A High-Intensity Multi-Component Agility Intervention Improves Parkinson’s Patients’ Clinical and Motor Symptoms

Publication date: Available online 7 June 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): József Tollár, Ferenc Nagy, Norbert Kovács, Tibor Hortobágyi
ObjectiveTo determine the effects of a high-intensity exercise therapy using sensorimotor and visual stimuli on non-demented Parkinson's disease (PD) patients' clinical symptoms, mobility, and standing balanceDesignRandomized clinical intervention, using a before-after trial design.SettingUniversity hospital setting.Participants72 PD patients with Hoehn-Yahr stage of 2 to 3, of whom 64 were randomized, and 55 completed the study.InterventionPD 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 outcomesPrimary outcome was the MDS-UPDRS M-EDL. Secondary outcomes were: Beck depression score, PDQ-39, EQ5D VAS, Schwab & England Activities of daily living scale, timed up and go test, and 12 measures of static posturographyResultsThe agility program improved MDS-UPDRS M-EDL by 38% compared with the 2% change in control (Group by Time interaction, p = 0.001). Only the intervention group improved in PDQ-39 (6.6 points), depression (18%), EQ5D VAS score (15%), the Schwab and England ADL score (15%), the TUG (39%), and in 8 of 12 posturography measures by 42 to 55% (all p < 0.001). The levodopa equivalent dosage did not change.ConclusionA high-intensity agility program improved non-demented, stage 2-3 PD patients' clinical symptoms, mobility, and standing balance by functionally meaningful margins at short-term follow-up.



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