Exercise and Parkinson Disease: Comparing Tango, Treadmill, and Stretching

Abstract

Background and purpose: Impaired gait, balance, and motor function are common in Parkinson disease (PD) and may lead to falls and injuries. Different forms of exercise improve motor function in persons with PD, but determining which form of exercise is most effective requires a direct comparison of various approaches. In this prospective, controlled trial, we evaluated the impact of tango, treadmill walking, and stretching on gait, balance, motor function, and quality of life. We hypothesized tango and treadmill would improve forward walking and motor symptom severity, and tango would also improve backward walking, balance, and quality of life.

Methods: Ninety-six participants (age: 67.2 ± 8.9 years, 42% female) with mild to moderate idiopathic PD were serially assigned to tango, treadmill walking, or stretching (active control group) and attended 1-hour classes twice weekly for 12 weeks. Assessments occurred OFF anti-PD medication before and after the intervention and at follow-up 12 weeks after the intervention.

Results: Forward velocity and backward velocity improved for the treadmill group from baseline to posttest and improvements persisted at follow-up. Backward velocity and motor functioning improved for the stretching group from baseline to posttest, but results did not persist at follow-up. There were no significant changes in the tango group across time points.

Discussion and conclusions: Contrary to our hypotheses, only treadmill improved forward walking, while backward walking improved with treadmill and stretching. Future research should examine combinations of exercises with a focus on optimizing dosing and examining whether specific characteristics of people with PD correlate with different types of exercise.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A237).

Trial registration: ClinicalTrials.gov NCT01768832.

Figure 1.

Participant flow diagram.

Figure 2.

Means and standard errors for tango, treadmill, and stretching groups at baseline, post-test (after 12 week intervention), and follow-up (12 weeks after post-test). Estimates of significance from simple differences of group by time least square means generated from the generalized estimating equation models (also see Supplemental Digital Content 3). A. Forward velocity: Significant improvements for treadmill group between baseline and post-test (p = 0.0007). B. Backward velocity: Significant improvement for treadmill group between baseline and post-test (p < 0.0001) and baseline and follow-up (p = 0.0002). Significant improvement for stretching group between baseline and post-test (p = 0.0047). C. SMWT: A trend towards improvement for tango between baseline and post-test (p = 0.026). Participants in the tango group significantly declined between post-test and follow-up (p = 0.0043). D. Mini-BESTest: No significant effects. E. MDS-UPDRS-III: Significant improvement between baseline and post-test for the stretching group (p = 0.0004). F. PDQ-39: Significant improvement for stretching group between post-test and follow-up (p = 0.0002).