Cited by 515Parkinson's Disease Mechanisms and TreatmentsBalance, Gait, and Falls PreventionPhysical Activity and Health

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Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial

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Schenkman, Margaret, Moore, Charity G., Kohrt, Wendy M., Hall, Deborah A., Delitto, Anthony, Comella, Cynthia L., Josbeno, Deborah A., Christiansen, Cory L., Berman, Brian D., Kluger, Benzi M., Melanson, Edward L., Jain, Samay, Robichaud, Julie A., Poon, Cynthia, Corcos, Daniel M.·2018·JAMA Neurology

DOI 10.1001/jamaneurol.2017.3517PMC PMC5838616

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Abstract

Importance: Parkinson disease is a progressive neurologic disorder. Limited evidence suggests endurance exercise modifies disease severity, particularly high-intensity exercise. Objectives: To examine the feasibility and safety of high-intensity treadmill exercise in patients with de novo Parkinson disease who are not taking medication and whether the effect on motor symptoms warrants a phase 3 trial. Design, Setting, and Participants: The Study in Parkinson Disease of Exercise (SPARX) was a phase 2, multicenter randomized clinical trial with 3 groups and masked assessors. Individuals from outpatient and community-based clinics were enrolled from May 1, 2012, through November 30, 2015, with the primary end point at 6 months. Individuals with idiopathic Parkinson disease (Hoehn and Yahr stages 1 or 2) aged 40 to 80 years within 5 years of diagnosis who were not exercising at moderate intensity greater than 3 times per week and not expected to need dopaminergic medication within 6 months participated in this study. A total of 384 volunteers were screened by telephone; 128 were randomly assigned to 1 of 3 groups (high-intensity exercise, moderate-intensity exercise, or control). Interventions: High-intensity treadmill exercise (4 days per week, 80%-85% maximum heart rate [n = 43]), moderate-intensity treadmill exercise (4 days per week, 60%-65% maximum heart rate [n = 45]), or wait-list control (n = 40) for 6 months. Main Outcomes and Measures: Feasibility measures were adherence to prescribed heart rate and exercise frequency of 3 days per week and safety. The clinical outcome was 6-month change in Unified Parkinson's Disease Rating Scale motor score. Results: A total of 128 patients were included in the study (mean [SD] age, 64 [9] years; age range, 40-80 years; 73 [57.0%] male; and 108 [84.4%] non-Hispanic white). Exercise rates were 2.8 (95% CI, 2.4-3.2) days per week at 80.2% (95% CI, 78.8%-81.7%) maximum heart rate in the high-intensity group and 3.2 (95% CI, 2.8-3.6; P = .13) days per week at 65.9% (95% CI, 64.2%-67.7%) maximum heart rate in the moderate-intensity group (P < .001). The mean change in Unified Parkinson's Disease Rating Scale motor score in the high-intensity group was 0.3 (95% CI, -1.7 to 2.3) compared with 3.2 (95% CI, 1.4 to 5.1) in the usual care group (P = .03). The high-intensity group, but not the moderate-intensity group, reached the predefined nonfutility threshold compared with the control group. Anticipated adverse musculoskeletal events were not severe. Conclusions and Relevance: High-intensity treadmill exercise may be feasible and prescribed safely for patients with Parkinson disease. An efficacy trial is warranted to determine whether high-intensity treadmill exercise produces meaningful clinical benefits in de novo Parkinson disease. Trial Registration: clinicaltrials.gov Identifier: NCT01506479.

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Additional file 2 of Feasibility of a novel eHealth intervention for Parkinson’s disease targeting motor-cognitive function in the home
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Additional file 2 of The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson’s disease: a long-term feasibility study
Lützow, L., Teckenburg, I., Koch, V., Marxreiter, F., Jukic, J., Stallforth, S., Regensburger, M., Winkler, J., Klucken, J., & Gaßner, H. (2023) · Figshare · doi:10.6084/m9.figshare.24465326
Additional file 3 of The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson’s disease: a long-term feasibility study
Lützow, L., Teckenburg, I., Koch, V., Marxreiter, F., Jukic, J., Stallforth, S., Regensburger, M., Winkler, J., Klucken, J., & Gaßner, H. (2023) · Figshare · doi:10.6084/m9.figshare.26634033
Additional file 1 of The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson’s disease: a long-term feasibility study
Lützow, L., Teckenburg, I., Koch, V., Marxreiter, F., Jukic, J., Stallforth, S., Regensburger, M., Winkler, J., Klucken, J., & Gaßner, H. (2023) · Figshare · doi:10.6084/m9.figshare.24465090
Additional file 1 of Feasibility of a novel eHealth intervention for Parkinson’s disease targeting motor-cognitive function in the home
Sedhed, J., Johansson, H., Andersson, N., Åkesson, E., Kalbe, E., Franzén, E., & Leavy, B. (2024) · Figshare · doi:10.6084/m9.figshare.25556567
Additional file 3 of Feasibility of a novel eHealth intervention for Parkinson’s disease targeting motor-cognitive function in the home
Sedhed, J., Johansson, H., Andersson, N., Åkesson, E., Kalbe, E., Franzén, E., & Leavy, B. (2024) · Figshare · doi:10.6084/m9.figshare.26702506
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Authors: 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., Melanson, E. L., Jain, S., Robichaud, J. A., Poon, C., & Corcos, D. M.
Affiliations: University of Colorado Anschutz (US)
University of Pittsburgh (US)
VA Eastern Colorado Health Care System (US)
Rush University Medical Center (US)
University of Illinois Hospital & Health Sciences System (US)
Northwestern University (US)
Corresponding author: Schenkman, Margaret
ORCID: Hall, Deborah A.
Delitto, Anthony
Christiansen, Cory L.
Berman, Brian D.
Kluger, Benzi M.
Melanson, Edward L.
Jain, Samay
Poon, Cynthia
Corcos, Daniel M.
Venue: JAMA Neurology
Publisher: American Medical Association (AMA)
Published: 2018-02-01
Volume: 75
Issue: 2
Pages: 219
ISSN: 2168-6149 (ISSN-L)
DOI: 10.1001/jamaneurol.2017.3517
PMC: PMC5838616
OpenAlex: W2773186181
Cited by: 515
References: 45
Citations by year: 2026: 59 · 2025: 72 · 2024: 82 · 2023: 71 · 2022: 66 · 2021: 70 · 2020: 38 · 2019: 33 · 2018: 24
FWCI: 18.09
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Neurology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Parkinson's Disease Foundation
National Institutes of Health
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK048520)
Topics: Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
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
Keywords: Parkinson's disease, high-intensity exercise, treadmill exercise, motor symptoms, exercise adherence, exercise safety, moderate-intensity exercise, early-stage Parkinson's disease
MeSH terms: High-Intensity Interval Training, Adult, Aged, Aged, 80 and over, Exercise Test, Exercise Therapy, Female, Humans, Longitudinal Studies, Male, Middle Aged, Parkinson Disease, Retrospective Studies, Treatment Outcome

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Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial

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