Finding the Best Exercise Prescription for Parkinsons Disease

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Doctors agree that exercise is an important component of therapy for patients with Parkinson’s disease (PD), but, to date, just how much and to what intensity has not been fully explored. Daniel Corcos of the University of Illinois at Chicago, who has studied the neurodegenerative condition for more than 20 years, intends to attempt to quantify the benefits of aerobic exercise in managing symptoms in persons with recently diagnosed Parkinson’s disease.

Parkinson’s disease is a progressive disorder associated with the degeneration of dopamine-producing neurons. Dopamine is a chemical substance that supports any physical activity in humans. By the time a patient is diagnosed with the condition, they have experienced a whopping 80% decrease in the chemical along with some degree of rigidity, slowness of movements, gait changes and possible balance troubles.

The theory is that exercise would help to restore some of this dopamine production. Although it is not clear yet whether exercise actually has a neuroprotective effect, studies do show that for people with mild-to-moderate PD, interventions that target flexibility, lower-extremity strength and cardiovascular conditionings can have benefit, improving symptoms such as those listed above.

Corcos, a professor of kinesiology and nutrition, will lead a four-year, $3 million National Institute of Neurological Disorders and Stroke-funded study of aerobic exercise. Dr. Corcos has already found that two years of weight training can significantly improve motor symptoms when compared to alternatives such as stretching and balancing exercises.

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Along with co-investigator Margaret Schenkman of the University of Colorado-Denver, newly diagnosed PD patients who are not yet on medications such as Levodopa will be randomly assigned to one of three groups. The first will act as a control and continue with their current patterns of exercise. The second will walk 30 minutes on a treadmill four times a week at between 60 and 65% of maximum heart rate. The third will exercise more vigorously at 80 to 85% MHR.

The researchers will use the Unified Parkinson’s Disease Ratings Scale to determine how each group manages symptoms such as slow movement, tremor, rigidity, and abnormal postural reflexes. The tool also assesses areas such as mentation and behavior, activities of daily living, and potential complications such as anorexia or sleep disturbance.

"Our first aim is just to test the feasibility of whether they can exercise at both the moderate and high dose (rates)," Corcos said. "Then we'll ask, does exercise at one or the other dose modify symptoms of the disease?"

"Any treatment that reduces the amount of medication is beneficial to a patient, because they'll get a longer and better response from their medication," Corcos concludes. "The goal of our work is to help Parkinson's disease patients lead a better life until a cure is found."

Resources:
University of Illinois at Chicago
National Parkinson Foundation
Parkinson's Disease Foundation

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