The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in People With Early Parkinson's Disease

• Published in: Archives of physical medicine and rehabilitation Vol. 89; no. 7; pp. 1221 - 1229
• Main Authors: Fisher, Beth E., Wu, Allan D., Salem, George J., Song, Jooeun, Lin, Chien-Ho (Janice), Yip, Jeanine, Cen, Steven, Gordon, James, Jakowec, Michael, Petzinger, Giselle
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2008; Elsevier
• Subjects: Aged; Basal ganglia; Biological and medical sciences; Central nervous system; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Diseases of the osteoarticular system; Exercise Therapy; Feasibility Studies; Female; Gait Disorders, Neurologic - rehabilitation; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Motor Cortex - physiopathology; Neurology; Neuronal plasticity; Neuronal Plasticity - physiology; Parkinson Disease - physiopathology; Parkinson Disease - radiotherapy; Physical Medicine and Rehabilitation; Postural Balance - physiology; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Task Performance and Analysis; Transcranial Magnetic Stimulation; Treatment Outcome; Walking; CSP; Basal ganglia; Neuronal plasticity; PT; USC; AAMHR; BDNF; Central nervous system; CNS; FDI; Walking; ROM; METS; BWSTT; PD; MMSE; GABA; MEP; UPDRS; Rehabilitation; TMS; BWS; Parkinson's disease; body-weight support; transcranial magnetic stimulation; cortical silent period; motor evoked potential; range of motion; brain-derived neurotrophic factor; Unified Parkinson's Disease Rating Scale; age-appropriate maximal heart rate; University of Southern California; body weight–supported treadmill training; metabolic equivalents; γ-aminobutyric acid; physical therapy; first dorsal interosseous; Mini-Mental State Examination; Performance evaluation; Physical exercise; Nervous system diseases; Parkinson disease; Basal ganglion; Cerebral disorder; Reeducation; Orthopedics; Central nervous system disease; Degenerative disease; Extrapyramidal syndrome
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2008.01.013

Fisher BE, Wu AD, Salem GJ, Song J, Lin C-H, Yip J, Cen S, Gordon J, Jakowec M, Petzinger G. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease. To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS). Cohort (prospective), randomized controlled trial. University-based clinical and research facilities. Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2. Subjects were randomized to high-intensity exercise using body weight–supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks. Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS. A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP. The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD.