Objectives:
To investigate whether people with Parkinson’s disease (PD) can benefit from a cognitively challenging exercise regarding motor and cognitive function
Methods:
Eighty-two subjects with idiopathic PD (54 males; mean age 68.9±7.7 years; mean Hoehn and Yahr stage 2.3 ± 0.6; mean disease duration 6.4±5.0 years) participated in a cross-over, randomized, double-blind, controlled study (Table 1). They were randomized into either a 6-week exercise (n=44) or a 6-week education (n=38) intervention (Figure 1). After the first intervention, they crossed over to the other treatment for 6 weeks. The exercise intervention was an 80-minute, 3 days a week cognitively-challenging group (up to 6) exercise program. It was based on the Agility Boot Camp-Cognition (ABC-C) program led by an exercise trainer. The exercises were designed as a circuit to challenge movement skills known to be impaired in PD and each activity was systematically progressed for 3 levels integrated with various cognitive tasks. The education intervention was a 90-minute, once a week group (up to 6) program developed to be specific for people with PD.
Clinical assessment and outcome measures were performed at baseline (T0), after 6 weeks of the first intervention (T1), and at the end of the second intervention (T2).
Results:
The motor dual-task cost (DTCmotor) on gait speed and stride length improved after exercise (5.1±1.1%, 4.0±1.3%), but not after education (0.3±1.1%, 1.0±1.0%, Figure 2). The MDS-UPDRS Part II score improved after exercise (-1.3±0.4) more than after education (0.04±0.4, p=0.03). The PIGD score decreased after exercise (-0.9±0.2) more than after education (-0.2±0.2, p=0.02). The anticipatory postural adjustment subscore of the Mini-BESTest improved after exercise (0.3±0.1) more than after education (-0.3±0.1, p=0.003). The SCOPA-COG total score showed a significant improvement after exercise (1.6±0.3) than after education (0.5±0.4, p=0.045).
Participants who did light intensity exercise or exercise for less than 3 hours before trial showed significant improvement in DTCmotor on gait speed and stride length and SCOPA-COG total score after exercise. Freezers showed significant improvement in DTCmotor on gait speed (p<0.001) and stride length (p=0.047) after exercise. Individuals who had cognitive impairment showed significant improvement in DTCmotor on gait speed (p=0.001) and stride length (p=0.001) after exercise.
Conclusions:
People with PD can improve the dual-task performance, motor function and cognitive function with a cognitively challenging group exercise intervention.
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