Symptom and gait changes after sensory attention focused exercise vs aerobic training in Parkinson's disease

Abstract

The current study compared lower-limb aerobic training and sensory attention focused exercise (PD SAFEx) to a non-exercise control group with the overall objective of determining which strategy would have a greater benefit for Parkinson's disease (PD) symptoms and gait. PD SAFEx was developed to focus on sensorimotor deficits identified in PD with the aim of increasing sensory feedback and body awareness, while the lower-limb aerobic training utilized a specially designed semi-recumbent elliptical device. Intervention groups (PD SAFEx, n = 18; aerobic, n = 13) exercised three times/week for 10-12 weeks, while nonexercise control participants (n = 15) maintained their regular activity level for 12 weeks. Outcome measures included the Unified Parkinson's disease rating scale motor section (UPDRS) administered by a blinded clinician; a posture and gait (PG) score (total of UPDRS items 27-31); the Timed-Up-and-Go (TUG); and spatiotemporal aspects of self-paced gait. PD SAFEx resulted in an improved UPDRS, PG score, and TUG (reached significance when participants with poor attendance were excluded) but not self-paced gait. The lower-limb aerobic training led to increased step length and velocity but had no change to disease severity. Since gait improvements were not combined with symptomatic changes, lower-limb aerobic exercise may not be optimal for individuals with PD. Conversely, sensory-based exercise (PD SAFEx) was beneficial, and led to improvement in symptoms and functional movement control.