner BU, Butz M, Dalal SS. Parkinson's disease patients benefit from bicycling - a systematic review and meta-analysis. NPJ Parkinsons Dis 2021; 7:86. [PMID: 34561455 PMCID: PMC8463550 DOI: 10.1038/s41531-021-00222-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/10/2021] [Indexed: 12/17/2022] Open
Abstract
Many Parkinson's disease (PD) patients are able to ride a bicycle despite being severely compromised by gait disturbances up to freezing of gait. This review [PROSPERO CRD 42019137386] aimed to find out, which PD-related symptoms improve from bicycling, and which type of bicycling exercise would be most beneficial. Following a systematic database literature search, peer-reviewed studies with randomized control trials (RCT) and with non-randomized trials (NRCT) investigating the interventional effects of bicycling on PD patients were included. A quality analysis addressing reporting, design and possible bias of the studies, as well as a publication bias test was done. Out of 202 references, 22 eligible studies with 505 patients were analysed. An inverse variance-based analysis revealed that primary measures, defined as motor outcomes, benefitted from bicycling significantly more than cognitive measures. Additionally, secondary measures of balance, walking speed and capacity, and the PDQ-39 ratings improved with bicycling. The interventions varied in durations, intensities and target cadences. Conclusively, bicycling is particularly beneficial for the motor performance of PD patients, improving crucial features of gait. Furthermore, our findings suggest that bicycling improves the overall quality-of-life of PD patients.
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Affiliation(s)
- Marianne Tiihonen
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music Aarhus/Aalborg, Aarhus, Denmark.
| | - Britta U Westner
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Markus Butz
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sarang S Dalal
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Uygur M, Dinzeo TJ. Acceptability and effectiveness of a novel cycling training on the parkinsonian motor and psychiatric symptoms in individuals with schizophrenia: A pilot study. Complement Ther Med 2021; 61:102760. [PMID: 34274448 DOI: 10.1016/j.ctim.2021.102760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 05/31/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent evidence suggests that high-speed, low-resistance stationary cycling training (termed as speedwork) alleviates motor symptoms in people with Parkinson's disease. Similar motor symptoms commonly exist in people with schizophrenia (Sz); however, they were neglected in the previous literature. OBJECTIVES Our objective was to evaluate if speedwork could also be used as a strategy to improve parkinsonian motor symptoms in Sz. We aimed 1) to evaluate the adherence and acceptability of speedwork in Sz, 2) to assess test-retest reliability of the motor assessments that are novel to Sz research, 3) to evaluate the effectiveness of speedwork in improving parkinsonian motor, and 4) psychiatric symptoms in Sz. METHODS Ten Sz outpatients with concurrent parkinsonian motor symptoms completed 12 sessions (2 sessions/week) of speedwork training. Participants were evaluated on motor functioning and psychiatric symptom severity twice before (double baseline) and twice after (post-completion and 6-wk follow-up) the speedwork training. RESULTS The adherence to speedwork was high (92 %) and the results of exercise acceptability questionnaire indicate participants found various domains of exercise highly acceptable (overall average 4.49/5). There were improvements in various domains of motor symptoms including, walking speed, functional mobility, static and dynamic balance, and upper extremity motor function after the completion of training (all p < 0.025), with many of these improvements remaining at the 6-wk follow-up. Moreover, there was evidence for improvement in positive psychotic symptoms after the completion of speedwork (p < 0.025). CONCLUSIONS Speedwork training could be an acceptable and effective strategy to improve motor and psychiatric symptoms in Sz.
