Treadmill in Parkinson’s: influence on gait, balance, BDNF and Reduced Glutathione

Abstract

Introduction: Parkinson’s disease (PD) is characterized by nigrostriatal degeneration, with dopaminergic depletion, and inflammatory and oxidative changes in the brain, leading to movement and coordination disorders. Recent studies have shown that treadmill training can be beneficial for these patients, but there is little evidence assessing the related blood parameters, such as oxidative stress and neurotrophin levels. Objective: Assess the influence of treadmill training for patients with Parkinson’s on gait, balance, Brain-Derived Neurotrophic Factor (BDNF) and reduced glutathione. Methods: Twenty-two patients with PD (Hoehn and Yahr II and III), older than 40 years, were randomly allocated to two groups: CG (n = 12) - drug treatment and IG (n = 10) - treadmill. Assessments related to functional capacity (quality of life, static and dynamic analysis of gait) and blood parameters such as GSH and BDNF were conducted before and after the eight-week intervention. Results: The demographic data of the groups were homogeneous in terms of age, sex, height, weight, time since disease onset, mini mental examination and the geriatric depression scale. Significant intergroup differences were found for the mental component summary, surface variation, latero-lateral oscillation, antero-posterior oscillation and mean velocity in the post-intervention period. The IG exhibited a strong association between BDNF and GSH, with statistically significant values. Conclusion: It was concluded that controlled treadmill walking improves static balance, quality of life and plasma BDNF and GSH levels in patients with PD.

Does Exercise Attenuate Disease Progression in People With Parkinson’s Disease? A Systematic Review With Meta-Analyses

“…Twenty trials (29 pairwise comparisons) involving 1225 participants compared exercise with a control group (ie, no intervention or sham exercise). 6-8,27,28,35-38,43,46-48,53,56,60,63,64,66,68,71,73,74,77 Twenty-four trials (31 comparisons) involving 1044 participants compared 2 different exercise groups. 6,27,33,34,41,42,44,45,49-52,54,55,57-59,61,62,65,67,69-72,75-78…”

“…Exercise was categorized according to the primary nature of the intervention: aerobic, 6,7,27,28,33,42,48,52,53,55,58,63,65,67,69,70,72,77,78 strength, 35,38,44,62,71 balance, 43,56,59,60,73,74,77 dance, 46,66 aquatic, 51,76 or multimodal, 6,8,34,36-38,41,42,44,45,47,49,50,54,55,57,59,61,62,64,68,71,72,75 the latter including a combination of aerobic, strength, balance, flexibility, and/or functional exercises where no single component was ≥50% of the entire intervention. The dosage of exercise varied among the 60 pairwise comparisons: session duration ranged from 30 55,…”

“…Fourteen trials reported clinical outcomes, that is, “off” medication MDS/UPDRS scores 27,28,36,37,44-47,51,52,55,61,66,67,74,76 ; all trials reported motor scores except 1 76 which reported total scores. Thirteen trials reported neurochemical outcomes, that is, trophic factors, 8,34,38,49,56,63,72,73,77 oxidative stress, 35,43,49,63,64 and/or inflammatory markers, 34,38,49,72,73,77 with most not reporting medication status when outcomes were taken. Ten trials reported neuroimaging outcomes, that is, brain functional activation, 53,54,56,69,70,75 connectivity, 48,57,58,65,68,78 structure, 48,60 or volume 48,60 measured through fMRI or functional near-infrared spectroscopy in 1 trial, 69 mostly “on” medication 54,56-58,…”

“…Findings for glutathione were equivocal. 43,63,64 For neuroimaging outcomes, 4 trials (5 comparisons) reported fMRI outcomes and examined aerobic, 48,53 balance, 56,60 and multimodal 68 exercise. Findings from these trials suggest that exercise generally had a neuroplastic effect, by improving activation 53 and network connectivity 60 toward normal function or by improving the efficiency of compensatory brain networks.…”

“…As 7 trials were reported across 17 records, and 1 record reported 2 trials, a total of 40 trials were included in this review. The mean PEDro score for the included trials was 5.6 (range 2-8), with 23 trials (47%) of high quality, 8,27,28,37,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] 25 (51%) of moderate quality, 6,7,[33][34][35][36]38,[60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77] and 1 (2%) of low quality 78 (Figure 2, Supplemental File 2).…”