Research on High-Intensity Exercise for Parkinson’s Disease

Introduction to Parkinson’s Disease

Parkinson’s disease is a progressive neurological disorder that affects the nervous system over time. Symptoms vary among individuals, but common early signs include hand tremors, slowed movement, rigidity, reduced facial expression, and slurred speech. As the condition advances, patients may face additional challenges such as body tremors, cognitive difficulties, swallowing issues, incontinence, fatigue, disrupted sleep, and feelings of depression or anxiety. A significant characteristic of Parkinson’s is the presence of Lewy bodies, protein clumps found in brain cells, although their role as a cause or effect of the disease remains unclear. This condition primarily affects those over 60 years of age, with men and individuals with a family history of Parkinson’s at a higher risk of developing it.

Strategies to Slow Parkinson’s Disease Progression

Currently, there is no cure for Parkinson’s disease. However, lifestyle modifications can significantly alleviate symptoms and potentially slow disease progression. Key recommendations include maintaining hydration, consuming a balanced, high-fiber diet, and engaging in exercise aimed at enhancing balance, flexibility, and strength. Traditionally, moderate-intensity exercise has been advised, as high-intensity workouts were believed to impose excessive strain on individuals with Parkinson’s.

Study Overview

In a recent study published in JAMA Neurology, researchers from Denver, Colorado, sought to challenge the conventional view regarding exercise intensity. They investigated the effects of high-intensity treadmill exercise on individuals with Parkinson’s disease. The study involved 128 participants aged between 40 and 80 years who were in the early stages of the disease. To eliminate the influence of medication, none of the participants were receiving any Parkinson’s treatments.

Exercise Regimen and Safety Assessment

To ensure the safety of the exercise protocols, the research team conducted a cardiologist-supervised graded exercise test to assess each participant’s heart response. At the study’s onset, the severity of symptoms was evaluated using the Unified Parkinson’s Disease Rating Scale, which ranges from 0 to 108, with higher scores indicating more severe symptoms. Initially, participants averaged a score of approximately 20.

Over six months, one-third of the participants engaged in a moderate-intensity exercise program (60%-65% of maximum heart rate) three times weekly, while another third participated in a high-intensity program (80%-85% of maximum heart rate) three times a week. The remaining third served as a control group and did not participate in any exercise. After the six-month period, the researchers reassessed the severity of symptoms using the same scale.

Findings on the Effectiveness of Exercise

The results indicated that participants in the high-intensity exercise group maintained their symptom scores around 20. Conversely, those in the moderate-intensity group experienced an average worsening of symptoms by 1.5 points, while the control group saw an average increase of 3.0 points in symptom severity. The research team concluded that high-intensity exercise is both feasible and safe for patients with Parkinson’s disease and may help delay the progression of the condition.

Future Research Directions

Further investigation is necessary, as larger and longer phase three randomized trials are needed to validate these findings and explore the duration of the observed effects.

Author Information

Written by Debra A. Kellen, PhD.

References

(1) Schenkman, M., et al. (2017). Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients with De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial. JAMA Neurology. DOI:10.1001/jamaneurol.2017.3517
(2) Brooks, D. J. (2012). Parkinson’s Disease: Diagnosis. Parkinsonism Related Disord. Suppl 1:S31-33. doi: 10.1016/S1353-8020(11)70012-8.
(3) Pedrosa, D. J., & Timmermann, L. (2013). Review: Management of Parkinson’s Disease. Neuropsychiatr Dis Treat. 9:321-340. doi: 10.2147/NDT.S32302.