Therapeutic value of exercise training in Parkinson's disease

Purpose: The objective of this study was to investigate the influence of an intensive exercise training on motor disability, mood, and subjective well-being in parkinsonian patients. Methods: The study was designed as an open long-term pilot trial over 20 wk. Sixteen slightly to moderately affected idiopathic parkinsonian patients (PD) were included. An intensive standardized exercise training was performed twice weekly over 14 wk in all patients. Evaluations were performed before the start of the study (exam. 1), after 7 wk (exam 2), 14 wk (exam 3), and 20 wk (exam 4/long-term effect). The test battery included: 1) basic motor test (BMT) [test for muscle strength, flexibility, and coordination]; 2) Unified Parkinson's Disease Raring Scale (UPDRS) and Columbia University Rating Scale (CURS) for PD-specific motor disability; and 3) registration of psychometric data by Mini Mental State (MMS) for dementia and the Adjective Mood Questionnaire of Zeersen (AMQZ) and Sickness Impact Profile (SLP) for subjective well-being. Results: UPDRS Sigma score (P < 0.0001), CUPS Sigma score (P < 0.0001) and BMT Sigma score (P < 0.0001) improved significantly by exercise training. Six weeks after termination of the training program, the majority of the patients had lost only minor components of their regained motor skills. There was no significant change in cognitive function during the study. The results of open interviews referring to subjective well-being were confirmed by the AMQZ and SIP. As an unexpected side effect, dyskinesias seemed to be better controlled. Conclusion: Motor disability as well as mood and subjective well-being. can be clearly improved by intensive sports activities in early to medium stage PD patients. A sustained ongoing benefit outlasting the active training period for at least 6 wk can be achieved but the exact duration of this benefit is open.