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Affiliation(s)
- Mehmet Uygur
- Rowan University, Department of Health and Exercise Science, 201 Mullica Hill Road, Glassboro, NJ, United States.
| | - Thomas J Dinzeo
- Rowan University, Department of Psychology, 201 Mullica Hill Road, Glassboro, NJ, United States
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McKee KE, Johnson RK, Chan J, Wills A. Implementation of high-cadence cycling for Parkinson's disease in the community setting: A pragmatic feasibility study. Brain Behav 2021; 11:e02053. [PMID: 33559973 PMCID: PMC8035480 DOI: 10.1002/brb3.2053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Efficacy of exercise to improve motor symptoms in Parkinson's Disease (PD) has been established in multiple clinical trials. The Pedaling for Parkinson's ™ (PFP) program is an existing community-based cycling intervention for individuals with PD. Although PFP program design was informed by in-laboratory efficacy studies, the implementation and effectiveness of the program in the community have not been studied. This feasibility study explores implementation and effectiveness of PFP utilizing the RE-AIM implementation evaluation framework. METHODS This was a pragmatic open-label multi-site study. First, community-based gyms were recruited to implement the PFP protocol with enhanced multi-modal training and support. Second individuals with Hoehn and Yahr stage I-III idiopathic PD were recruited to participate. Reach, effectiveness (both clinical scores and participant enjoyment), adoption, implementation (gym and participant fidelity, cost), and maintenance (sustainability) were assessed. Tracking of adverse events was used to monitor safety of the intervention. RESULTS Reach was moderate: 59% of participants who expressed interest opted to participate. No effectiveness outcomes demonstrated a significant change from pre to post; however, the program was highly enjoyable (96% of participants who started classes enjoyed the program and 87% wished to continue). Adoption was poor with only four out of 34 gyms participating. The program had poor gym and moderate participant fidelity. The program was maintained for at least 4 months across all sites. The program was implemented safely. CONCLUSION Barriers to implementation of nonpharmacologic interventions such as exercise protocols limit reach and availability of these interventions to patients. Pilot studies are needed to inform and direct further implementation efforts. Our pilot study suggests the PFP cycling intervention should be modified prior to attempts at widespread implementation. Modifications made by gyms in this study suggest adaptations to the protocol that may increase fidelity and effectiveness.
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Affiliation(s)
- Kathleen E. McKee
- Department of NeurologyMassachusetts General HospitalBostonMAUSA
- Henry and Allison McCance Center for Brain HealthMassachusetts General HospitalBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
- Present address:
Neurosciences Clinical ProgramIntermountain HealthcareMurrayUTUSA
| | - Remy K. Johnson
- Department of NeurologyMassachusetts General HospitalBostonMAUSA
| | - James Chan
- Department of BiostatisticsMassachusetts General HospitalBostonMAUSA
| | - Anne‐Marie Wills
- Department of NeurologyMassachusetts General HospitalBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
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Passos-Monteiro E, Peyré-Tartaruga LA, Zanardi APJ, da Silva ES, Jimenez-Reyes P, Morin JB, Pagnussat AS. Sprint exercise for subjects with mild-to-moderate Parkinson's disease: Feasibility and biomechanical outputs. Clin Biomech (Bristol, Avon) 2020; 72:69-76. [PMID: 31838213 DOI: 10.1016/j.clinbiomech.2019.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 10/28/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND High-intensity training, a still unexplored exercise for individuals with Parkinson's disease, is positively related with increased functionality and aerobic profile in healthy individuals. The aim of this work was to evaluate the feasibility, safety, and acceptance of sprint running in individuals with mild-to-moderate Parkinson's. Additionally, we compared sprint biomechanical outputs of force, velocity and power between individuals with Parkinson's disease and healthy. METHODS Physically trained subjects with Parkinson's, men, (n = 16, 64:9.01 years, stage between 1 and 3 in the Hoehn and Yahr, 16.8:7.1 at Unified Parkinson's disease Rating Scales, and control group (n = 21, 65:9.27 years) performed 20 m sprint sessions. We analyzed the self-reported satisfaction and acceptance using a self-administered questionnaire, and the sprint biomechanics and performance based on high-speed video recordings. FINDINGS All participants completed the tests with high feasibility, acceptability and satisfaction scores. The sprint maximal force and maximal power outputs were higher in Parkinson's disease. Conversely, control group showed higher mechanical effectiveness values. Interestingly, no difference in velocity capabilities and overall 20-m sprint performance was observed between groups, possibly explained by different mechanical strategies in both groups over the sprint accelerations. Linear regression analyses showed that physical qualities are predictors of mechanical effectiveness, and mechanical variables are important determinants of sprint performance on Parkinson's disease. INTERPRETATION Sprint is a feasible exercise for people with mild-to-moderate Parkinson's disease. Even though differences in physical qualities and mechanical effectiveness exist between subjects with Parkinson's disease and healthy, there is no overall substantial impact on sprint running performance.
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Affiliation(s)
- Elren Passos-Monteiro
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil; Laboratory of Locomotion PhysioMecanics, Faculty of Physical Education, Universidade Federal do Pará (UFPA), Brazil
| | | | - Ana P J Zanardi
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil
| | - Edson S da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | - Aline S Pagnussat
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
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Hunt AP, Minett GM, Gibson OR, Kerr GK, Stewart IB. Could Heat Therapy Be an Effective Treatment for Alzheimer's and Parkinson's Diseases? A Narrative Review. Front Physiol 2020; 10:1556. [PMID: 31998141 PMCID: PMC6965159 DOI: 10.3389/fphys.2019.01556] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022] Open
Abstract
Neurodegenerative diseases involve the progressive deterioration of structures within the central nervous system responsible for motor control, cognition, and autonomic function. Alzheimer's disease and Parkinson's disease are among the most common neurodegenerative disease and have an increasing prevalence over the age of 50. Central in the pathophysiology of these neurodegenerative diseases is the loss of protein homeostasis, resulting in misfolding and aggregation of damaged proteins. An element of the protein homeostasis network that prevents the dysregulation associated with neurodegeneration is the role of molecular chaperones. Heat shock proteins (HSPs) are chaperones that regulate the aggregation and disaggregation of proteins in intracellular and extracellular spaces, and evidence supports their protective effect against protein aggregation common to neurodegenerative diseases. Consequently, upregulation of HSPs, such as HSP70, may be a target for therapeutic intervention for protection against neurodegeneration. A novel therapeutic intervention to increase the expression of HSP may be found in heat therapy and/or heat acclimation. In healthy populations, these interventions have been shown to increase HSP expression. Elevated HSP may have central therapeutic effects, preventing or reducing the toxicity of protein aggregation, and/or peripherally by enhancing neuromuscular function. Broader physiological responses to heat therapy have also been identified and include improvements in muscle function, cerebral blood flow, and markers of metabolic health. These outcomes may also have a significant benefit for people with neurodegenerative disease. While there is limited research into body warming in patient populations, regular passive heating (sauna bathing) has been associated with a reduced risk of developing neurodegenerative disease. Therefore, the emerging evidence is compelling and warrants further investigation of the potential benefits of heat acclimation and passive heat therapy for sufferers of neurodegenerative diseases.
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Affiliation(s)
- Andrew P. Hunt
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Geoffrey M. Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Graham K. Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ian B. Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Vaartio-Rajalin H, Rauhala A, Fagerström L. Person-centered home-based rehabilitation for persons with Parkinson's disease: A scoping review. Int J Nurs Stud 2019; 99:103395. [PMID: 31525645 DOI: 10.1016/j.ijnurstu.2019.103395] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Due to vague, initial symptoms, persons with Parkinson's disease (PD) usually receive a definitive diagnosis after a prolonged period of time. At the time of diagnosis, they have already experienced limitations in activities of daily living and quality of life and are thus in need of immediate rehabilitation. OBJECTIVE To describe the existing knowledge on the rehabilitation of persons with PD suitable to a home environment and to describe the person-centeredness, interprofessionality and clinical effectiveness of existing rehabilitation activities. SOURCES OF EVIDENCE 67 full-text papers from the EBSCO, CINAHL, Medline, Google and Google Scholar databases, published in English, Swedish or Finnish between January 2010 and October 2018, were charted (type of rehabilitation, sample, instrumentation, reported effects) and summarized. RESULTS Rehabilitation through physical activities still appears to be the most common form of rehabilitation, varying from walking to individually tailored exercise programs. The majority of physical rehabilitation activities were conducted outside the home even though they were suitable for a home setting. Physical activities not only improved several physical outcomes but also quality of life, well-being and activities of daily living functions, especially when digital devices were used. Cognitive and psychosocial rehabilitation were much less researched but seen to be an emerging area of research. The focus of rehabilitation seems to lie on persons with PD, not their near-ones. The majority of interventions were planned without discussing in advance with the persons with PD about their preferences, needs or values. Very few interventions were individually tailored or conducted in a home setting, and many studies included patient-recorded outcome measures, but only as secondary to clinical measures. Only a few studies focused on an interprofessional approach to PD rehabilitation, despite the approach being found effective in regard to quality of life for persons with PD. CONCLUSIONS There appears to be a focus on physical outcomes and symptom management in the rehabilitation of persons with PD, even though cognitive and psychosocial well-being are often explored as secondary outcomes. Very few rehabilitation interventions were planned with persons or conducted in a home setting, and no interventions were seen that included near-ones. The majority of interventions were planned without the involvement of persons with PD. Still, many of the studies included patient-recorded outcome measures. Digital devices that assist in physical rehabilitation and an interprofessional approach to rehabilitation yield positive clinical outcomes, which in turn promotes a person-centered and holistic approach to rehabilitation.
