Disease‐inclusive exercise classes improve physical fitness and reduce depressive symptoms in individuals with and without Parkinson's disease—A feasibility study

Abstract

Background and purpose:Exercise is an adjunctive treatment in the management of Parkinson's disease (PD), but barriers such as health status, fear of overexertion, and lack of transportation to the location prevent regular exercise participation. Diseaseinclusive exercise classes may offer an opportunity to make exercise more accessible for older adults with and without diseases. However, the efficacy of such heterogenous exercise classes is still widely unknown. Therefore, it was the aim of this study to analyze the feasibility of disease-inclusive exercise classes in older adults with and without PD. Methods: Twenty-one older adults (healthy older adults (HOA): n = 13; PD: n = 8) completed an 8-week multimodal exercise intervention in supervised group sessions. Exercise classes lasted 60 min with the goal of two participations a week. We assessed physical fitness (timed up and go test [TUG], 6-minute walking test [6MWT], single leg stance), depressive symptoms and cognitive functions, and we determined growth factors (BDNF & IGF-1) before and after the intervention to determine the effects and by that, the feasibility of a disease-inclusive exercise program. Repeated measures ANOVA were used to establish changes. Results: TUG and 6MWT improved significantly after the training in both HOA (p = .008; p < .001) and individuals with PD (p = .024; p < .001). Furthermore, individuals with PD increased single leg stance left (p = .003). HOA (p = .003) and individuals with PD (p = .001) decreased their depressive symptoms between pre-and post-test significantly. Whereas growth factors tended to improve, no differences in cognitive functions were revealed. Conclusion: Disease-inclusive multicomponent exercise improved physical functions and reduced depressive symptoms independent of health status. This should encourage exercise providers, researchers, and clinicians to further investigate This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Effects and Mechanisms of Exercise on Brain-Derived Neurotrophic Factor (BDNF) Levels and Clinical Outcomes in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…Several other non-controlled studies, due to lack of proper control not included in our meta-analysis, support the notion that exercise therapy has positive effects on BDNF and various clinical outcomes [ 33 , 34 , 40 , 41 , 42 , 58 , 59 , 60 , 61 ]. Recently, Gomes et al [ 62 ] also showed promising results by studying the effects of High-Intensity Interval Training (HIIT) on BDNF and motor and non-motor outcomes using a single-case experimental design.…”

Changes of brain-derived neurotrophic factor (BDNF) levels after different exercise protocols: a systematic review of clinical studies in Parkinson’s disease

“…A total of 3,179 records were identified after removing duplicates. Fifty-three studies were considered potentially relevant by screening titles and abstracts and 16 studies (8 two-arm trials ( Frazzitta et al, 2014 ; Freidle et al, 2022 ; Landers et al, 2019 ; O'Callaghan et al, 2020 ; Sajatovic et al, 2017 ; Segura et al, 2020 ; Soke et al, 2021 ; Szymura et al, 2020 ) and 8 single-arm trials ( Oliveira et al, 2020 ; Angelucci et al, 2016 ; da Silva Germanos et al, 2019 ; Harro et al, 2022 ; Ponde et al, 2019 ; Schaeffer et al, 2022 ; Stuckenschneider et al, 2021 ; Zoladz et al, 2014 )), which included a total of 370 patients with PD, were finally deemed eligible for the systematic review. The PRISMA flow diagram illustrating the number of studies excluded at each stage of the systematic review is shown in Figure 1 .…”

Potential molecular mechanism of exercise reversing insulin resistance and improving neurodegenerative diseases

“…Studies have shown that aerobic exercise alone and lower-intensity balance exercises are not effective in reducing insulin resistance and IGF-1 levels in the PD population ( Szymura et al, 2020 ; Soke et al, 2021 ). However, combining aerobic and strength exercises along with multi-modal exercise has been demonstrated to significantly reduce fasting blood glucose levels and increase IGF-1 levels and cognitive abilities ( Krumpolec et al, 2017 ; Stuckenschneider et al, 2021 ). The mixed exercise model thus appears to be more effective in lowering blood sugar levels and improving peripheral insulin resistance in individuals with PD.…”