Exercise as a Supplementary Treatment for Parkinson's Disease
DOI:
https://doi.org/10.14288/hfjc.v14i1.289Abstract
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
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Alexa Delia Ranahan, Emma Reiter, Shamus Menard, Sarah Cortese, Kelly To, Borislav Sinik
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Terms of Publication
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the Health & Fitness Journal of Canada’s right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- The Contributor (author(s)) represents and guarantees that the Contributor is the sole proprietor of the work and the Contributor has full power to make this Agreement and grant that the work does not infringe the copyright or other proprietary right of any other person; and the work contains no libellous or other unlawful matter and makes no improper invasion of the privacy of any other person. The Contributor also represents and is responsible for the accuracy of the work.
- The Contributor will read, correct, and return promptly galleys and page proofs to the Editor (or designate). The Contributor will be responsible for the completeness and accuracy of these corrections. If the Contributor does not return galleys and page proofs within the schedule agreed upon with the Editor (or designate), the Publisher may proceed without the Contributor corrections.
- When applicable, the Contributor agrees to obtain written permissions and letters of agreement for all matter contained in the work that is protected by existing copyright, paying any permission fees for the use of text or illustrations controlled by others, and furnishing the Publisher with written evidence of the copyright owner’s authorization to use the material.
- When applicable, the Contributor agrees to obtain written permission for inclusion of any photographic materials involving a human subject, and provide the Publisher with written evidence of the subject’s authorization to use this material. In the case of subjects who have not reached the age of majority, the Contributor agrees to obtain and furnish the Publisher with written permission from the parent and/or legal guardian.
- The Contributor may draw on and refer to material in the work in preparing other articles for publication in scholarly and professional journals and papers for delivery at professional meetings, provided that credit is given to the work and to the Publisher.
- This agreement may not be changed unless the Contributor and the Publisher agree to the change by means of a formal addendum signed by the Contributor and the Publisher’s representative.
- This agreement shall be construed and governed according to the laws of the province of British Columbia and shall be binding upon the parties hereto, their heirs, successors, assigns, and personal representatives. Should any formal proceedings related to this agreement be brought, such formal proceeding may be brought only in the province of British Columbia.
By submitting an article to the Health & Fitness Journal of Canada the Contributor has accepted and agreed to all terms outlined in the copyright notice.