Changes in Movement, Fitness, and Quality of Life in People With Parkinson's Disease After Different Exercise Programs

May 4, 2026 updated by: Katherine Reyes-Brooks, University of Texas, El Paso

Changes in Motor Function, Quality of Life, Cardiorespiratory Fitness, and Physiological Markers in People With Parkinson's Disease Following Different Exercise Interventions.

Parkinson's disease (PD) is a progressive neurological condition that can affect movement, balance, endurance, and overall quality of life. Exercise is widely recognized as one of the most effective non-pharmacological treatments to help people with PD maintain function and independence. However, not all exercise programs produce the same results, and more research is needed to understand which types of exercise offer the greatest physical and physiological benefits.

This study is designed to examine how different types of structured exercise programs influence motor function, cardiorespiratory fitness, and markers of overall health in individuals with Parkinson's disease. The goal is to better understand how exercise can be used to improve movement, daily activities, and general well-being, as well as how it affects the body at a physiological level.

Participants will be adults diagnosed with idiopathic Parkinson's disease who are medically stable and able to safely participate in exercise. Before beginning the study, participants will complete screening procedures to ensure safety and eligibility. Eligible participants will then be assigned to one of several supervised exercise interventions conducted over a defined period. Each exercise program is designed to improve movement and function but differs in structure or training emphasis (for example, aerobic, functional, or task-specific activity).

Exercise sessions will take place under the supervision of licensed physical therapist. Each session will include warm-up, exercise, and cool-down components. Intensity will be monitored using heart rate and perceived exertion to ensure safety and appropriate challenge. Participants will attend sessions multiple times per week for 8 weeks.

Researchers will collect information about movement abilities, balance, walking, endurance, and daily function using standardized physical therapy assessments such as gait tests, balance measures, and questionnaires related to quality of life at baseline, after 8-weeks of intervention and once more after a 4-week follow-up. In addition, blood samples will be collected to analyze physiological responses to exercise at the same 3 testing intervals. These samples will allow investigators to measure biomarkers related to cardiovascular health, nitric oxide availability, oxidative stress, and inflammation. These biological indicators can help identify how exercise affects underlying health mechanisms that may contribute to improved function in people with Parkinson's disease.

All data will be collected by trained research personnel who are experienced in working with individuals with Parkinson's disease. Participants will be monitored for safety at each session, and any adverse events will be documented and reviewed by the principal investigator and the Institutional Review Board (IRB).

By comparing changes across the different exercise programs, this study aims to determine which interventions have the most meaningful impact on mobility, endurance, and quality of life, as well as which ones produce measurable physiological benefits. Results from this research may help guide physical therapists, rehabilitation professionals, and people with Parkinson's disease in choosing the most effective exercise approaches for maintaining function and promoting overall health.

Ultimately, this project seeks to contribute to the growing evidence that targeted, engaging, and appropriately dosed exercise can play a key role in improving the lives of people living with Parkinson's disease. The findings may also help inform future clinical practice guidelines, community exercise programs, and long-term wellness strategies for individuals with movement disorders.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a randomized, controlled, parallel-group trial designed to evaluate the effects of three distinct exercise interventions in individuals with Parkinson's disease. The study compares guided cycling, non-contact boxing, and traditional physical therapy, each representing different approaches to exercise based on differences in intensity, motor demands, and cardiovascular engagement.

Participants will be randomly assigned to one of the three intervention groups using a computer-generated allocation process. Each participant will complete a structured intervention program consisting of supervised exercise sessions conducted twice weekly over an eight-week period. Interventions will be delivered in outpatient clinical and community-based settings under the supervision of licensed physical therapists, with exercise intensity and progression adjusted according to individual performance and tolerance.

The total duration of participation is approximately 15 weeks and includes baseline assessment, an intervention phase, post-intervention testing, and a follow-up assessment following a four-week washout period without structured exercise. This design allows for evaluation of both immediate responses to training and short-term retention of exercise-related adaptations.

The guided cycling intervention utilizes structured aerobic training performed on stationary ergometers, with workload adjusted based on individualized physiological responses. The non-contact boxing intervention incorporates large-amplitude, rhythmical, and task-specific movements designed to engage motor, cognitive, and cardiovascular systems simultaneously. The traditional physical therapy intervention reflects standard rehabilitation practice and includes a combination of aerobic conditioning, balance training, strengthening, and functional mobility exercises.

All intervention sessions will be supervised by licensed physical therapists with support from trained personnel to ensure consistency of delivery and participant safety. Monitoring procedures will be used across all intervention groups to assess participant response and guide appropriate modification of activity as needed.

