Comparison of strength training, aerobic training, and additional physical therapy as supplementary treatments for Parkinson's disease: pilot study

Alessandro Carvalho, Dannyel Barbirato, Narahyana Araujo, Jose Vicente Martins, Jose Luiz Sá Cavalcanti, Tony Meireles Santos, Evandro S Coutinho, Jerson Laks, Andrea C Deslandes, Alessandro Carvalho, Dannyel Barbirato, Narahyana Araujo, Jose Vicente Martins, Jose Luiz Sá Cavalcanti, Tony Meireles Santos, Evandro S Coutinho, Jerson Laks, Andrea C Deslandes

Abstract

Introduction: Physical rehabilitation is commonly used in patients with Parkinson's disease (PD) to improve their health and alleviate the symptoms.

Objective: We compared the effects of three programs, strength training (ST), aerobic training (AT), and physiotherapy, on motor symptoms, functional capacity, and electroencephalographic (EEG) activity in PD patients.

Methods: Twenty-two patients were recruited and randomized into three groups: AT (70% of maximum heart rate), ST (80% of one repetition maximum), and physiotherapy (in groups). Subjects participated in their respective interventions twice a week for 12 weeks. The assessments included measures of disease symptoms (Unified Parkinson's Disease Rating Scale [UPDRS]), functional capacity (Senior Fitness Test), and EEG before and after 12 weeks of intervention.

Results: The PD motor symptoms (UPDRS-III) in the group of patients who performed ST and AT improved by 27.5% (effect size [ES]=1.25, confidence interval [CI]=-0.11, 2.25) and 35% (ES=1.34, CI=-0.16, 2.58), respectively, in contrast to the physiotherapy group, which showed a 2.9% improvement (ES=0.07, CI=-0.85, 0.99). Furthermore, the functional capacity of all three groups improved after the intervention. The mean frequency of the EEG analysis mainly showed the effect of the interventions on the groups (F=11.50, P=0.0001).

Conclusion: ST and AT in patients with PD are associated with improved outcomes in disease symptoms and functional capacity.

Keywords: Parkinson’s disease; functional capacity; physical exercise; physical therapy; quality of life.

Figures

Figure 1
Figure 1
Flow diagram for identification of eligible patients. Abbreviations: AT, aerobic training; P, physiotherapy; PD, Parkinson’s disease; ST, strength training.
Figure 2
Figure 2
Effect size (ES) of symptoms of Parkinson’s disease. Abbreviations: CI, confidence interval; L, large; M, moderated; S, small; UPDRS, Unified Parkinson’s Disease Rating Scale; UPDRS-I, behavioral; UPDRS-II, activities of daily living; UPDRS-III, motor examination; UPDRS-IV, pharmacological complications.
Figure 3
Figure 3
Spectral analysis of mean frequency by delta (post and pre) of aerobic training (AT), strength training (ST), and physiotherapy (P) groups.a Note:aThe yellow and orange colors represent increased cortical activation after intervention. Abbreviations: AA, anterior area; PA, posterior area.

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