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Tuesday, December 12, 2017

Pittsburgh-tied study links intense exercise to Parkinson's benefits

GARY ROTSTEIN Pittsburgh Post-Gazette     December12,  2017



Intense aerobic exercise in the early stage of Parkinson’s disease can at least temporarily avoid the worsening of motor symptoms commonly associated with the affliction, according to a study that involved Pittsburgh researchers and participants.
The findings published in Monday’s JAMA Neurology suggest that new Parkinson’s patients can benefit from high-paced walking in the same way that they might from starting drugs to combat the disease. Other forms of exercise that push their heart rate toward its capacity may also postpone a decline in functioning, although more examination is needed of alternative forms of activity and how long the benefits last, the researchers noted.
“The earlier in the disease you intervene, the more likely it is you can prevent the progression of the disease,” said co-lead author Daniel Corcos, a Northwestern University professor of physical therapy and human movement sciences. “We delayed worsening of symptoms for six months. Whether we can prevent progression any longer than six months will require further study.”
The University of Pittsburgh and University of Denver joined in the Northwestern-based study, with local Parkinson’s patients making up about one-fourth of the 128 individuals between 40 and 80 years old who were involved between 2012 and 2016. Those recruited were neither habitual exercisers nor yet taking medication for the neurodegenerative disorder, an affliction that can cause trembling, stiffness, gait and balance problems and other loss of muscle control.
The Pitt researchers said the participants were assessed individually beforehand for their physical health and heart capacities. A third gradually built up over a six-month period to do 30 minutes of treadmill exercise at 80 to 85 percent of their maximum heart rate capacity, four days a week; another third did more moderate treadmill walking; one-third were given no exercise regimen.
The study reported that the high-intensity group suffered no worsening of Parkinson’s motor symptoms after half a year. The group that did not exercise saw symptoms worsen by about 15 percent, and the moderate exercisers had a decline about half of that.
High-intensity use of the treadmill equated roughly to taking a brisk half-hour walk in which it would be hard to carry on a conversation, with some labored breathing and perspiration, said Deborah Josbeno, Pitt associate professor of physical therapy. Though exercise benefits by means other than the treadmill are not as well documented for Parkinson’s patients, she noted plenty of evidence connects physical activity to positives for brain health and cardiovascular functioning.
“I would tell my patients to exercise — that any exercise you would do is good — and I want them to keep doing it, so find something you like that you’re going to stick to,” even if it’s not a treadmill, Ms. Josbeno said.
Charity Moore, a Pitt physical therapy professor who also joined in the research, said a 15 percent difference in symptoms between intense exercise and doing nothing at all should serve as ample motivation.
“We saw effects that were similar to some of the drug studies, and we were surprised and happy that exercise can potentially be that powerful,” she said. “It’s very powerful to know you have something within your own control to do, as long as it’s safe, to hopefully make a difference in your disease.”
The Pitt researchers cautioned that individuals should consult with their doctor before beginning any exercise regimen, and a physical therapist would be helpful in developing the right exercise program.
http://www.post-gazette.com/news/health/2017/12/11/Parkinsons-disease-intense-exercise-research-delay-symptoms-University-of-Pittsburgh-study/stories/201712110157

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