Aerobic Exercise in Rehabilitation of Patients with Parkinson’s Disease

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Abstract

Disability due to Parkinson’s disease (PD) is increasing faster than for any other neurodegenerative disorder. A multidisciplinary approach to rehabilitation of patients with PD is recommended including various types of physical training. Because of its general beneficial effect, aerobic endurance training is necessary for all people to maintain their health. Aerobic exercise in PD is also used for rehabilitation of motor and non-motor symptoms. This article justifies the choice of aerobic exercise intensity, shows challenges in selecting intensity based on maximum oxygen consumption due to the influence of clinical and behavioral factors, difficulties in assessing the effectiveness of therapy due to the wide range of training intensity and amount in the studies. The article summarizes types of exercises used in rehabilitation of patients with PD (walking, Nordic walking, training with a bicycle ergometer and treadmill, aquatic exercises) and their benefits for patients with different courses of the disease. For patients with freezing of gait, bicycle ergometer is a piece of equipment of choice for aerobic stationary training, and Nordic walking is a preferred type of outdoor training. The author shows the role of aerobic training in the treatment of non-motor symptoms such as depression, cognitive changes, and sleep disorders. A question about the use of aerobic training in patients with Hoehn–Yahr grade 4–5 of PD remains open. Further studies are needed to evaluate training protocols, assess rehabilitation effectiveness and evaluate physical training in the advanced PD.

About the authors

Olga V. Guseva

Siberian State Medical University

Author for correspondence.
Email: gusolvl@gmail.com
ORCID iD: 0000-0001-8659-9832

Cand. Sci. (Med.), exercises treatment doctor, Physiotherapy department, assistant professor, Division of advanced-level therapy with a course in rehabilitation, physiotherapy and sports medicine

