Exercise Training for Parkinson's Disease
Recruiting in Palo Alto (17 mi)
+1 other location
Overseen byAmy Amara, MD, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Alabama at Birmingham
Must not be taking: Neuroleptics
Disqualifiers: Cardiovascular disease, Pulmonary disease, Atypical Parkinsonism, others
Trial Summary
What is the purpose of this trial?
The purpose of this study is to investigate the effects of exercise rehabilitation on cognition and to evaluate slow wave sleep (SWS) as a biomarker and mediator of response to rehabilitation-induced improvement in cognitive performance among persons with Parkinson's disease (PwP), with the ultimate goal of maximizing rehabilitation efficacy at the individual level (i.e. precision rehabilitation).
Will I have to stop taking my current medications?
The trial requires that you have been on stable medications for at least 4 weeks before joining and that you do not expect to change medications during the study.
What data supports the effectiveness of the treatment Delayed Exercise Training (DE) and related exercise therapies for Parkinson's Disease?
Research shows that exercise and motor training are beneficial for people with Parkinson's disease, improving motor symptoms and movement efficiency. Goal-based task-specific training and endurance exercise have been particularly effective, suggesting that structured exercise programs can help manage Parkinson's symptoms.12345
Is exercise training safe for people with Parkinson's disease?
How does the exercise training treatment for Parkinson's disease differ from other treatments?
This exercise training treatment for Parkinson's disease is unique because it combines different types of physical activities like endurance and resistance training, which have been shown to improve motor symptoms and muscle strength. Unlike medications, this approach focuses on physical rehabilitation to enhance mobility and quality of life.3891011
Eligibility Criteria
This trial is for people aged 45 or older with Parkinson's Disease (PD) who can walk without help and have mild to moderate symptoms. They should be on stable PD meds, not expecting changes during the study, and score between 18-26 on a cognitive test. Those with serious heart conditions, other types of Parkinsonism, deep brain stimulation implants, untreated sleep disorders or those already doing regular exercise cannot join.Inclusion Criteria
My medications have been the same for the last 4 weeks and won't change during the study.
My cognitive test score is between 18 and 25.
My Parkinson's disease is at a moderate stage.
See 3 more
Exclusion Criteria
I show signs of unusual Parkinson-like symptoms.
You have had deep brain stimulation (DBS) treatment.
My Parkinson's symptoms were caused by medication, strokes, or head injuries.
See 8 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Initial Treatment
Participants undergo 12 weeks of supervised progressive resistance training (PRT) 3 times per week
12 weeks
36 visits (in-person)
Follow-up Treatment
Responders to PRT continue with PRT for an additional 12 weeks, while non-responders transition to endurance training (ET)
12 weeks
36 visits (in-person)
Delayed Exercise
Participants in the delayed exercise group do not exercise for the first 12 weeks, then transition to PRT for the second 12 weeks
24 weeks
36 visits (in-person) during the second 12 weeks
Follow-up
Participants are monitored for changes in cognition and slow wave sleep (SWS) after treatment
4 weeks
Treatment Details
Interventions
- Delayed Exercise Training (DE) (Behavioural Intervention)
- Endurance Training (ET) (Behavioural Intervention)
- Progressive Resistance Training (PRT) (Behavioural Intervention)
Trial OverviewThe study tests how different exercise programs—Endurance Training (ET), Delayed Exercise Training (DE), Progressive Resistance Training (PRT)—affect thinking skills in PD patients and if Slow Wave Sleep can indicate improvement from these exercises.
Participant Groups
2Treatment groups
Active Control
Placebo Group
Group I: Exercise GroupActive Control2 Interventions
PD participants randomized to progressive resistance training PRT) will have 12 weeks of supervised PRT 3 times per week. After the 1st 12 weeks, responders to PRT (increase in slow wave sleep) will continue PRT for an additional 12 weeks, non-responders to PRT will transition to endurance training (ET).
Group II: Delayed Exercise GroupPlacebo Group2 Interventions
PD participants randomized to the delayed exercise control group will not exercise for the 1st 12 weeks of the study. After the 1st 12 weeks, participants in the delayed exercise group will transition to PRT for the 2nd 12 weeks.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Alabama at BirminghamBirmingham, AL
University of Colorado, Anschutz Medical CampusAurora, CO
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Who Is Running the Clinical Trial?
University of Alabama at BirminghamLead Sponsor
University of Colorado, DenverLead Sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)Collaborator
National Institutes of Health (NIH)Collaborator
References
Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial. [2018]Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention.
Exercise and motor training in people with Parkinson's disease: a systematic review of participant characteristics, intervention delivery, retention rates, adherence, and adverse events in clinical trials. [2021]There is research evidence that exercise and motor training are beneficial for people with Parkinson's disease (PD), and clinicians seek to implement optimal programs. This paper summarizes important factors about the nature and reporting of randomized controlled trials of exercise and/or motor training for people with PD which are likely to influence the translation of research into clinical practice. Searches identified 53 relevant trials with 90 interventions conducted for an average duration of 8.3 (SD 4.2) weeks. Most interventions were fully supervised (74%) and conducted at a facility (79%). Retention rates were high with 69% of interventions retaining ≥85% of their participants; however adherence was infrequently reported, and 72% of trials did not report adverse events. Overall, the labor-intensive nature of most interventions tested in these trials and the sparse reporting of adherence and adverse events are likely to pose difficulties for therapists attempting to balance benefits and costs when selecting protocols that translate to sustainable clinical practice for people with PD.