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Affiliation(s)
- Heli Vaartio-Rajalin
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Nursing Program, Novia University of Applied Sciences, Henriksgatan 7, 20500, Åbo, Finland.
| | - Auvo Rauhala
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Vaasa Central Hospital, Sandviksgatan 2-4, 65100, Vasa, Finland
| | - Lisbeth Fagerström
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Faculty of Health and Social Sciences, University of South-Eastern Norway, PO 235, 3603, Kongsberg, Norway
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Klemann CJHM, Xicoy H, Poelmans G, Bloem BR, Martens GJM, Visser JE. Physical Exercise Modulates L-DOPA-Regulated Molecular Pathways in the MPTP Mouse Model of Parkinson's Disease. Mol Neurobiol 2018; 55:5639-5657. [PMID: 29019056 PMCID: PMC5994219 DOI: 10.1007/s12035-017-0775-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 09/15/2017] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD) is characterized by the degeneration of dopaminergic (DA) neurons in the substantia nigra pars compacta (SNpc), resulting in motor and non-motor dysfunction. Physical exercise improves these symptoms in PD patients. To explore the molecular mechanisms underlying the beneficial effects of physical exercise, we exposed 1-methyl-4-phenyl-1,2,3,6-tetrahydropyrimidine (MPTP)-treated mice to a four-week physical exercise regimen, and subsequently explored their motor performance and the transcriptome of multiple PD-linked brain areas. MPTP reduced the number of DA neurons in the SNpc, whereas physical exercise improved beam walking, rotarod performance, and motor behavior in the open field. Further, enrichment analyses of the RNA-sequencing data revealed that in the MPTP-treated mice physical exercise predominantly modulated signaling cascades that are regulated by the top upstream regulators L-DOPA, RICTOR, CREB1, or bicuculline/dalfampridine, associated with movement disorders, mitochondrial dysfunction, and epilepsy-related processes. To elucidate the molecular pathways underlying these cascades, we integrated the proteins encoded by the exercise-induced differentially expressed mRNAs for each of the upstream regulators into a molecular landscape, for multiple key brain areas. Most notable was the opposite effect of physical exercise compared to previously reported effects of L-DOPA on the expression of mRNAs in the SN and the ventromedial striatum that are involved in-among other processes-circadian rhythm and signaling involving DA, neuropeptides, and endocannabinoids. Altogether, our findings suggest that physical exercise can improve motor function in PD and may, at the same time, counteract L-DOPA-mediated molecular mechanisms. Further, we hypothesize that physical exercise has the potential to improve non-motor symptoms of PD, some of which may be the result of (chronic) L-DOPA use.
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Affiliation(s)
- Cornelius J H M Klemann
- Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Helena Xicoy
- Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Cell Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Gerard J M Martens
- Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jasper E Visser
- Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
- Department of Neurology, Amphia Hospital, Breda, The Netherlands.
