Exercise , exercise , exercise

Physical Exercise Improves Gait Speed, Muscle Strength, Fitness in Patients With Parkinson's Disease

ScienceDaily (Nov. 5, 2012) — Physical exercise, including treadmill, stretching and resistance exercises, appears to improve gait speed, muscle strength and fitness for patients with Parkinson disease (PD), according to a report of a randomized clinical trial published Online First by Archives of Neurology, a JAMA Network publication.

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Physical exercise

Gait impairment is associated with functional decline in patients with PD and current therapies are inadequate at preserving mobility as PD progresses. There is growing interest in the use of exercise to improve mobility and function, the authors write in the study background.

Lisa M. Shulman, M.D., of the University of Maryland School of Medicine, Baltimore, and colleagues conducted a randomized clinical trial of three types of physical exercise to compare the effectiveness of treadmill, stretching and resistance exercises in improving gait speed, strength and fitness for patients with PD.

The study included 67 patients with PD who had gait impairment and were randomly assigned to one of three groups in the trial: a higher intensity treadmill exercise (30 minutes at 70 percent to 80 percent of heart rate reserve); a lower-intensity treadmill exercise (50 minutes at 40 percent to 50 percent of heart rate reserve); and stretching and resistance exercises (two sets of 10 repetitions on each leg on three resistance machines). Patients performed the exercises three times a week for three months.

"The effects of exercise were seen across all three exercise groups. The lower-intensity treadmill exercise resulted in the greatest improvement in gait speed. Both the higher- and lower-intensity treadmill exercises improved cardiovascular fitness. Only the stretching and resistance exercises improved muscle strength. Therefore, exercise can improve gait speed, muscle strength and fitness for patients with Parkinson disease," the study notes.

According to the study results, all three types of exercise improved distance on the 6-minute walk: lower-intensity treadmill exercise (12 percent increase), stretching and resistance exercises (9 percent increase) , and higher-intensity treadmill exercises (6 percent increase). Both types of treadmill training improved cardiovascular fitness, whereas stretching and resistance had no effect. Only stretching and resistance improved muscle strength (16 percent increase).

"The fact that the lower-intensity treadmill exercise is the most feasible exercise for most patients with PD has important implications for clinical practice. Although treadmill and resistance training are beneficial for gait, fitness and muscle strength, these benefits were not accompanied by improvements in disability and quality of life," the authors conclude. "Future directions for study include trials of combinations of exercise types, longer training periods and investigation of the potential for exercise to modify the trajectory of disease progression over time."

Editorial: Benefits of Exercise in Parkinson Disease

In an editorial, Liana S. Rosenthal, M.D., and E. Ray Dorsey, M.D., M.B.A., of The Johns Hopkins University School of Medicine,Baltimore,Md., write: "In this issue of the journal, Shulman and colleagues offer compelling evidence that exercise can improve gait and fitness among individuals with PD."

"This research adds to the evidence regarding the value of interventions for PD beyond medications and surgery and offers an opportunity for patients to be active participants in their care," they continue.

"Exercise programs among those with neurological disorders increase the patients' sense of self-efficacy, their sense of involvement in their care and overall belief in their abilities to perform certain activities," they conclude. "In essence, exercise puts the patient -- not a pill -- at the center of care, which is exactly where patients want and ought to be."

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[Helshubby]

I knew it !! 12 marathons since 2001 (dxd 2005) still running and have added Tai Chi - keep moving , stay strong !!

Dave

[hilarypeta in reply to Helshubby]

Well done! Has it slowed it down or improved it?

[Helshubby in reply to hilarypeta]

I think the running keeps it in check. But i noticed it actually improved after i started Taiji (and some Qi Gong) i try to practice every day , run 3/4x a week, taiji class (2hrs) and Qi gong (1hr) classes once a week.It's become a lot easier to control especially after i was forced to retire from my career in the fire & rescue service just over a year ago.

[hilarypeta in reply to Helshubby]

Thata what this guy said ..qi gong and veggie diet got rid of his completely in 7 mionths" i try john colemans advice in his book. Also claims to have made a fullrecovery...he suggests bowen technique and feldenkrais method for exercise. My shiatsu friend recommends qi gong..i went to one class and stood like a tree for an hour..i think standing still is strengthening.

Can understand the punching motion in boxing is good for getting frustration and stress out of our bodies. Shouting is also good!

[hilarypeta]

Ive found that myself..but too much stresses the nervous system...we also need to be kind to our bodies with gentler exercise, breathing with yoga and qi gong..all levels can try...

[dbean]

I am in a boxing program, have been doing this for 4 years. Along with meds that are a big help my shaking has gone and my life is back to as normal as I can be with Pd. I do this three times a week and enjoy the sharing with 25-30 others with PD

[DeParkiePoet]

Thanks again Anthony! I read that GABA article that you posted a few days ago and introduced GABA to my regimen! Had a great day yesterday, wasted it on work though....

[PatV]

I love my exercise programs. Sometimes the stress of getting there and home undo the benefits, but not always. I always seem to injure myself in the hiatus between classes. It's hard to keep up on my own. If I were rich, I'd hire a personal trainer. Like the guy who taught our class Monday. (Hey I'm a pwp, I'm not dead )