A High-Intensity Multicomponent Agility Intervention Improves Parkinson Patients' Clinical and Motor Symptoms

Abstract

Objective: To determine the effects of a high-intensity exercise therapy using sensorimotor and visual stimuli on nondemented Parkinson disease (PD) patients' clinical symptoms, mobility, and standing balance.

Design: Randomized clinical intervention, using a before-after trial design.

Setting: University hospital setting.

Participants: A total of 72 PD patients with Hoehn and Yahr stage of 2-3, of whom 64 were randomized, and 55 completed the study.

Intervention: PD patients were randomly assigned to a no physical intervention control (n=20 of 29 completed, 9 withdrew before baseline testing) or to a high-intensity agility program (15 sessions, 3 weeks, n=35 completed).

Main outcome measures: Primary outcome was the Movement Disorders Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) motor experiences of daily living (M-EDL). Secondary outcomes were Beck Depression score, Parkinson Disease Questionnaire-39 (PDQ-39), EuroQoL Five-Dimension (EQ5D) Questionnaire visual analog scale, Schwab and England Activities of Daily Living (SE ADL) Scale, timed Up and Go (TUG) test, and 12 measures of static posturography.

Results: The agility program improved MDS-UPDRS M-EDL by 38% compared with the 2% change in control (group by time interaction, P=.001). Only the intervention group improved in PDQ-39 (6.6 points), depression (18%), EQ5D visual analog scale score (15%), the SE ADL Scale score (15%), the TUG test (39%), and in 8 of 12 posturography measures by 42%-55% (all P<.001). The levodopa equivalent dosage did not change.

Conclusion: A high-intensity agility program improved nondemented, stage 2-3 PD patients' clinical symptoms, mobility, and standing balance by functionally meaningful margins at short-term follow-up.

Keywords: Gait; Posture; Quality of life; Rehabilitation.