[New approaches in exercise therapy for Parkinson's disease]. [2022]Exercise therapy is an important component in the treatment of motor symptoms in people with Parkinson's disease (PD). In this context, goal-based task-specific training has shown to be particularly effective compared to nonspecific approaches.
Endurance exercise training to improve economy of movement of people with Parkinson disease: three case reports. [2022]Even early in Parkinson disease (PD), individuals have reduced economy of movement. In this case report, the effects of endurance exercise training are examined on walking economy and other measures for 3 individuals in early and middle stages of PD.
Locomotor training in people with Parkinson disease. [2022]The purpose of this article is to consider the role of the physical therapist in locomotor training for people with Parkinson disease. The ways in which disease progression, medication status, environmental conditions, individual factors, and the goals of locomotor tasks contribute to clinical decision making are explored. Using the International Classification of Functioning, Disability and Health, gait training will be considered in relation to impairments of body structure and function, activity limitations, and participation restrictions in people who are newly diagnosed through to those with end-stage disease. Based on the principles of neural adaptation and clinical research findings, practical suggestions are made on how to provide the most efficient and effective physical therapy services at different stages of Parkinson disease.
Progressive Resistance Training Improves Bradykinesia, Motor Symptoms and Functional Performance in Patients with Parkinson's Disease. [2022]Bradykinesia and muscle weaknesses are common symptoms of Parkinson's Disease (PD) and are associated with impaired functional performance, increased risk of falls, and reduced quality of life. Recent studies have pointed to progressive resistance training (PRT) as an effective method to control and reduce these symptoms, increasing possibilities to treat the disease. However, few studies have focused on assessing the PRT effects in the short-term. Therefore, the present study aimed to assess the short-term PRT effects on people with PD, in order to offer new parameters for a better understanding of its effects, so as an adequation and PRT use as a complementary therapy.
Effects of Resistance Training on Motor- and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. [2022]Previous reviews indicated positive effects of resistance training (RT) on motor outcomes in Parkinson's disease (PD). However, inconsistencies between the included studies exist, and non-motor outcomes have only scarcely been considered in a review on RT in PD.
Effectiveness of aerobic and resistance training on the motor symptoms in Parkinson's disease: Systematic review and network meta-analysis. [2023]Aerobic and resistance training are common complementary therapies to improve motor symptoms in people with Parkinson's disease (PD), and there is still a lack of advice on which intensity and period of aerobic or resistance training is more appropriate for people with PD. Therefore, a network meta-analysis was conducted to assess the comparative efficacy of aerobic and resistance training of different intensities and cycles on motor symptoms in patients with Parkinson's disease.
Effectiveness of Progressive Resistance Training in Parkinson's Disease: A Systematic Review and Meta-Analysis. [2023]The aim of this study was to systematically explore progressive resistance training (PRT) effects in Parkinson's disease (PD).
Parkinson's disease and intensive exercise therapy--a systematic review and meta-analysis of randomized controlled trials. [2018]To evaluate and compare the effect of 3 intensive exercise therapy modalities - Resistance Training (RT), Endurance Training (ET) and Other Intensive Training Modalities (OITM) - in Parkinson's Disease (PD). Design A systematic review and meta-analysis of randomized controlled trials.
A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease. [2022]Strength training has, in recent years, been shown to be beneficial for people with Parkinson disease and multiple sclerosis. Consensus regarding its utility for these disorders nevertheless remains contentious among healthcare professionals. Greater clarity is required, especially in regards to the type and magnitude of effects as well as the response differences to strength training between individuals with Parkinson disease or multiple sclerosis. This study examines the effects, magnitude of those effects, and response differences to strength training between patients with Parkinson disease or multiple sclerosis. A comprehensive search of electronic databases including Physiotherapy Evidence Database scale, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL was conducted from inception to July 2014. English articles investigating the effect of strength training for individuals with neurodegenerative disorders were selected. Strength training trials that met the inclusion criteria were found for individuals with Parkinson disease or multiple sclerosis. Individuals with Parkinson disease or multiple sclerosis were included in the study. Strength training interventions included traditional (free weights/machine exercises) and nontraditional programs (eccentric cycling). Included articles were critically appraised using the Physiotherapy Evidence Database scale. Of the 507 articles retrieved, only 20 articles met the inclusion criteria. Of these, 14 were randomized and 6 were nonrandomized controlled articles in Parkinson disease or multiple sclerosis. Six randomized and 2 nonrandomized controlled articles originated from 3 trials and were subsequently pooled for systematic analysis. Strength training was found to significantly improve muscle strength in people with Parkinson disease (15%-83.2%) and multiple sclerosis (4.5%-36%). Significant improvements in mobility (11.4%) and disease progression were also reported in people with Parkinson disease after strength training. Furthermore, significant improvements in fatigue (8.2%), functional capacity (21.5%), quality of life (8.3%), power (17.6%), and electromyography activity (24.4%) were found in individuals with multiple sclerosis after strength training. The limitations of the study were the heterogeneity of interventions and study outcomes in Parkinson disease and multiple sclerosis trials. Strength training is useful for increasing muscle strength in Parkinson disease and to a lesser extent multiple sclerosis.