High-Intensity Exercise May Be Feasible in Patients With Parkinson’s Disease

November 24, 2016

Merrill R. Landers, PT, DPT, PhD, OCS

PORTLAND, OR —High-intensity exercise is feasible and safe in patients with Parkinson's disease, according to trial results presented at the Fourth World Parkinson Congress. An eight-week high-intensity exercise and fall-prevention boot camp was well attended, and participants tolerated high-intensity aerobic, strength, and balance training exercises, researchers said. 

Most contemporary exercise programs for people with Parkinson's disease are low to moderate in intensity. Recent studies, however, suggest that older adults can safely tolerate high-intensity exercise programs and attain more meaningful benefits. "The optimal parameters of exercise for Parkinson's disease have not been thoroughly explored," said Merrill R. Landers, PT, DPT, PhD, OCS, Professor of Physical Therapy, and James Navalta, PhD, Associate Professor of Kinesiology, both at the University of Nevada in Las Vegas.

To test the feasibility and safety of a high-intensity exercise and fall-prevention boot camp in people with Parkinson's disease, Drs. Landers and Navalta conducted a phase II, pragmatic, randomized clinical trial. 

Twenty-seven participants were included in the study. Fourteen patients were randomized to the high-intensity exercise program, and 13 patients were randomized to a low-intensity control program (ie, Fitness Counts Exercise Program). Physiotherapists supervised the exercise programs at community exercise gyms. 

Patients had an average age of about 64 and disease duration of nearly five years. Nineteen men and eight women enrolled in the study. Most patients were Hoehn and Yahr stage 2. 

The high-intensity boot camp sessions consisted of 30 minutes of aerobic exercise (70% of heart rate maximum), 30 minutes of strengthening (50% to 80% of one-repetition maximum), 15 minutes of balance training, and 15 minutes of active rest and stretching. The control sessions consisted of 15 minutes of aerobic exercise (60% of heart rate maximum), 15 minutes of strengthening (less than 50% of one-repetition maximum), 10 minutes of balance training, 10 minutes of rest, and 10 minutes of stretching. There was not a significant difference in the rate of injuries, falls, or exercise side effects between groups. Adverse events were similar in the two arms. Compared with low-intensity exercise, high-intensity exercise produced greater improvements in balance, physical activity, parkinsonian symptoms, endurance, fatigue, and bone health. 

"These results warrant further investigation in a large-scale comparative effectiveness trial," the researchers concluded. 

—Jake Remaly

http://www.mdedge.com/neurologyreviews/article/113292/parkinsons-disease/high-intensity-exercise-may-be-feasible-patients?channel=249