Parkinson's disease is a neurodegenerative motor system disorder characterized by uncontrolled tremor in various parts of the body, particularly the arms and legs, as well as poor balance and coordination of movements.
In the United States, about 1 million people live with Parkinson's disease, and about 60,000 new cases are diagnosed each year, according to data from the U.S. National Library of Medicine of the National Institutes of Health (NIH).
SPARX (Study in Parkinson Disease of Exercise).
A phase II clinical trial, called Parkinson's Disease Study (SPARX), was recently conducted by researchers from the Northwestern University at Feinberg School of Medicine at Chicago, IL, and from the University of Colorado at Denver.
Their findings suggest that high-intensity exercise is beneficial for people with early-stage Parkinson's disease, as it can delay the progression of symptoms related to motor skills.
If you have Parkinson's disease and want to delay the progression of symptoms, you should exercise three times a week with a heart rate between 80% and 85% maximum. It is as simple as that.
The author of the study is the Dr. Daniel Corcos, Feinberg School of Medicine, Northwestern University and the results were published in JAMA Neurology.
Early intervention can delay symptoms
The authors cite previous research showing that drugs used to treat Parkinson's tend to be less effective over time and expose people to side effects.
For this reason, they say, it is important to identify effective alternative treatments that do not involve drugs.
In phase II of the current randomized clinical trial, the Dr. Corcos and his team worked with 128 participants between the ages of 40 and 80.
Participants were recruited through various institutions and medical centers in three states (Colorado, Illinois and Pennsylvania).
Who participated in the study
The institutions included Northwestern University in Chicago, IL, Rush University Medical Center in Chicago, IL, the University of Colorado at Denver, and the University of Pittsburgh in Pennsylvania.
All of the participants were still in an early stage of Parkinson's disease and were not taking medication for the symptoms of this disease when the study was conducted, as Dr. Corcos suggests:
The earlier you intervene in the disease, the more likely you are to prevent disease progression
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How does physical activity affect the course of Parkinson's disease?
The trial compared the effects of moderate and high-intensity exercise. More specifically, it studied the effects of a physical activity routine on the progression of disease symptoms. The researchers also examined how safe exercise was in the early stage of Parkinson's disease.
All participants had to exercise 3 times a day for 6 months
Study participants were asked to exercise three times a week for a period of 6 months at moderate (characterized by a maximum heart rate of 60-65%) or high intensity (defined as a maximum heart rate of 80-85%). All participants exercised on a treadmill.
For consistency, the scientists also referred to a control group that did not exercise.
After the program, all participants were rated on a relevant scale from 0 to 108, measuring the severity of their symptoms. Higher scores indicated more acute manifestations of the disease.
What did the study find after only 6 months?
Before the trial began, all had measured a score of about 20. However, the results differed after the 6-month period, and the differences were dictated by the intensity of the participants' workouts.
While participants engaged in high-intensity exercise continued to score around 20 on the symptom severity scale, those who had practiced moderate intensity exercise showed worsened symptoms and scored 1.5 points higher.
Meanwhile, those who did not exercise scored three points higher, indicating an even more acute worsening of symptoms.
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More effective high-intensity exercise
According to the researchers, the three-point difference suggests a significant disparity in quality of life. Because high-intensity exercise appeared to keep the development of motor symptoms in check, physical activity requires further research as a potential treatment for Parkinson's disease. Dr. Corcos states:
We delayed the worsening of symptoms for 6 months, whether we can prevent progression of more than 6 months will require further study.
The high-intensity exercise was carried out safely through graded exercises supervised by cardiologists, who monitored how stressful the regimen was on the participants' hearts.
“Exercise is medicine.”
The researchers acknowledge that their study had some limitations, particularly the fact that the only type of exercise studied was treadmill training. This means that the potential benefits of other types of exercise remain unknown.
However, they point out that the high number of participants and the long period of time over which they were observed reinforce the validity of the results. Dr. Corcos explains that most Parkinson's studies have fewer participants and do not exceed 12 weeks.
We gave them [the participants] a proper workout, it's not a mild stretch,” he says. “This is high intensity, it's part of the idea that exercise is medicine.
First study on the benefits of physical activity that considers different workout intensities
Existing studies had already found that exercise was beneficial for people with Parkinson's disease, but this was the first time that the effects of different intensities were considered during research. Dr. Codrin Lungu, program director at the National Institute of Neurological Disorders and Stroke, comments:
Several lines of evidence point to a beneficial effect of exercise in Parkinson's disease. However, it is unclear which type of exercise is most effective.The SPARX trial attempts to rigorously address this issue.The results are interesting and warrant further exploration of optimal exercise regimens for Parkinson's.
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