Johnny Collett1, Marloes Franssen1,2, Andy Meaney1, Derick Wade1,3, Hooshang Izadi1,4, Martin Tims1, Charlotte Winward1,5, Marko Bogdanovic6, Andrew Farmer2, Helen Dawes1,7. 1. Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK. 2. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 3. Oxford Centre for Enablement, Oxford University Hospitals, Oxford, UK. 4. Department of Mechanical Engineering and Mathematical Sciences, Oxford Brookes University, Oxford, UK. 5. Department of Infectious Disease, Churchill Hospital, Oxford University Hospitals, Oxford, UK. 6. Department of Neurology, Royal Berkshire Hospital, Reading, UK. 7. Department of Clinical Neurology, University of Oxford, Oxford, UK.
Abstract
BACKGROUND: Evidence for longer term exercise delivery for people with Parkinson's disease (PwP) is deficient. AIM: Evaluate safety and adherence to a minimally supported community exercise intervention and estimate effect sizes (ES). METHODS: 2-arm parallel phase II randomised controlled trial with blind assessment. PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames valley, UK, and randomised (1:1) to intervention (exercise) or control (handwriting) groups, via a concealed computer-generated list. Groups received a 6-month, twice weekly programme. Exercise was undertaken in community facilities (30 min aerobic and 30 min resistance) and handwriting at home, both were delivered through workbooks with monthly support visits. Primary outcome was a 2 min walk, with motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS III), fitness, health and well-being measured. RESULTS:Between December 2011 and August 2013, n=53 (n=54 analysed) were allocated to exercise and n=52 (n=51 analysed) to handwriting. N=37 adhered to the exercise, most attending ≥1 session/week. Aerobic exercise was performed in 99% of attended sessions and resistance in 95%. Attrition and adverse events (AEs) were similar between groups, no serious AEs (n=2 exercise, n=3 handwriting) were related, exercise group-related AEs (n=2) did not discontinue intervention. Largest effects were for motor symptoms (2 min walk ES=0.20 (95% CI -0.44 to 0.45) and MDS-UPDRS III ES=-0.30 (95% CI 0.07 to 0.54)) in favour of exercise over the 12-month follow-up period. Some small effects were observed in fitness and well-being measures (ES>0.1). CONCLUSIONS: PwP exercised safely and the possible long-term benefits observed support a substantive evaluation of this community programme. TRIAL REGISTRATION NUMBER: NCT01439022. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
RCT Entities:
BACKGROUND: Evidence for longer term exercise delivery for people with Parkinson's disease (PwP) is deficient. AIM: Evaluate safety and adherence to a minimally supported community exercise intervention and estimate effect sizes (ES). METHODS: 2-arm parallel phase II randomised controlled trial with blind assessment. PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames valley, UK, and randomised (1:1) to intervention (exercise) or control (handwriting) groups, via a concealed computer-generated list. Groups received a 6-month, twice weekly programme. Exercise was undertaken in community facilities (30 min aerobic and 30 min resistance) and handwriting at home, both were delivered through workbooks with monthly support visits. Primary outcome was a 2 min walk, with motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS III), fitness, health and well-being measured. RESULTS: Between December 2011 and August 2013, n=53 (n=54 analysed) were allocated to exercise and n=52 (n=51 analysed) to handwriting. N=37 adhered to the exercise, most attending ≥1 session/week. Aerobic exercise was performed in 99% of attended sessions and resistance in 95%. Attrition and adverse events (AEs) were similar between groups, no serious AEs (n=2 exercise, n=3 handwriting) were related, exercise group-related AEs (n=2) did not discontinue intervention. Largest effects were for motor symptoms (2 min walk ES=0.20 (95% CI -0.44 to 0.45) and MDS-UPDRS III ES=-0.30 (95% CI 0.07 to 0.54)) in favour of exercise over the 12-month follow-up period. Some small effects were observed in fitness and well-being measures (ES>0.1). CONCLUSIONS: PwP exercised safely and the possible long-term benefits observed support a substantive evaluation of this community programme. TRIAL REGISTRATION NUMBER: NCT01439022. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Jacqueline A Osborne; Rachel Botkin; Cristina Colon-Semenza; Tamara R DeAngelis; Oscar G Gallardo; Heidi Kosakowski; Justin Martello; Sujata Pradhan; Miriam Rafferty; Janet L Readinger; Abigail L Whitt; Terry D Ellis Journal: Phys Ther Date: 2022-04-01
Authors: Foteini Mavrommati; Johnny Collett; Marloes Franssen; Andy Meaney; Claire Sexton; Andrea Dennis-West; Jill F Betts; Hooshang Izadi; Marko Bogdanovic; Martin Tims; Andrew Farmer; Helen Dawes Journal: BMJ Open Date: 2017-12-26 Impact factor: 2.692