This study is conducted within a collaborative clinical and academic framework to support standardized implementation of interventions and data collection. The findings are intended to improve understanding of how different exercise strategies may influence adaptation in individuals with Parkinson's disease and to inform the development of more targeted rehabilitation approaches.

Study Design

This is a single-site, randomized, controlled, interventional trial conducted in El Paso, Texas, with collaboration between the University of Texas at El Paso (UTEP) and MOVE Therapy Services. Participants will be randomized (computer-generated block randomization) into one of three intervention arms:

  1. Guided Cycling Group
  2. Non-Contact Boxing Group
  3. Traditional Physical Therapy (Standard Care) Group

The total duration for each participant is 15 weeks, consisting of:

  • Week 1: Baseline testing
  • Weeks 2-9: 8-week intervention (two 60-minute sessions per week)
  • Week 10: Post-intervention testing
  • Weeks 11-14: Four-week rest/washout
  • Week 15: Final follow-up testing

All sessions will be led by licensed physical therapists with assistance from trained Doctor of Physical Therapy (DPT) students. Data collection will occur at UTEP's Rehabilitation Sciences Complex for the cycling and physical therapy groups, and at MOVE Therapy Services for the boxing group.

Intervention Descriptions

  1. Non-Contact Boxing:

    This intervention emphasizes large-amplitude, rhythmical, and task-specific movements that combine cognitive, motor, and cardiovascular elements. Sessions include warm-up, boxing rounds (heavy bag, speed bag, mitt work), agility and balance circuits, and cool-down routines. Participants wear gloves, engage in multi-directional footwork, and perform high-intensity drills under therapist supervision. HR and BP are continuously monitored for safety.

  2. Guided Cycling:

    This program uses stationary cycle ergometers (Lode Corival) with intensity determined by participants' lactate threshold, established through cardiopulmonary exercise testing (CPET). Each session includes a warm-up, 40-minute cycling component with alternating low, moderate, and high-intensity bouts, and a cool-down. HR and RPE are recorded throughout. Lactate micro-sampling from the earlobe is used periodically to confirm workloads within prescribed zones.

  3. Traditional Physical Therapy (Standard Care):

This intervention incorporates multimodal training emphasizing aerobic exercise, resistance and balance training, gait practice, and task-specific functional activities. Intensity is set between 60-85% HRmax, adjusted by perceived exertion and HR monitoring. Each session includes warm-up, treadmill or cycling intervals, balance tasks with and without visual cues, strength training, and community-oriented gait exercises. Safety is ensured through therapist supervision, gait belts, and appropriate rest breaks.

Study Type

Interventional

Enrollment (Estimated)

45

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Texas
      • El Paso, Texas, United States, 79902
        • Recruiting
        • University of Texas at El Paso Doctor of Physical Therapy and Movement Sciences Building
        • Contact:
      • El Paso, Texas, United States, 79935
        • Recruiting
        • Move Therapy Services
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Diagnosis of Parkinson's Disease
  2. Independent ambulation
  3. Hoehn and Yahr stage of 1-3
  4. 50 years of age or older
  5. Must speak English or Spanish

Exclusion Criteria:

  1. History of stroke
  2. History of heart attack
  3. Non-ambulatory
  4. Hoehn and Yahr of stage 4 or 5
  5. Osteoporosis
  6. Unmanaged Parkinson's medication

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Guided Cycling
Participants in this group will complete supervised cycling sessions on a stationary ergometer twice per week for eight weeks. Exercise intensity will be based on each participant's lactate threshold, determined during cardiopulmonary exercise testing (CPET). Each session includes a warm-up, a 40-minute cycling protocol alternating low, moderate, and high intensities, and a cool-down. Heart rate and perceived exertion are continuously monitored.
Behavioral: Guided Cycling
Participants will complete supervised cycling sessions on a stationary ergometer twice per week for eight weeks. Exercise intensity is based on each participant's lactate threshold as determined by cardiopulmonary exercise testing (CPET). Each 60-minute session includes a warm-up, cycling intervals of varying intensity, and a cool-down. Heart rate and perceived exertion are monitored continuously to ensure safety and adherence to prescribed intensity zones.
Experimental: Non-contact Boxing
Participants in this group will take part in a structured non-contact boxing program modeled after the Rock Steady Boxing® framework. Each 60-minute session includes warm-up, agility drills, four rounds of boxing activities (heavy bag, speed bag, mitt work, and double bag), balance circuits, and a cool-down. Sessions are led by a licensed physical therapist and certified boxing coach.
Behavioral: Non-Contact Boxing

