Exercise for Parkinson's Disease
Recruiting in Palo Alto (17 mi)
+2 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: McGill University
Disqualifiers: Atypical parkinsonism, Dementia, Stroke, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
This trial will test if different types of exercise can improve sleep and quality of life in people with Parkinson's disease. Participants will do cardiovascular, resistance, or combined exercises for a few months. The study aims to see if better sleep leads to better movement, thinking, and overall well-being.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but it requires that you have been on a stable dosage of medication for the past month.
What data supports the effectiveness of the treatment for Parkinson's disease?
Is exercise safe for people with Parkinson's disease?
How is the exercise treatment for Parkinson's disease different from other treatments?
This exercise treatment for Parkinson's disease is unique because it combines cardiovascular, multimodal, and resistance training, which can improve strength, balance, and overall function. Unlike medications, this approach focuses on physical activity to enhance muscle strength and cardiorespiratory fitness, offering a non-drug option that can be tailored to individual needs.1491011
Eligibility Criteria
This trial is for people with mild to moderate Parkinson's Disease who have poor sleep quality. They must be on a stable medication dose and not have severe cognitive or mental health issues, untreated sleep apnea, osteoporosis, or other neurological conditions. They shouldn't already be very active or in another exercise/drug study.Inclusion Criteria
My medication dose has been the same for the last month.
My Parkinson's Disease is in the early to mid stages.
Having poor sleep quality defined as a score > 15 in the PDSS-2
Exclusion Criteria
Having absolute contraindications to exercise
Having a Beck Depression Inventory score >31
I have severe osteoporosis.
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants perform either cardiovascular training, resistance training, multimodal training, or are allocated to a control condition for 12 weeks. Training is performed three times per week.
12 weeks
36 sessions (in-person)
Follow-up
Participants are monitored for changes in sleep quality, cognitive function, and quality of life 8 weeks after the intervention.
8 weeks
Treatment Details
Interventions
- Cardiovascular training (CT) (Behavioural Intervention)
- Multimodal training (MT) (Behavioural Intervention)
- Resistance training (RT) (Behavioural Intervention)
Trial OverviewThe study tests how cardiovascular training (CT), resistance training (RT), and multimodal training (MT) affect sleep and life quality in Parkinson's patients over 12 weeks. Participants will train three times a week and are compared to a control group on a waiting list.
Participant Groups
4Treatment groups
Experimental Treatment
Active Control
Group I: Resistance training (RT)Experimental Treatment1 Intervention
Resistance training (RT) intensity will be estimated using the percentage of one-maximal repetition (1-RM) defined as the maximal weight liftable for ten maximal repetitions with proper form. The program will include five exercises (leg press, lat machine, leg extension, leg curl, bench press) and will start at high-volume low intensity. RT will follow a periodization to reach high-intensity low-volume at the end of the intervention (week 12). The training sessions will start and end with five-minute of warm-up and cool-down, which will include exercise on a recumbent stepper and stretching, respectively. RT's sessions will last approximately 45 minutes (40 to 50 minutes) and will be interspersed with 48 hours of recovery.
Group II: Multimodal training (MT)Experimental Treatment1 Intervention
Multimodal training (MT) will combine cardiovascular and resistance training interventions using the modalities described previously, but each component will be shortened to match the overall training duration (i.e., volume) among groups. The first part of each training session will always include three resistance exercises, which will be followed by 15-20 minutes of cardiovascular training performed on the total body recumbent stepper. Periodization will follow the same progression previously described for cardiovascular and resistance training, respectively, reaching vigorous intensity towards the end of the training period. Training sessions will include a five-minute warm-up and cool-down on the total body recumbent stepper. MT's sessions will approximately last 45 minutes (40 to 50 minutes) and will be interspersed with 48 hours of recovery.
Group III: Cardiovascular training (CT)Experimental Treatment1 Intervention
Cardiovascular training (CT) will be performed on a recumbent stepper. CT will start at low intensity, and, through a linear progression, will reach vigorous intensity; then, this intensity will be maintained until the end of the training period. Each session will include five minutes of warm-up and cool-down performed at the beginning and at the end of the training, respectively. Furthermore, five minutes of stretching will be performed after the cool-down. CT's sessions will last approximately 45 minutes (30 to 50 minutes) and will be interspersed with 48 hours of recovery.
Group IV: Control condition (CON; waiting list)Active Control1 Intervention
The control condition (CON; waiting list) will receive no intervention (i.e., exercise) but usual care. Participants in the CON will be required to go about their normal life, maintaining their current physical activity levels until the end of the study. Then, they will be offered to join one of the training programs/condition.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Jewish Rehabilitation HospitalLaval, Canada
Human Brain Control of Locomotion LaboratoryMontréal, Canada
Cummings CentreMontréal, Canada
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Who Is Running the Clinical Trial?
McGill UniversityLead Sponsor
Canadian Institutes of Health Research (CIHR)Collaborator
The Memory LabCollaborator
Jewish Rehabilitation HospitalCollaborator
The Human Brain Control of Locomotion Lab (HBCL)Collaborator
The Cummings CentreCollaborator
References
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.
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.
