Home-based exercise training by using a smartphone app in patients with Parkinson’s disease: a feasibility study

Putzolu, Martina; Manzini, Virginia; Gambaro, Matteo; Cosentino, Carola; Bonassi, Gaia; Botta, Alessandro; Ravizzotti, Elisa; Avanzino, Laura; Pelosin, Elisa; Mezzarobba, Susanna

doi:10.3389/fneur.2023.1205386

Cited by 5 publications

(1 citation statement)

References 56 publications

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“…[8][9][10] It was reported that proper aerobic exercise training could potentially delay PD progression, and long-term community-and-home-based exercise interventions were demonstrated effective and safe for PD patients. [10][11][12][13][14] In addition, Flynn et al [12] reviewed and analyzed 16 clinical trials and concluded that home-based prescribed exercise achieved similar improvements to equivalent center-based exercise in terms of gait speed and balance-related activities in individuals with PD. Nonetheless, the specific mechanism underlying the exercise-induced positive effects in PD still warrants further exploration.…”

Section: Introductionmentioning

confidence: 99%

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease

Zhang,

Wu,

et al. 2024

Medicine

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Background: Long-term physical exercise has been shown to benefit patients with Parkinson disease (PD), but there is a lack of evidence regarding the underlying mechanism. A better understanding of how such benefits are induced by exercise might contribute to the development of therapeutic targets for improving the motor function in individuals with PD. The purpose of this study was therefore to investigate the possible association between exercise-induced motor improvements and the changes in serum microRNA (miRNA) levels of PD patients through small RNA sequencing for the first time. Methods: Thirteen PD patients completed our 3-month home-and-community-based exercise program, while 6 patients were assigned to the control group. Motor functions were measured, and small RNA sequencing with data analysis was performed on serum miRNAs both before and after the program. The results were further validated by quantitative real-time polymerase chain reaction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were then conducted to determine the role of differentially expressed miRNAs. Results: The 3-month home-and-community-based exercise program induced significant motor improvements in PD patients in terms of Unified Parkinson’s Disease Rating Scale activities of daily living and Motor Subscale (P < .05), comfortable walking speed (P = .003), fast walking speed (P = .028), Six-Minute Walk Test (P = .004), Berg Balance Scale (P = .039), and Timed Up and Go (P = .002). A total of 11 miRNAs (10 upregulated and one downregulated) were identified to be remarkably differentially expressed after intervention in the exercise group, but not in the control group. The results of miRNA sequencing were further validated by quantitative real-time polymerase chain reaction. It was found that the targets of altered miRNAs were mostly enriched in the mitogen-activated protein kinase, Wnt, and Hippo signaling pathways and the GO annotations mainly included binding, catalytic activity, and transcription regulator activity. Conclusion: The exercise-induced motor improvements were possibly associated with changes in circulating miRNA levels in PD patients. These miRNAs, as well as the most enriched pathways and GO terms, may play a critical role in the mechanism of exercise-induced benefits in PD and serve as novel treatment targets for the disease, although further investigations are needed.

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Section: Introductionmentioning

confidence: 99%

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease

Zhang,

Wu,

et al. 2024

Medicine

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Exercise Habits in People with Parkinson's: A Multinational Survey

Jagota,

Phutrakool,

Kamble

et al. 2024

Movement Disord Clin Pract

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BackgroundExercise has been demonstrated to result in improvements in physical function, cognition, and quality of life in People with Parkinson's (PwP) but its adoption is variable.ObjectivesTo investigate exercise preferences, levels, influencing factors among a diverse Parkinson's disease (PD) population, to understand exercise adoption patterns and plan informed interventions.MethodsA cross‐sectional survey collected data through online platforms and paper‐based methods. The Exercise Index (ExI) calculated exercise level based on frequency and duration.ResultsOf 2976 PwP, 40.6% exercised regularly, 38.3% occasionally, and 21.2% did not exercise. The overall mean ExI was 18.99 ± 12.37. Factors associated with high exercise levels included exercising in groups (ExI 24–26), weightlifting (ExI 27 (highest)), using muscle‐building equipment (ExI 25–26), and exercising at home following an app (ExI 26). A positive trend between ExI and varied exercise groups, locations, types, and equipment was observed. No expected benefit from exercise achieved the lowest ExI (8). Having at least two exercise‐promoting factors, a bachelor's degree or higher, receiving exercise advice at initial visits, and aged ≤40 years at PD onset were strong predictors of exercise (adjust OR = 7.814; 6.981; 4.170; 3.565). Falls and “other” most troublesome PD symptoms were negative predictors (aOR = 0.359; 0.466). Barriers to exercise did not predict the odds of exercise.ConclusionsThe study shows that PwP's exercise behavior is influenced by their exercise belief, age at PD onset, doctor's advice at initial visits, education level, symptoms, and exercise‐promoting factors. High exercise levels were associated with certain types of exercises and exercising in groups.

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Effectiveness of Live-Streaming Tele-Exercise Intervention in Patients With Parkinson’s Disease: A Pilot Study

Ha,

Park,

Lee

et al. 2024

JMD

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Objective Exercise can improve both motor and nonmotor symptoms in people with Parkinson’s disease (PwP), but there is an unmet need for accessible and sustainable exercise options. This study aimed to evaluate the effect, feasibility, and safety of a regularly performed live-streaming tele-exercise intervention for PwP.Methods A live-streaming exercise intervention for PwP was implemented twice a week for 12 weeks. We measured the motor and nonmotor symptom scores of the included patients before and after the intervention. Changes in clinical scores from baseline to postintervention were analyzed using paired t-tests. Factors associated with improvements in clinical scores and compliance were analyzed using Pearson’s correlation analysis.Results Fifty-six participants were enrolled in the study. There were significant improvements in Hospital Anxiety and Depression Scale (HADS)-anxiety (p = 0.007), HADS-depression (p < 0.001), Unified Parkinson’s Disease Rating Scale (UPDRS) part III (p < 0.001), UPDRS total (p = 0.015), Hoehn and Yahr stage (p = 0.027), and Parkinson’s Disease Fatigue Scale-16 (p = 0.026) scores after the intervention. Improvements in motor symptoms were associated with improvements in mood symptoms and fatigue. Higher motor impairment at baseline was associated with a greater compliance rate and better postintervention composite motor and nonmotor outcomes (ΔUPDRS total score). Overall, the 12-week tele-exercise program was feasible and safe for PwP. No adverse events were reported. The overall adherence rate was 60.0% in our cohort, and 83.4% of the participants were able to participate in more than half of the exercise routines.Conclusion The live-streaming tele-exercise intervention is a safe, feasible, and effective nonpharmacological treatment option that can alleviate fatigue and improve mood and motor symptoms in PwP.

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Home-based exercise training by using a smartphone app in patients with Parkinson’s disease: a feasibility study

Cited by 5 publications

References 56 publications

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease

Exercise Habits in People with Parkinson's: A Multinational Survey

Effectiveness of Live-Streaming Tele-Exercise Intervention in Patients With Parkinson’s Disease: A Pilot Study

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