Exercise as a Supplementary Treatment for Parkinson's Disease

Authors

  • Alexa Delia Ranahan University of British Columbia
  • Emma Reiter University of British Columbia
  • Shamus Menard University of British Columbia
  • Sarah Cortese University of British Columbia
  • Kelly To University of British Columbia
  • Borislav Sinik University of British Columbia
  • Darren Warburton University of British Columbia

DOI:

https://doi.org/10.14288/hfjc.v14i1.289

Abstract

Background:  Parkinson’s Disease (PD) is a common neurological disorder with debilitating motor and non-motor symptoms. Purpose: To explore and understand PD, establish exercise as a treatment option, and determine the optimal evidence-based prescription of exercise based on current evidence. Methods: A narrative review of PD literature was conducted and four categories of findings were established. Results:  Based on the review of literature, established risk factors for PD include personal, genetic, and environmental factors. Clinical tests for postural sway and instability are used for diagnosis. PD is associated with fatigue and falls, leading to further adversities. Treatment options such as medication and surgical procedures can mitigate symptoms but have side effects and do not improve postural stability. Exercise as a co-treatment has been indicated as a potential solution to some limitations. Guidelines include a variety of exercises and a progressive increase in frequency. Optimal benefits arise from aerobic components, amplitude-specific training, and vigorous intensity. Conclusion: Exercise is a valid component of PD treatment. Prescription should be individualized and include a variety of exercises, including balance, flexibility, resistance, aerobic, and amplitude-specific exercises performed at a vigorous intensity whenever possible.

References

Ahlskog, J. (2011). Does vigorous exercise have a neuroprotective effect in parkinson disease? Neurology, 77(3), 288-294. doi:10.1212/WNL.0b013e318225ab66

Bennett, D. A., Beckett, L. A., Murray, A. M., Shannon, K. M., Goetz, C. G., Pilgrim, D. M., & Evans, D. A. (1996). Prevalence of parkinsonian signs and associated mortality in a community population of older people. The New England Journal of Medicine, 334(2), 71-76. doi:10.1056/NEJM199601113340202

Bloem, B. R., Beckley, D. J., van Dijk, J. G., Zwinderman, A. H., Remler, M. P., & Roos, R. A. (1996). Influence of dopaminergic medication on automatic postural responses and balance impairment in parkinson's disease. Movement Disorders: Official Journal of the Movement Disorder Society, 11(5), 509. doi:10.1002/mds.870110506

Bloem, B. R., Hausdorff, J. M., Visser, J. E., & Giladi, N. (2004). Falls and freezing of gait in parkinson’s disease: A review of two interconnected, episodic phenomena. Movement Disorders, 19(8), 871–884. doi:10.1002/mds.20115

Chinta, S, J., & Andersen, J. K. (2005). Dopaminergic neurons. International Journal of Biochemistry and Cell Biology, 37(5), 942-946. doi:10.1016/j.biocel.2004.09.009

Dauer, W., & Przedborski, S. (2003). Parkinson’s disease: Mechanisms and models. Neuron, 39(6), 889-909. doi:10.1016/S08966273(03)00568-3

Ebersbach, G., & Gunkel, M. (2010). Posturography reflects clinical imbalance in parkinson's disease. Movement Disorders, 26(2), 241-246. doi:10.1002/mds.23189

Farley, B. G., Fox, C. M., Ramig, L. O. & McFarland, D. H. (2008). Intensive amplitude-specific therapeutic approaches for parkinson's disease. Topics in Geriatric Rehabilitation, 24(2), 99–114. doi:10.1097/01.TGR.0000318898.87690.0d.

Farley, B., & Koshland, G. (2005). Training BIG to move faster: The application of the speed-amplitude relation as a rehabilitation strategy for people with parkinson's disease. Experimental Brain Research, 167(3), 462-467. doi:10.1007/s00221-005-0179-7

Goodwin, V. A., Richards, S. H., Henley, W., Ewings, P., Taylor, A. H., & Campbell, J. L. (2011). An exercise intervention to prevent falls in people with parkinson's disease: A pragmatic randomised controlled trial. Journal of Neurology, Neurosurgery & Psychiatry, 82(11), 232-1238. doi:10.1136/jnnp-2011-300919

Goodwin, V. A., Richards, S. H., Taylor, R. S., Taylor, A. H., & Campbell, J. L. (2008). The effectiveness of exercise interventions for people with parkinson's disease: A systematic review and meta‐analysis. Movement Disorders, 23(5), 631-640. doi:10.1002/mds.21922

Hirsch, M. A., Iyer, S. S., & Sanjak, M. (2016). Exercise-induced neuroplasticity in human parkinson's disease: What is the evidence telling us? Parkinsonism and Related Disorders, 22, S78-S81. doi:10.1016/j.parkreldis.2015.09.030

Kalia, Koros, C., Simitsi, A., & Stefanis, L. (2017). Genetics of parkinson's disease: Genotype-phenotype correlations. International Review of Neurobiology, 132, 197. doi: 10.1016/bs.irn.2017.01.009

L. V., MD, & Lang, A. E., Dr. (2015). Parkinson's disease. The Lancet, 386(9996), 896-912. doi:10.1016/S0140-6736(14)61393-3

Nonnekes, J., Goselink, R., Weerdesteyn, V., & Bloem, B. R. (2015). The retropulsion test: A good evaluation of postural instability in parkinson's disease? Journal of Parkinson's Disease, 5(1), 43. doi: 10.3233/JPD-140514