Russian Federation, Tomsk

References

  1. Ellis T.D., Colón-Semenza C., DeAngelis T.R. Evidence for early and regu-lar physical therapy and exercise in Parkinson's disease. Semin. Neurol. 2021;4(2):189–205. doi: 10.1055/s-0041-1725133
  2. Braak H., Ghebremedhin E., Rüb U. et al. Stages in the development of Parkinson’s disease-related pathology. Cell Tissue Res. 2004;318(1):121–134. doi: 10.1007/s00441-004-0956-9
  3. Zia A., Pourbagher-Shahri A.M., Farkhondeh T., Samarghandian S. Molecular and cellular pathways contributing to brain aging. Behav. Brain Funct. 2021;17(1):6. doi: 10.1186/s12993-021-00179-9
  4. Sliter D.A., Martinez J., Hao L. et al. Parkin and PINK1 mitigate STING-induced inflammation. Nature. 2018;561(7722):258–262. doi: 10.1038/s41586-018-0448-9
  5. Borsche M., König I.R., Delcambre S. Mitochondrial damage-associated inflammation highlights biomarkers in PRKN/PINK1 parkinsonism. Brain. 2020;143(10):3041–3051. doi: 10.1093/brain/awaa246
  6. Balestrino R., Schapira A.H.V. Parkinson disease. Eur. J. Neurol. 2020;27(1):27–42. doi: 10.1111/ene.14108
  7. Chen J., Liu J. Management of nonmotor symptoms in Parkinson disease. Journal of Innovations in Medical Research. 2022;1(5):18–33. doi: 10.56397/jimr/2022.12.03
  8. Kalia L.V., Lang A.E. Parkinson's disease. Lancet. 2015;386(9996):896–912. doi: 10.1016/s0140-6736(14)61393-3
  9. Virameteekul S., Phokaewvarangkul O., Bhidayasiri R. Profiling the most elderly Parkinson’s disease patients: does age or disease duration matter? PLoS One. 2021;16(12):e0261302. doi: 10.1371/journal.pone.0261302
  10. Jopowicz A., Wiśniowska J., Tarnacka B. Cognitive and physical intervention in metals’ dysfunction and neurodegeneration. Brain Sci. 2022;12(3):345. doi: 10.3390/brainsci12030345
  11. WHO guidelines on physical activity and sedentary behaviour. Geneva; 2020.
  12. Marusiak J., Fisher B., Jaskólska A. et al. Eight weeks of aerobic interval training improves psychomotor function in patients with Parkinson’s disease — randomized controlled trial. Int. J. Environ. Res. Public. Health. 2019;16(5):880. doi: 10.3390/ijerph16050880
  13. Schenkman M., Moore C.G., Kohrt W.M. et al. Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: a phase 2 randomized clinical trial. JAMA Neurol. 2018;75(2):219–226. doi: 10.1001/jamaneurol.2017.3517
  14. van der Kolk N.M., de Vries N.M., Kessels R.P.S. et al. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson's disease: a double-blind, randomised controlled trial. Lancet Neurol. 2019;18(11):998–1008. doi: 10.1016/s1474-4422(19)30285-6
  15. Grippi M.A. Pulmonary pathophysiology. Philadelphia; 1995.
  16. Bo B., Guo A., Kaila S.J. et al. Elucidating the primary mechanisms of high-intensity interval training for improved cardiac fitness in obesity. Front. Physiol. 2023;14:1170324. doi: 10.3389/fphys.2023.1170324
  17. Luthra N.S., Christou D.D. et al. Targeting neuroendocrine abnormalities in Parkinson’s disease with exercise. Front. Neurosci. 2023;17:1228444. doi: 10.3389/fnins.2023.1228444
  18. Figueroa C.A., Rosen C.J. Parkinson’s disease and osteoporosis: basic and clinical implications. Expert. Rev. Endocrinol. Metab. 2020;15(3):185–193. doi: 10.1080/17446651.2020.1756772
  19. Osborne J.A., Botkin R., Colon-Semenza C. et al. Physical therapist management of Parkinson disease: a clinical practice guideline from the American Physical Therapy Association. Phys. Ther. 2022;102(4):pzab302. doi: 10.1093/ptj/pzab302
  20. Zikereya T., Shi K., Chen W. Goal-directed and habitual control: from circuits and functions to exercise-induced neuroplasticity targets for the treatment of Parkinson’s disease. Front. Neurol. 2023;14:1254447. doi: 10.3389/fneur.2023.1254447
  21. Johansson M.E., Cameron I.G.M., Van der Kolk N.M. Aerobic exercise alters brain function and structure in Parkinson's disease: a randomized controlled trial. 2022. Ann. Neurol. 2022;91(2):203–216. doi: 10.1002/ana.26291
  22. Cui W., Li D., Yue L., Xie J. The effects of exercise dose on patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials. J. Neurol. 2023;270(11):5327–5343. doi: 10.1007/s00415-023-11887-9
  23. Fan B., Jabeen R., Bo B. et al. What and how can physical activity prevention function on Parkinson’s disease? Oxid. Med. Cell. Longev. 2020;2020:4293071. doi: 10.1155/2020/4293071
  24. Sujkowski A., Hong L., Wessells R.J., Todi S.V. The protective role of exercise against age-related neurodegeneration. Ageing Res. Rev. 2022;74:101543. doi: 10.1016/j.arr.2021.101543
  25. Sacheli M.A., Murray D.K., Vafai N. et al. Habitual exercisers versus sedentary subjects with Parkinson's disease: multimodal PET and fMRI study. Mov. Disord.2018;33(12):1945–1950. doi: 10.1002/mds.27498
  26. Schootemeijer S., van der Kolk N.M., Bloem B.R., de Vries N.M. Current perspectives on aerobic exercise in people with Parkinson’s disease. Neurotherapeutics. 2020;17(4):1418–1433. doi: 10.1007/s13311-020-00904-8
  27. Rawson K.S., McNeely M.E., Duncan R.P. et al. Exercise and Parkinson disease: comparing tango, treadmill, and stretching. J. Neurol. Phys. Ther. 2019;43(1):26–32. doi: 10.1097/npt.0000000000000245
  28. Berra E., De Icco R., Avenali M. et al. Body weight support combined with treadmill in the rehabilitation of Parkinsonian gait: a review of literature and new data from a controlled study. Front. Neurol. 2019;9:1066. doi: 10.3389/fneur.2018.01066
  29. Chen R., Berardelli A., Bhattacharya A. et al. Clinical neurophysiology of Parkinson’s disease and parkinsonism. Clin. Neurol. Pract. 2022;7:201–227. doi: 10.1016/j.cnp.2022.06.002
