The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.
Randomized Clinical Trial of 3 Types of Physical Exercise for Patients With Parkinson Disease
Open accessAbstract
OBJECTIVE: To compare the efficacy of treadmill exercises and stretching and resistance exercises in improving gait speed, strength, and fitness for patients with Parkinson disease. DESIGN: A comparative, prospective, randomized, single-blinded clinical trial of 3 types of physical exercise. SETTING: The Parkinson's Disease and Movement Disorders Center at the University of Maryland and the Baltimore Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center. PATIENTS: A total of 67 patients with Parkinson disease who had gait impairment were randomly assigned to 1 of 3 arms of the trial. INTERVENTIONS; (1) A higher-intensity treadmill exercise (30 minutes at 70%-80% of heart rate reserve), (2) a lower-intensity treadmill exercise (50 minutes at 40%-50% of heart rate reserve), and (3) stretching and resistance exercises (2 sets of 10 repetitions on each leg on 3 resistance machines [leg press, leg extension, and curl]). These exercises were performed 3 times a week for 3 months. MAIN OUTCOME MEASURES: The primary outcome measures were gait speed (6-minute walk), cardiovascular fitness (peak oxygen consumption per unit time [$$ VO2], and muscle strength (1-repetition maximum strength). RESULTS: All 3 types of physical exercise improved distance on the 6-minute walk: lower-intensity treadmill exercise (12% increase; P=.001), stretching and resistance exercises (9% increase; P<.02), and higher-intensity treadmill exercise (6% increase; P=.07), with no between-group differences. Both treadmill exercises improved peak $$ VO2 (7%-8% increase; P<.05) more than did the stretching and resistance exercises. Only stretching and resistance improved muscle strength (16% increase; P<.001). CONCLUSIONS: The effects of exercise were seen across all 3 exercise groups. The lower-intensity treadmill exercise resulted in the greatest improvement in gait speed. Both the higher- and lower-intensity treadmill exercises improved cardiovascular fitness. Only the stretching and resistance exercises improved muscle strength. Therefore, exercise can improve gait speed, muscle strength, and fitness for patients with Parkinson disease. The combination of treadmill and resistance exercises may result in greater benefit and requires further investigation.
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“Studies have reported similar improvements in gait speed and stride length (Pohl et al., 2003) and aerobic capacity (Ridgel et al., 2009; Shulman et al., 2013) for high-intensity (80% of maximum capacity) and low-intensity (50% of maximum capacity) training programs.”
From Perception of Physical Demand, Mental Demand, and Performance: A Comparison of Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Shulman et al., 2013
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Cites
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“A random number generator allocated eligible participants into 1 of 3 exercise groups in a 1:1:1 ratio: (1) higher-intensity treadmill, (2) lower-intensity treadmill, or (3) stretching and resistance.”
BackgroundMethodTai chi and postural stability in patients with Parkinson's disease
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Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trial
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Cited by
Sorted by citations
Fox, S. H., Katzenschlager, R., Lim, S., Barton, B. R., de Bie, R. M. A., Seppi, K., Coelho, M. M., & Sampaio, C. (2018) · Movement Disorders · doi:10.1002/mds.27372 · Cited by 1,009
van der Kolk, N. M., de Vries, N. M., Kessels, R. P. C., Joosten, H., Zwinderman, A. H., Post, B., & Bloem, B. R. (2019) · The Lancet Neurology · doi:10.1016/s1474-4422(19)30285-6 · Cited by 565
“25 Importantly, our high exercise inten sity 10 was similar to laboratory-based trials 7,8,11 and higher compared with a previous (partly) home-based trial, 25 underlining the feasibility of our multifaceted approach.”
BackgroundResultLong-term effects of exercise and physical therapy in people with Parkinson disease
Mak, K. Y., Wong-Yu, I. S. K., Shen, X., & Chung, C. L. H. (2017) · Nature Reviews Neurology · doi:10.1038/nrneurol.2017.128 · Cited by 553
Schenkman, M., Moore, C. G., Kohrt, W. M., Hall, D. A., Delitto, A., Comella, C. L., Josbeno, D. A., Christiansen, C. L., Berman, B. D., Kluger, B. M., et al. (2018) · JAMA Neurology · doi:10.1001/jamaneurol.2017.3517 · Cited by 515
Kwok, J. Y. Y., Kwan, J. C. Y., Auyeung, M., Mok, V. C. T., Lau, C. K. Y., Choi, K. C., & Chan, H. Y. L. (2019) · JAMA Neurology · doi:10.1001/jamaneurol.2019.0534 · Cited by 379
Metadata
- Authors
- Shulman, L. M., Katzel, L. I., Ivey, F. M., Sorkin, J. D., Favors, K., Anderson, K. E., Smith, B. A., Reich, S. G., Weiner, W. J., & Macko, R. F.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Shulman, Lisa M.
- ORCID
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2013-02-01
- Volume
- 70
- Issue
- 2
- Pages
- 183
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC4574905
- OpenAlex
- W2124808208
- Cited by
- 410
- References
- 40
- Citations by year
- 2026: 16 · 2025: 25 · 2024: 33 · 2023: 19 · 2022: 32 · 2021: 36 · 2020: 78 · 2019: 34 · 2018: 27 · 2017: 25 · 2016: 21 · 2015: 24 · 2014: 21 · 2013: 16
- FWCI
- 50.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (T32AG000219, R01AG034161, P30AG028747)
- National Heart, Lung, and Blood Institute (R01HL095136, K30HL004518)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK090401)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR057967)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Keywords
- Parkinson's disease, physical activity, treadmill exercise, resistance training, stretching, walking speed, cardiorespiratory fitness, peak oxygen uptake, muscle strength, exercise intensity, 6-minute walk test
- MeSH terms
- Adult, Aged, Electrocardiography, Exercise Test, Female, Gait, Humans, Male, Middle Aged, Parkinson Disease, Prospective Studies, Exercise, Single-Blind Method, Muscle Stretching Exercises, Resistance Training
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