1. DEPARTMENT OF KINESIOLOGY, UNIVERSITY OF WISCONSIN-MADISON
Exercise and Gait in Parkinson Disease
Vaughan K. Collins, Kristen A. Pickett Ph.D.
Introduction Likely Results
Future Implications
• More studies will provide some form of exercise access
to individuals with PD that reside in rural areas.
• Provide an opportunity for individuals with PD to contact
health providers
• Gait disabilities and motor symptoms will decrease in
participants who participate in weekly exercise.
• This study will provide further research into the effects
of exercise on PD.
• More individuals with PD will participate in exercise of
any kind to help relieve PD symptoms and to promote
general health.
• Forced exercise will be more commonly used with
individuals with PD.
• Forced exercise will allow individuals with PD to regain
mobility, increase posture, balance, and gait.
• Decreased gait disabilities which include walking speed,
stride length, balance, and mobility.
• Participants with a history of FOG will experience a decrease
in falls.
• By engaging in exercise participants will see a reduction in
depression levels due to the release of neurotransmitters and
endorphins.
• Support the health of individuals with PD with increased
oxygen delivery and neuroprotection.
• Individuals will have an increased QoL.
• This study will include 30 individuals with Parkinson disease who do not have access to an exercise facility; 15 individuals with
PD and no reported history of FOG and 15 individuals with PD and a history of FOG (score of one on New FOG Questionnaire).
• All participants will be required to have a physical assessment and be deemed healthy for exercise activity as well as receive a
diagnosis of idiopathic “definite PD”.
• Medication history will be recorded while pre and posttesting will be observed with a minimum 12-hour medication withdrawal
(off) and a medication “on” testing over a period of two half days.
• The testing will occur in the Sensory Motor Lab which will consist of biomechanical and disease severity data. The tests that will
be used are MDS-UPDRS, New Freezing of Gait Questionnaire, TUG test, Four square step test, small radius turns, gait analysis,
Sleepless index, Mini-Mental State Examination, and Beck Depression Inventory. One week after testing the individual will begin
the exercise regime.
• During the initial session, the testing team will set up a Diamondback 910SR Fitness Recumbent Bike that will be fitted with a
digital interface in the individual’s home and a baseline measure of comfortable exercise will be taken. The team will ensure
that the bike is set-up in a safe and clutter-free area while a remote connection will be made to an individual at the UW.
• Following the initial session, stationary bike training will occur three time per week for three months while each session is
monitored by a PD team member via telemedicine. Each session will consist of 45 minutes of cycling at a targeted speed with a
10 minute warm-up session.
• The initial targeted speed will be 130% of the average pace established by the individual during the testing session while the
targeted speeds for future sessions will be based upon the previous training sessions.
• After the three months of exercise training, the individual will be tested in the Sensory Motor Lab again and results of the two
treatment groups will be compared.
• Important aspects of Parkinson disease (PD) disabilities are atypical gait and balance.5
• Gait and balance problems include bradykinesia, freezing of gait (FOG), change in posture, and dual tasking
(resulting in increased risk of falling).1
• Regular exercise can result in a reduction of disability and disease modifying impact on PD and other
neurodegenerative diseases.7
•Exercise “dose” matters based on the association of exercise frequency with less severe symptoms of PD and
increased cognitive functions.6
•When early insensitive physical rehabilitation is used it can break the motor performance degradation cycle and
therefore slow down the rate of motor decay.3
• Individuals with advanced PD adjust well to a high-intensity exercise program which favorably changes skeletal
muscle at both the cellular and sub cellular levels which can help improve motor functioning, physical capabilities,
and fatigue.4
• Current results demonstrate that exercise can improve functional fitness and QoL.2
• The goal of this research is to reduce gait disabilities in individuals with Parkinson disease who have a history of
FOG.
Research Design & Methods
References
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Movement Disorders. 19, 871–884.
2. Cheon, S. M., Chae, B. K., Sung, H. R., Lee, G. C., & Kim, J. W. (2013). The Efficacy of Exercise Programs for Parkinson’s Disease: Tai Chi versus Combined Exercise. Journal of
Clinical Neurology, 9(4), 237-243.
3. Frazzitta, G., Maestri, R., Bertotti, G., Riboldazzi, G., Boveri, N., Perini, M., Uccellini, D., Turla, M., Comi, C., Pezzoli, G., & Ghilardi, M. F., (2014). Intensive rehabilitation
treatment in early parkinson’s disease: A randomized pilot study with a 2-year follow-up. Neurorehabilitation and Neural Repair, 29(2), 123-131.
4. Kelly, N. A., Ford, M. P., Standaert, D. G., Watts, R. L., Bickel, C. S., Moellering, D. R., Tuggle, S. C., Williams, J. Y., Lieb, L., Windham, S. T., & Bamman, M. M., (2014). Novel,
high-intensity exercise prescription improves muscle mass, mitochondrial function, and physical capacity in individuals with parkinson’s disease. Journal of Applied
Physiology, 16, 582-592.
5. Morris, M. E., (2000). Movement disorders in people with parkinson disease: A model for physical therapy. Physical Therapy, 80, 578-597.
6. Oguh, O., Einstein, A., Kwansy, M., & Simuni, T., (2014). Back to the basics: Regular exercise matters in Parkinson disease: Results from the national parkinson foundation
QII registry study. Parkinsonism and Related Disorders, 20(11).
7. Xu Q, Park Y, Huang X, Hollenbeck A, Blair A, Schatzkin A, et al., (2010). Physical activities and future risk of Parkinson disease. Neurology, 75(4), 341-348.