Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting

Ergun Y Uc; Kevin C Doerschug; Vincent Magnotta; Jeffrey D Dawson; Teri R Thomsen; Joel N Kline; Matthew Rizzo; Sara R Newman; Sonya Mehta; Thomas J Grabowski; Joel Bruss; Derek R Blanchette; Steven W Anderson; Michelle W Voss; Arthur F Kramer; Warren G Darling

doi:10.1212/wnl.0000000000000644

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Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting

Journal article

Open access

Peer reviewed

Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting

Ergun Y Uc, Kevin C Doerschug, Vincent Magnotta, Jeffrey D Dawson, Teri R Thomsen, Joel N Kline, Matthew Rizzo, Sara R Newman, Sonya Mehta, Thomas J Grabowski, …

Neurology, Vol.83(5), pp.413-425

07/29/2014

DOI: 10.1212/wnl.0000000000000644

PMCID: PMC4132568

PMID: 24991037

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Abstract

To (1) investigate effects of aerobic walking on motor function, cognition, and quality of life in Parkinson disease (PD), and (2) compare safety, tolerability, and fitness benefits of different forms of exercise intervention: continuous/moderate intensity vs interval/alternating between low and vigorous intensity, and individual/neighborhood vs group/facility setting. Initial design was a 6-month, 2 × 2 randomized trial of different exercise regimens in independently ambulatory patients with PD. All arms were required to exercise 3 times per week, 45 minutes per session. Randomization to group/facility setting was not feasible because of logistical factors. Over the first 2 years, we randomized 43 participants to continuous or interval training. Because preliminary analyses suggested higher musculoskeletal adverse events in the interval group and lack of difference between training methods in improving fitness, the next 17 participants were allocated only to continuous training. Eighty-one percent of 60 participants completed the study with a mean attendance of 83.3% (95% confidence interval: 77.5%-89.0%), exercising at 46.8% (44.0%-49.7%) of their heart rate reserve. There were no serious adverse events. Across all completers, we observed improvements in maximum oxygen consumption, gait speed, Unified Parkinson's Disease Rating Scale sections I and III scores (particularly axial functions and rigidity), fatigue, depression, quality of life (e.g., psychological outlook), and flanker task scores (p < 0.05 to p < 0.001). Increase in maximum oxygen consumption correlated with improvements on the flanker task and quality of life (p < 0.05). Our preliminary study suggests that aerobic walking in a community setting is safe, well tolerated, and improves aerobic fitness, motor function, fatigue, mood, executive control, and quality of life in mild to moderate PD. This study provides Class IV evidence that in patients with PD, an aerobic exercise program improves aerobic fitness, motor function, fatigue, mood, and cognition.

Parkinson Disease - therapy

Residence Characteristics

Humans

Middle Aged

Male

Treatment Outcome

Parkinson Disease - physiopathology

Aged, 80 and over

Parkinson Disease - diagnosis

Quality of Life

Female

Aged

Exercise - physiology

Details

Title: Subtitle: Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting
Creators: Ergun Y Uc - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign. ergun-uc@uiowa.edu
Kevin C Doerschug - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Vincent Magnotta - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Jeffrey D Dawson - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Teri R Thomsen - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Joel N Kline - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Matthew Rizzo - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Sara R Newman - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Sonya Mehta - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Thomas J Grabowski - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Joel Bruss - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Derek R Blanchette - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Steven W Anderson - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Michelle W Voss - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Arthur F Kramer - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Warren G Darling - From the Departments of Neurology (E.Y.U., T.R.T., M.R., S.R.N., J.B., S.W.A.), Internal Medicine (K.C.D., J.N.K.), Radiology (V.M.), Biostatistics (J.D.D., D.R.B.), Psychology (M.W.V.), and Health and Human Physiology (W.G.D.), University of Iowa, Iowa City; Neurology Service (E.Y.U., T.R.T., S.R.N.), Veterans Affairs Medical Center, Iowa City, IA; Department of Neurology (S.M., T.J.G.), University of Washington, Seattle; and Department of Psychology (A.F.K.), Beckman Institute, University of Illinois, Urbana-Champaign
Resource Type: Journal article
Publication Details: Neurology, Vol.83(5), pp.413-425
DOI: 10.1212/wnl.0000000000000644
PMID: 24991037
PMCID: PMC4132568
NLM abbreviation: Neurology
ISSN: 0028-3878
eISSN: 1526-632X
Publisher: United States
Grant note: ES005605 / NIEHS NIH HHS R01 AG017177 / National Institute on Aging P30 ES005605 / National Institute of Environmental Health Sciences UL1RR024979 / NCRR NIH HHS UL1 RR024979 / National Center for Research Resources R01 NS044930 / National Institute of Neurological Disorders and Stroke
Language: English
Date published: 07/29/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Public Health Administration; Psychiatry; Occupational and Environmental Health; Psychological and Brain Sciences; Iowa Neuroscience Institute; Biostatistics; Physical Therapy and Rehabilitation Science; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9983997489602771

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