Non-Contact Boxing Exercise Program

Participants will engage in a structured, non-contact boxing program modeled after the Rock Steady Boxing® framework. Sessions are held twice weekly for eight weeks and include warm-up activities, agility and coordination drills, four boxing rounds using heavy and speed bags, and a circuit for balance and strength training. Each session concludes with a cool-down. All activities are supervised by licensed physical therapists trained in Parkinson's-specific exercise safety.
Active Comparator: Traditional Physical Therapy (Standard Care)
Participants in this group will receive standard physical therapy sessions that include aerobic, balance, strengthening, gait, and task-specific training exercises. Each session lasts approximately 60 minutes and is conducted twice weekly for eight weeks under the supervision of a licensed physical therapist. Exercise intensity is set between 60-85% of maximum heart rate, monitored throughout the session.
Behavioral: Traditional Physical Therapy Program (Standard of Care)
Participants in this group will receive multimodal physical therapy sessions twice per week for eight weeks. Each 60-minute session includes aerobic training (cycling or treadmill), resistance and balance exercises, gait training, and task-specific functional activities such as transfers and turning. Intensity is maintained at 60-85% of maximum heart rate, with continuous heart-rate monitoring. Sessions are led by a licensed physical therapist following standard clinical practice guidelines.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mini-BESTest Total Score
Time Frame: Baseline, Week 10, Week 15.
The Mini-Balance Evaluation Systems Test (Mini-BESTest) assesses anticipatory control, reactive postural control, sensory orientation, and dynamic gait. Total score range 0-28; higher scores indicate better balance.
Baseline, Week 10, Week 15.
Change in VO₂peak (mL/kg/min) During CPET
Time Frame: Baseline, Week 10, Week 15.
Peak oxygen uptake measured by metabolic cart during graded cycle ergometry; higher values indicate greater cardiorespiratory fitness.
Baseline, Week 10, Week 15.
PDQ-39 Summary Index
Time Frame: Baseline, Week 10, Week 15.
Parkinson's Disease Questionnaire-39 overall summary index; lower scores indicate better health-related quality of life.
Baseline, Week 10, Week 15.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
10-Meter Walk Test (10MWT) Speed
Time Frame: Baseline, Week 10, Week 15.
The 10MWT measures gait speed in meters per second over a 10-meter distance. Increased speed indicates improved walking ability.
Baseline, Week 10, Week 15.
Tinetti Performance-Oriented Mobility Assessment (POMA) Score
Time Frame: Baseline, Week 10, Week 15.
The POMA evaluates balance and gait function. Scores range from 0-28, with higher scores reflecting improved mobility and reduced fall risk.
Baseline, Week 10, Week 15.
Modified Clinical Test of Sensory Interaction in Balance (mCTSIB) Score
Time Frame: Baseline, Week 10, Week 15.
The mCTSIB assesses postural stability under four sensory conditions. Longer hold times indicate improved sensory integration and balance.
Baseline, Week 10, Week 15.
Flow-Mediated Dilation (FMD) Percentage
Time Frame: Baseline, Week 10, Week 15.
Endothelial function will be evaluated by ultrasound measurement of brachial artery diameter changes after occlusion. Greater FMD percentage indicates improved vascular function.
Baseline, Week 10, Week 15.
Blood Biomarker Levels (NOx, CRP, TNF-α, Homocysteine, Vitamin B-12, 8-Isoprostane)
Time Frame: Baseline, Week 10, Week 15.
Venous blood samples will be analyzed for nitric oxide bioavailability (NOx), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), homocysteine, vitamin B-12, and oxidative stress marker 8-isoprostane. These biomarkers reflect inflammatory and metabolic responses to exercise.
Baseline, Week 10, Week 15.
Blood Lactate Concentration During CPET
Time Frame: Baseline, Week 10, Week 15.
Blood lactate levels (mmol/L) will be collected through micro-sampling from the earlobe during graded exercise testing. A rightward shift in lactate threshold indicates improved metabolic efficiency.
Baseline, Week 10, Week 15.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Texas, El Paso

Investigators

  • Principal Investigator: Katherine M Reyes-Brooks, PT, DPT, University of Texas, El Paso

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 21, 2026

Primary Completion (Estimated)

May 31, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

October 23, 2025

First Submitted That Met QC Criteria

October 23, 2025

First Posted (Actual)

October 27, 2025

Study Record Updates

Last Update Posted (Actual)

May 8, 2026

Last Update Submitted That Met QC Criteria

May 4, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2310334

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Individual participant data will be available without identifiers upon request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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