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Evens A, Clark C. Does assisted cycling improve function in those with Parkinson’s disease? PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1399513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Alex Evens
- Faculty of Health and Social Sciences, Department of Human Sciences and Public Health, Bournemouth University, Dorset, UK
| | - Carol Clark
- Faculty of Health and Social Sciences, Department of Human Sciences and Public Health, Bournemouth University, Dorset, UK
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Uygur M, Bellumori M, Knight CA. Effects of a low-resistance, interval bicycling intervention in Parkinson's Disease. Physiother Theory Pract 2017; 33:897-904. [PMID: 28812404 DOI: 10.1080/09593985.2017.1359868] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous studies have shown that people with Parkinson's disease (PD) benefit from a variety of exercise modalities with respect to symptom management and function. Among the possible exercise modalities, speedwork has been identified as a promising strategy, with direct implications for the rate and amplitude of nervous system involvement. Considering that previous speed-based exercise for PD has often been equipment, personnel and/or facility dependent, and often time intensive, our purpose was to develop a population-specific exercise program that could be self-administered with equipment that is readily found in fitness centers or perhaps the home. Fourteen individuals with PD (Hoehn-Yahr (H-Y) stage of 3.0 or less) participated in twelve 30-min sessions of low-resistance interval training on a stationary recumbent bicycle. Motor examination section of the Unified Parkinson's Disease Rating Scale (UPDRS), 10-meter walk (10mW), timed-up-and-go (TUG), functional reach, four-square step test (4SST), nine-hole peg test (9HPT) and simple reaction time scores all exhibited significant improvements (p < 0.05). These results add further support to the practice of speedwork for people with PD and outline a population-amenable program with high feasibility.
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Affiliation(s)
- Mehmet Uygur
- a Department of Health and Exercise Science , Rowan University , Glassboro , NJ , USA
| | - Maria Bellumori
- b Kinesiology Department , California State University , Monterey Bay , CA , USA
| | - Christopher A Knight
- c Department of Kinesiology and Applied Physiology , University of Delaware , Newark , DE , USA
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13
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Pretzer-Aboff I, Bunting-Perry L, Spindler M. The Implications of Parkinson's Disease for Women's Health. J Obstet Gynecol Neonatal Nurs 2016; 45:723-36. [DOI: 10.1016/j.jogn.2016.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 10/21/2022] Open
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14
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McNeely ME, Mai MM, Duncan RP, Earhart GM. Differential Effects of Tango Versus Dance for PD in Parkinson Disease. Front Aging Neurosci 2015; 7:239. [PMID: 26733865 PMCID: PMC4685181 DOI: 10.3389/fnagi.2015.00239] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/07/2015] [Indexed: 11/13/2022] Open
Abstract
Over half of the general population does not achieve recommended daily levels of physical activity, and activity levels in people with Parkinson disease (PD) are lower than in healthy older adults. Dance can serve as an adjunct to traditional treatments to improve gait, balance, and quality of life in people with PD. This study directly compares a tango dance intervention and a dance intervention based on the Dance for PD model, which integrates multiple dance styles. Eleven people with PD participated in a community-based mixed styles dance intervention called Dance for Parkinson's (D4PD). Participants in the D4PD group were matched to participants in an ongoing community-based exercise study who participated in tango dance. The groups received 12 weeks of intervention, attending 1-h group classes twice a week. Participants were evaluated off anti-PD medication before and after intervention. Measures of balance, repeated sit-to-stand performance and endurance (mini-balance evaluation systems test, four square step test, five times sit to stand, 6-min walk time) improved from pre to post similarly in both groups. Motor sign severity (movement disorders society unified Parkinson disease rating scale motor subsection) and functional mobility (timed up and go) improved in the tango group and worsened in the D4PD group. Gait velocity was not affected by either intervention. Direct comparisons of different interventions are -critical for developing optimal exercise interventions designed to specifically target motor impairments in PD. Tango dance interventions may preferentially improve mobility and motor signs in people with PD, compared to D4PD.
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Affiliation(s)
- Marie E McNeely
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Marina M Mai
- Department of Anthropology, Washington University in St. Louis School of Medicine , St. Louis, MO , USA
| | - Ryan P Duncan
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Anatomy and Neurobiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
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