  30. Aerts M.B., Abdo W.F., Bloem B.R. The “bicycle sign” for atypical parkinsonism. Lancet. 2011;377(9760):125–126. doi: 10.1016/S0140-6736(11)60018-4
  31. Saluja A., Goyal V., Dhamija R.K. Multi-modal rehabilitation therapy in Parkinson's disease and related disorders. Ann. Indian Acad. Neurol. 2023;26(Suppl 1):15–25. doi: 10.4103/aian.aian_164_22
  32. Harro C.C., Shoemaker M.J., Coatney C.M. et al. Effects of Nordic walking exercise on gait, motor/non-motor symptoms, and serum brain-derived neurotrophic factor in individuals with Parkinson's disease. Front. Reh. Sci. 2022;3:1010097. doi: 10.3389/fresc.2022.1010097
  33. Warlop T., Detrembleur C., Lopez M.B. et al. Does Nordic walking restore the temporal organization of gait variability in Parkinson’s disease? J. Neuroeng. Rehabil. 2017;14(1):17. doi: 10.1186/s12984-017-0226-1
  34. Wróblewska A., Gajos A., Smyczyńska U., Bogucki A. The therapeutic effect of Nordic walking on freezing of gait in Parkinson’s disease: a pilot study. Parkinsons. Dis. 2019;2019:3846279. doi: 10.1155/2019/3846279
  35. Terashi H., Ueta Y., Taguchi T. et al. Clinical features of Parkinson’s disease in patients with early-onset freezing of gait. Pakinsons. Dis. 2022;2022:4732020. doi: 10.1155/2022/4732020
  36. Peyré-Tartaruga L.A., Martinez F.G., Zanardi A.P.J. et al. Samba, deep water, and poles: a framework for exercise prescription in Parkinson's disease. Sport. Sci. Health. 2022;18(4):1119–1127. doi: 10.1007/s11332-022-00894-4
  37. Avenali M., Picascia M., Tassorelli C. et al. Evaluation of the efficacy of physical therapy on cognitive decline at 6-month follow-up in Parkinson disease patients with mild cognitive impairment: a randomized controlled trial. Aging Clin. Exp. Res. 2021;33(12):3275–3284. doi: 10.1007/s40520-021-01865-4
  38. Costa V., Suassuna A. de O.B., Brito T.S.S. et al. Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials. BMJ Neurol.Open. 2023;5(2):e3000469. doi: 10.1136/bmjno-2023-000469
  39. Tollár J., Nagy F., Hortobágyi T. Vastly different exercise programs similarly improve Parkinsonian symptoms: a randomized clinical trial. Gerontology. 2019;65(2):120–127. doi: 10.1159/000493127
  40. Buono V.L., Palmeri R., Salvo S. D. et al. Anxiety, depression, and quality of life in Parkinson’s disease: the implications of multidisciplinary treatment. Neural. Regen. Res. 2021;16(3):587–590. doi: 10.4103/1673-5374.293151
  41. Pagonabarraga J., Álamo C., Castellanos M. et al. Depression in major neurodegenerative diseases and strokes: a critical review of similarities and differences among neurological disorders. Brain Sci. 2023;13(2):318. doi: 10.3390/brainsci13020318
  42. Liu Y., Ding L., Xianyu Y. et al. Research on depression in Parkinson disease: a bibliometric and visual analysis of studies published during 2012–2021. Medicine (Baltimore). 2022;101(31):e29931. doi: 10.1097/md.0000000000029931
  43. Jiang X., Zhang L., Liu H. et al. Efficacy of non-pharmacological interventions on depressive symptoms in patients with Parkinson’s disease: a study protocol for a systematic review and network meta-analysis. BMJ Open. 2023;13(5):e068019. doi: 10.1136/bmjopen-2022-068019
  44. Smith P.J., Blumenthal J.A., Hoffman B.M. et al. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom. Med. 2010;72(3):239–252. doi: 10.1097/psy.0b013e3181d14633
  45. David F.D., Robichaud J.A., Leurgans S.E. et al. Exercise improves cognition in Parkinson's disease: the PRET-PD randomized, clinical trial. Mov. Disord. 2015;30(12):1657–1663. doi: 10.1002/mds.26291
  46. Sacheli M.A., Neva J.L., Lakhani B. et al. Exercise increases caudate dopamine release and ventral striatal activation in Parkinson's disease. Mov. Disord. 2019;34(12):1891–1900. doi: 10.1002/mds.27865
  47. van der Kolk N.M., de Vries N.M., Penko A.L. et al. A remotely supervised home-based aerobic exercise programme is feasible for patients with Parkinson’s disease: results of a small randomised feasibility trial. J. Neurol. Neurosurg. Psychiatry. 2018;89(9):1003–1005. doi: 10.1136/jnnp-2017-315728
  48. Thangaleela S., Sivamaruthi B.S., Kesika P. et al. Neurological insights into sleep disorders in Parkinson’s disease. Brain Sci. 2023;13(8):1202. doi: 10.3390/brainsci13081202
  49. Яковлева О.В., Полуэктов М.Г., Ляшенко Е.А., Левин О.С. Субъективные и объективные варианты дневной сонливости при болезни Паркинсона. Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски. 2019;119(9-2):44–50. Iakovleva O.V., Poluéktov M.G., Liashenko E.A., Levin O.S. Subjective and objective subtypes of excessive daytime sleepiness in Parkinson’s disease. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019;119(9-2):44–50. doi: 10.17116/jnevro201911909244
  50. Доронина К.С., Иллариошкин С.Н., Доронина О.Б. Влияние парасомний на клинические и функциональные характеристики экстрапирамидных расстройств. Журнал неврологии и психиатрии им. С.С. Корсакова. 2021;121(9):13–18. Doronina K.S., Illarioshkin S.N., Doronina O.B. The influence of parasomnia on clinical and functional characteristics of extrapyramidal disorders. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2021;121(9):13–18. doi: 10.17116/jnevro202112109113
  51. Amara A.W., Memon A.A. Effects of exercise on non-motor symptoms in Parkinson’s disease. Clin. Ther. 2018;40(1):8–15. doi: 10.1016/j.clinthera.2017.11.004

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