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Cited by 474Transcranial Magnetic Stimulation StudiesBalance, Gait, and Falls PreventionParkinson's Disease Mechanisms and Treatments

The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in People With Early Parkinson's Disease

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Fisher, Beth E., Wu, Allan D., Salem, George J., Song, Jooeun, Lin, Chien-Ho (Janice), Yip, Jeanine, Cen, Steven, Gordon, James +2 more·2008·Archives of Physical Medicine and Rehabilitation
DOI 10.1016/j.apmr.2008.01.013PMC PMC2989816
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Abstract

Objectives To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).Design Cohort (prospective), randomized controlled trial.Setting University-based clinical and research facilities.Participants Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2.Interventions Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks.Main outcome measures Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS.Results A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP.Conclusions The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD.

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  • Vigorous exercise improved corticomotor excitability in a Parkinson disease cohort, suggesting potential neuroplasticity.

    “Vigorous exercise improved corticomotor excitability in a PD cohort, suggesting potential neuroplasticity in one other investigation.10”

    From Does vigorous exercise have a neuroprotective effect in Parkinson disease? (2011) · cites this paper as [10]

  • Fisher and colleagues demonstrated that individuals with early stage Parkinson's disease were capable of engaging in gait training at faster speeds than their self-selected pace while maintaining observationally normal execution of movement.

    “Utilizing body weight supported treadmill training. Fisher and colleagues demonstrated that individuals with early stage PD were capable of engaging in gait training at faster speeds than their self-selected pace while maintaining observationally normal execution of movement 12.”

    From Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease (2013) · cites this paper as [12]

  • Exercise-related decrease in cortico-motor excitability through an increase in cortical silent period duration was shown with transcranial magnetic stimulation.

    “Along with improved gait and balance parameters, an exercise related decrease in cortico-motor excitability through an increase in cortical silent period duration (CSP) using Transcranial Magnetic Stimulation (TMS) was shown 12.”

    From Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease (2013) · cites this paper as [12]

  • Pathways involving the basal ganglia in PD may be capable of plasticity, and their activity patterns may be partly corrected with appropriate intensive training.

    “In fact, it has been shown that pathways involving the basal ganglia in PD may be capable of plasticity, and their activity patterns may be partly corrected with appropriate intensive training [5–7].”

    From A wearable system for gait training in subjects with Parkinson's disease (2014) · cites this paper as [5]

  • PD patients can acquire motor skills and improve their motor performance with sustained personalized training.

    “Although the rates of motor learning may be slower in PD, recent evidence highlights that PD patients can acquire motor skills and improve their motor performance with sustained personalized training [5,6,9].”

    From A wearable system for gait training in subjects with Parkinson's disease (2014) · cites this paper as [5]

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Authors
Fisher, B. E., Wu, A. D., Salem, G. J., Song, J., Lin, C.-H. (., Yip, J., Cen, S., Gordon, J., Jakowec, M., & Petzinger, G.
Affiliations
  • University of Southern California (US)
  • University of California, Los Angeles (US)
Corresponding author
Fisher, Beth E.
ORCID
Venue
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier BV
Published
2008-07
Volume
89
Issue
7
Pages
1221-1229
ISSN
0003-9993 (ISSN-L)
DOI
10.1016/j.apmr.2008.01.013
PMC
PMC2989816
OpenAlex
W2148747456
Cited by
474
References
62
Citations by year
2026: 15 · 2025: 18 · 2024: 30 · 2023: 20 · 2022: 30 · 2021: 21 · 2020: 25 · 2019: 22 · 2018: 30 · 2017: 31 · 2016: 28 · 2015: 34 · 2014: 42 · 2013: 38 · 2012: 34
FWCI
11.82
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Archives of Physical Medicine and Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
Funders
  • National Institutes of Health (5k23ns045764-06)
  • National Institute of Neurological Disorders and Stroke (K23-NS045764)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Keywords
Parkinson's disease, high-intensity exercise, exercise training, corticomotor excitability, cortical silent period, body weight-supported treadmill training, walking speed, stride length, sit-to-stand, motor performance, early-stage Parkinson's disease, dose-response relationship
MeSH terms
Aged, Postural Balance, Exercise Therapy, Feasibility Studies, Female, Humans, Male, Middle Aged, Motor Cortex, Neuronal Plasticity, Parkinson Disease, Prospective Studies, Task Performance and Analysis, Walking, Treatment Outcome, Gait Disorders, Neurologic, Transcranial Magnetic Stimulation

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