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

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.

Systematic review on strength training in Parkinson’s disease: an unsolved question

“…Of the remaining 62 items, 49 were excluded after quality assessment. A total of 13 articles were included in this review 26–38. Two articles showed shared data, so we combined them and considered them as a single item 35,36.…”

“…Three out of the twelve studies included, considered as external resistance cycle ergometer,26,29,33 three weight machines,28,31,38 and two studies considered both weight machines and cuff weights 34–36. One study analyzed elastic bands and cuff weights,32 punching bag,27 water,37 or therapeutic putty,30 respectively, as external resistance.…”

“…Most of the studies involved the training of the lower body with cycle ergometer,26,29,33 water,37 weight machines,31 elastic bands, and cuff weights,32 or both weight machines and cuff weights 34–36. Two studies involved training of both upper and lower limbs with weights/resistance machines 28,38. One study focused on manual dexterity and strength 30.…”

“…Out of the twelve studies that performed strength training, only six28–32,38 involved specific tests to verify the improvement of PD subjects’ muscle strength (Tables 2 and 3). In particular, three studies assessed the muscle isometric contraction,28,29,32 one of which also assessed the maximal voluntary contraction and the rate of force development 32.…”

“…In particular, three studies assessed the muscle isometric contraction,28,29,32 one of which also assessed the maximal voluntary contraction and the rate of force development 32. One study considered peak muscle power,31 one-hand grip, and pinch strength,30 and the other performed physical tests and no instrumental evaluation 38. In this review, we have considered only the effects tested at the peak of the medication cycle.…”