Enhanced Exercise Therapy in Parkinson's disease: A comparative effectiveness trial

• Published in: Journal of science and medicine in sport 2016-01, Vol.19 (1), p.12-17
• Main Authors: Ridgel, Angela L, Walter, Benjamin L, Tatsuoka, Curtis, Walter, Ellen M, Colón-Zimmermann, Kari, Welter, Elisabeth, Sajatovic, Martha
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bands; Behavior; Cognition & reasoning; Community support; Empowerment; Exercise; Exercise Therapy - methods; Female; Heart rate; Humans; Intervention; Male; Mental depression; Middle Aged; Motivation; Movement disorders; Outcome assessment (health care); Parkinson Disease - therapy; Parkinson's disease; Physical activity; Physical fitness; Physical Medicine and Rehabilitation; Physical therapy modalities; Psychoeducation; Sports Medicine; Teachers
• ISSN: 1440-2440; 1878-1861
• DOI: 10.1016/j.jsams.2015.01.005

Abstract Objectives Exercise can improve motor function in people with Parkinson's disease but depression reduces the motivation to participate in regular exercise. The aim of this study was to develop a novel Enhanced Exercise Therapy program that uses manual-driven guided exercise and peer-facilitated psychoeducation for individuals with Parkinson's disease and depression. Design 24 week randomized controlled design. Methods Thirty individuals were randomized to Enhanced Exercise Therapy or self-guided therapy, and evaluated at baseline, 12-weeks and at 24-weeks. Enhanced Exercise Therapy included group exercise and group psychoeducation for 12 weeks. Between 13 and 24 weeks, individuals had access to the fitness facility but group sessions were not held. Self-guided therapy included written guidelines for a self-paced exercise program and psychoeducation. Primary outcome measures included the number of exercise sessions and International Physical Activity Questionnaire score. Secondary measures included resting heart rate, supine blood pressure, estimated VO2 max and incidence of orthostatic hypotension. Results Twenty four individuals completed the study (80% retention) and both groups attended similar number of exercise sessions. There were no significant changes in cardiovascular fitness measures but there was a significant increase in the amount of physical activity in the Enhanced Exercise Therapy group and a decrease in the self-guided therapy group during the post-intervention period. Conclusions Enhanced Exercise Therapy appears to promote engagement in an exercise program and more physical activity, even after group sessions were concluded in individuals with Parkinson's disease and depression.