Exercise Training Guidelines for Multiple Sclerosis, Stroke, and Parkinson Disease: Rapid Review and Synthesis. [2023]The translation of knowledge from exercise training research into the clinical management of multiple sclerosis, stroke, and Parkinson disease requires evidence-based guidelines that are uniformly recognizable by healthcare practitioners and patients/clients. This article synthesized resources that reported aerobic and resistance training guidelines for people with multiple sclerosis, stroke, and Parkinson disease. Systematic searches yielded 25 eligible resources from electronic databases and Web sites or textbooks of major organizations. Data were extracted (exercise frequency, intensity, time, and type) and synthesized into three sets of recommendations. Exercise guidelines for multiple sclerosis consistently recommended 2-3 d/wk of aerobic training (10-30 mins at moderate intensity) and 2-3 d/wk of resistance training (1-3 sets between 8 and 15 repetition maximum). Exercise guidelines for stroke recommended 3-5 d/wk of aerobic training (20-40 mins at moderate intensity) and 2-3 d/wk of resistance training (1-3 sets of 8-15 repetitions between 30% and 50% 1 repetition maximum). Exercise guidelines for Parkinson disease recommended 3-5 d/wk of aerobic training (20-60 mins at moderate intensity) and 2-3 d/wk of resistance training (1-3 sets of 8-12 repetitions between 40% and 50% of 1 repetition maximum). This harmonization of exercise guidelines provides a prescriptive basis for healthcare providers, exercise professionals, and people with multiple sclerosis, stroke, and Parkinson disease regarding exercise programming.
Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. [2022]In 2015, Uhrbrand et al. published the first review on Parkinson´s disease (PD) and exercise entirely based on randomized controlled trials (RCT) applying strict exercise definitions. The present review aimed to update the PD literature by assessing the effects of different intensive exercise modalities: resistance training (RT), endurance training (ET), and other intensive exercise modalities (OITM). An updated systematic literature search identified 33 new RCTs. Qualitative and quantitative analyses were performed. A total of 18 RT, 14 ET, and 1 OITM studies were identified (adding to the 8 RT, 6 ET, and 4 OITM studies identified by Uhrbrand et al. in 2015). RT, ET, and OITM were feasible, safe, and did not worsen PD symptoms. Furthermore, RT, ET, and OITM may positively affect functional outcomes (e.g., balance) and depressive symptoms in PD but inconsistencies across these findings warrant cautious conclusions. Meta-analyses showed that RT had a positive impact on muscle strength (standardized mean difference (SMD) = 0.83 [95% CI;0.54, 1.12]), functional capacity (Timed Up and Go Test (TUG): SMD = -0.62 [-1.01, -0.24]), and quality of life (SMD = -0.41 [-0.72, -0.09]), while ET had a positive impact on cardiorespiratory fitness (SMD = 0.27 [0.07, 0.47]) and functional capacity (TUG: SMD = -0.21 [-0.46, 0.04], 6-Min Walk Test: SMD = 0.89 [0.17, 1.62]), and a potentially positive impact on "on-medication" UPDRS-III (SMD = -0.15 [-0.38, 0.09]) and "off-medication" UPDRS-III (SMD = -0.19 [-0.41, 0.04]). In conclusion, RT, ET, and OITM all represent safe, feasible, and beneficial adjunct rehabilitation strategies in PD, with particularly RT and ET showing solid effects.
Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. [2018]The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson's disease (PD).
Implementing resistance training in the rehabilitation of coronary heart disease: A systematic review and meta-analysis. [2022]Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy.
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.
Combined endurance-resistance training vs. endurance training in patients with chronic heart failure: a prospective randomized study. [2022]This study was designed to compare the effects of combined endurance-resistance training (CT) with endurance training (ET) only on submaximal and maximal exercise capacity, ventilatory prognostic parameters, safety issues, and quality of life in patients with chronic heart failure (CHF).
[Implementation of an individualized tablet-based training program in the domestic setting following complex treatment of Parkinson's disease-Success factors and barriers]. [2022]Regular physical activity is of great relevance in Parkinson's disease. As part of the project "Individualized training program for Parkinson's disease patients" (ParkProTrain), a tablet-based program was developed to support individual self-training. It has been tested over a period of 9 months in domestic settings. Patients were asked about the feasibility of use and satisfaction.
Effects of moderate-volume, high-load lower-body resistance training on strength and function in persons with Parkinson's disease: a pilot study. [2021]Background. Resistance training research has demonstrated positive effects for persons with Parkinson's disease (PD), but the number of acute training variables that can be manipulated makes it difficult to determine the optimal resistance training program. Objective. The purpose of this investigation was to examine the effects of an 8-week resistance training intervention on strength and function in persons with PD. Methods. Eighteen men and women were randomized to training or standard care for the 8-week intervention. The training group performed 3 sets of 5-8 repetitions of the leg press, leg curl, and calf press twice weekly. Tests included leg press strength relative to body mass, timed up-and-go, six-minute walk, and Activities-specific Balance Confidence questionnaire. Results. There was a significant group-by-time effect for maximum leg press strength relative to body mass, with the training group significantly increasing their maximum relative strength (P .05). Conclusions. Moderate volume, high-load weight training is effective for increasing lower-body strength in persons with PD.
The Efficacy of Exercise Programs for Parkinson's Disease: Tai Chi versus Combined Exercise. [2021]Exercise is recommended for every patient with Parkinson's disease (PD). The effectiveness of two different forms of exercise for PD, Tai Chi and combined stretching-strengthening exercise, was compared.