Noyce, A. J., Bestwick, J. P., Silveira‐Moriyama, L., Hawkes, C. H., Giovannoni, G., Lees, A. J., & Schrag, A. (2012). Meta‐analysis of early nonmotor features and risk factors for parkinson disease. Annals of Neurology, 72(6), 893-901. doi:10.1002/ana.23687

Nussbaum, R. L., & Ellis, C. E. (2003). Alzheimer's disease and parkinson's disease. The New England Journal of Medicine, 348(14), 1356-1364. doi:10.1056/NEJM2003ra020003

Oksenberg, A., Silverberg, D.S., Arons, E., & Radwan, H. (1999). The sleep supine position has a major effect on optimal nasal continuous positive airway pressure: Relationship with rapid eye movements and non-rapid eye movements sleep, body mass index, respiratory disturbance index, and age. Chest, 116, 1000-1006. doi: 10.1378/chest.116.4.1000

Oksenberg, A., Khamaysi, I., & Silverberg, D.S. (2001). Apnoea characteristics across the night in severe obstructive sleep apnoea: Influence of body posture. European Respiration Journal, 18, 340-346. doi: 10.1183/09031936.01.00038101

Parkinson Canada. (2012). Physical activity and parkinson’s disease [PDF File]. Retrieved from https://www.parkinson.ca/wp-content/uploads/PARKINSON-CANADA-PHYSICAL-ACTIVITY.pdf

Pfeiffer, R. F. (2016). Non-motor symptoms in parkinson's disease. Parkinsonism and Related Disorders, 22, S119-S122. (Original work published in 2015). doi:10.1016/j.parkreldis.2015.09.004

Ramirez-Zamora, A., & Ostrem, J. L. (2018). Globus pallidus interna or subthalamic nucleus deep brain stimulation for parkinson disease: A review. JAMA Neurology, 75(3), 367-372. doi:10.1001/jamaneurol.2017.4321

Riebe, D., Ehrman, J.K., Liguori, G., & Magal, M. Chapter 6 General Principles of Exercise Prescription. In: ACSM’s Guidelines for Exercise Testing and Prescription. 10th Ed. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, PA: 2018, 143-179.

Sethi, K. (2008). Levodopa unresponsive symptoms in parkinson disease. Movement Disorders, 23(S3), 521–533. doi: 10.1002/mds.22049

Shah, C., Beall, E. B., Frankemolle, A. M. M., Penko, A., Phillips, M. D., Lowe, M. J., & Alberts, J. L. (2016). Exercise therapy for parkinson's disease: Pedaling rate is related to changes in motor connectivity. Brain Connectivity, 6(1), 25. doi:10.1089/brain.2014.0328

Sicilano, M., Trojano, L., Santangelo, G., De Micco, R., Tedeschi, G., & Tessitore, A. (2018). Fatigue in Parkinson's disease: A systematic review and meta‐analysis. Movement Disorders, 33(11), 1712-1723. doi:10.1002/mds.27461

Silveira, C. R. A., Roy, E. A., Intzandt, B. N., & Almeida, Q. J. (2018). Aerobic exercise is more effective than goal-based exercise for the treatment of cognition in parkinson's disease. Brain and Cognition, 122, 1. doi:10.1016/j.bandc.2018.01.002

Smithson, F., Morris, M. E., & Iansek, R. (1998). Performance on clinical tests of balance in parkinson's disease. Physical Therapy, 78(6), 577-592. doi:10.1093/ptj/78.6.577.

Sommerauer, M., Werth, E., Poryazova, R., Gavrilov, Y.V., Hauser, S., & Valko, P.O. (2015). Bound to supine sleep: Parkinson's disease and the impact of nocturnal immobility. Parkinsonism & Related Disorders, 21(10), 1269-1272. doi:10.1016/j.parkreldis.2015.08.010.

Thevathasan, W., Debu, B., Aziz, T., Bloem, B. R., Blahak, C., Butson, C., . . . Moro E. (2018). Pedunculopontine nucleus deep brain stimulation in parkinson's disease: A clinical review. Movement Disorders, 33(1), 10-20. doi:10.1002/mds.27098

Warburton, D.E.R., Nicol, C.W., & Bredin, S.S.D. (2006). Health benefits of physical activity: The evidence. Canadian Medical Association Journal, 174(6), 801-809. doi:10.1503/cmaj.051351

Weaver, F. M., Follett, K., Stern, M., Hur, K., Harris, C., Marks, W. J., . . . Huang, G. D. (2009). Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: A randomized controlled trial. JAMA, 301(1), 63-73. doi:10.1001/jama.2008.929

Wong, S. L., Gilmour, H., & Ramage-Morin, P. L. (2014). Parkinson’s disease: Prevalence, diagnosis and impact. Health Reports, 25(11), 10.

Woodford, H., & Walker, R. (2005). Emergency hospital admissions in idiopathic parkinson's disease. Movement Disorders, 20(9), 1104-1108. doi:10.1002/mds.20485

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Published

2021-04-07

How to Cite

Ranahan, A. D., Reiter, E., Menard, S., Cortese, S., To, K., Sinik, B., & Warburton, D. (2021). Exercise as a Supplementary Treatment for Parkinson’s Disease. The Health & Fitness Journal of Canada, 14(1), 31–37. https://doi.org/10.14288/hfjc.v14i1.289

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