Luis Santos1,2, Javier Fernandez-Rio3, Kristian Winge4, Beatriz Barragán-Pérez5, Lucía González-Gómez3, Vicente Rodríguez-Pérez5, Vicente González-Díez6, Alejandro Lucía7,8, Eliseo Iglesias-Soler9, Xurxo Dopico-Calvo9, Miguel Fernández-Del-Olmo10, Miguel Del-Valle3, Miguel Blanco-Traba11, Oscar E Suman12,13, Javier Rodríguez-Gómez14. 1. University School of Sports Medicine, University of Oviedo, Oviedo, Spain - luis.santos.ef@gmail.com. 2. Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain - luis.santos.ef@gmail.com. 3. University School of Sports Medicine, University of Oviedo, Oviedo, Spain. 4. Department of Neurology, Zealand University Hospital, Roskilde, Denmark. 5. Faculty of Physiotherapy, University of León, León, Spain. 6. Medical Service of the Community of Cabo Peñas, Cabo Peñas, Spain. 7. European Univerity and Research Institute, Madrid, Spain. 8. Hospital 12 de Octubre ('i+12'), Madrid, Spain. 9. Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain. 10. Learning and Human Movement Control Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain. 11. Catholic University of Valencia, Valencia, Spain. 12. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA. 13. Shriners Hospitals for Children, Galveston, TX, USA. 14. Department of Neurology, Hospital of the Bierzo, Ponferrada, Spain.
Abstract
BACKGROUND:Progressive resistance exercise (PRE) can have a positive effect in individuals with Parkinson's disease (PD). However, the effect of PRE may vary with the clinical subtype of PD. To date, no study has assessed the effects of PRE in the different subtypes of PD. AIM: The aim of the present study was to assess the effects of PRE in PD patients with akinesia and rigidity (AR-subtype). DESIGN: A randomized controlled trial was conducted. SETTING:Outpatients clinics of the Bierzo Parkinson Association (Ponferrada, Spain) and the Asturias Parkinson Association (Oviedo, Spain). POPULATION: Twenty-eight patients with AR-subtype PD were randomized into an Experimental Group (EG, N.=13) and Control Group (CG, N.=15). METHODS:Static posturography (Centre of Pressure -CoP- parameters), gait (the Ten-Meter Walk Test [TMWT]), freezing of gait (the Freezing of Gait Questionnaire [FOG-Q]), the motor portion of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and patient-perceived quality of life (the 39-item Parkinson's disease Questionnaire [PDQ39]), were assessed at pre-test, post-test, and re-test. Ratings of perceived exertion (RPE) (Borg >6-20 Scale) were recorded at the end of each PRE training session. RESULTS: The EG displayed significant ameliorations in Length (CoP parameters) from pre- to post-test (P=0.048), in speed of fast rhythm walking (TMWT) from pre- to post-test (P=0.000), and from pre- to re-test (P=0.027), and in the PDQ39 Score from pre- to post-test (P=0.024). No significant differences were detected in Area or Speed (CoP parameters), speed of preferred rhythm walking (TMWT), FOG-Q scores, or the motor portion of the MDS-UPDRS scores. The EG reported a mean RPE of 9.95 (between "very light" and "fairly light") for the whole training program. CONCLUSIONS: These findings provide support for the use of PRE training in the rehabilitation of individuals with AR-subtype PD, as it can improve static posturography, gait, and quality of life. Furthermore, RPE scores showed that individuals with AR-subtype PD consider that PRE training require only light efforts. CLINICAL REHABILITATION IMPACT: The PRE training can be a helpful and fruitful rehabilitation tool for AR-subtype PD patients.
RCT Entities:
BACKGROUND: Progressive resistance exercise (PRE) can have a positive effect in individuals with Parkinson's disease (PD). However, the effect of PRE may vary with the clinical subtype of PD. To date, no study has assessed the effects of PRE in the different subtypes of PD. AIM: The aim of the present study was to assess the effects of PRE in PDpatients with akinesia and rigidity (AR-subtype). DESIGN: A randomized controlled trial was conducted. SETTING: Outpatients clinics of the Bierzo Parkinson Association (Ponferrada, Spain) and the Asturias Parkinson Association (Oviedo, Spain). POPULATION: Twenty-eight patients with AR-subtype PD were randomized into an Experimental Group (EG, N.=13) and Control Group (CG, N.=15). METHODS: Static posturography (Centre of Pressure -CoP- parameters), gait (the Ten-Meter Walk Test [TMWT]), freezing of gait (the Freezing of Gait Questionnaire [FOG-Q]), the motor portion of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and patient-perceived quality of life (the 39-item Parkinson's disease Questionnaire [PDQ39]), were assessed at pre-test, post-test, and re-test. Ratings of perceived exertion (RPE) (Borg >6-20 Scale) were recorded at the end of each PRE training session. RESULTS: The EG displayed significant ameliorations in Length (CoP parameters) from pre- to post-test (P=0.048), in speed of fast rhythm walking (TMWT) from pre- to post-test (P=0.000), and from pre- to re-test (P=0.027), and in the PDQ39 Score from pre- to post-test (P=0.024). No significant differences were detected in Area or Speed (CoP parameters), speed of preferred rhythm walking (TMWT), FOG-Q scores, or the motor portion of the MDS-UPDRS scores. The EG reported a mean RPE of 9.95 (between "very light" and "fairly light") for the whole training program. CONCLUSIONS: These findings provide support for the use of PRE training in the rehabilitation of individuals with AR-subtype PD, as it can improve static posturography, gait, and quality of life. Furthermore, RPE scores showed that individuals with AR-subtype PD consider that PRE training require only light efforts. CLINICAL REHABILITATION IMPACT: The PRE training can be a helpful and fruitful rehabilitation tool for AR-subtype PDpatients.
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