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Cited by 224Balance, Gait, and Falls PreventionParkinson's Disease Mechanisms and TreatmentsPhysical Activity and Health

The DOI matches its Crossref record; 71 of the 72 references it cites were found in a registry or an index.

Exercise for People in Early- or Mid-Stage Parkinson Disease: A 16-Month Randomized Controlled Trial

Open access
Schenkman, Margaret, Hall, Deborah A., Barón, Anna E., Schwartz, Robert S., Mettler, Pamela, Kohrt, Wendy M.·2012·Physical Therapy
DOI 10.2522/ptj.20110472PMC PMC3488266
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Abstract

BACKGROUND: Exercise confers short-term benefits for individuals with Parkinson disease (PD). OBJECTIVE: The purpose of the study was to compare short- and long-term responses among 2 supervised exercise programs and a home-based control exercise program. DESIGN: The 16-month randomized controlled exercise intervention investigated 3 exercise approaches: flexibility/balance/function exercise (FBF), supervised aerobic exercise (AE), and home-based exercise (control). SETTING: This study was conducted in outpatient clinics. PATIENTS: The participants were 121 individuals with PD (Hoehn & Yahr stages 1-3). INTERVENTIONS: The FBF program (individualized spinal and extremity flexibility exercises followed by group balance/functional training) was supervised by a physical therapist. The AE program (using a treadmill, bike, or elliptical trainer) was supervised by an exercise trainer. Supervision was provided 3 days per week for 4 months, and then monthly (16 months total). The control group participants exercised at home using the National Parkinson Foundation Fitness Counts program, with 1 supervised, clinic-based group session per month. MEASUREMENTS: Outcomes, obtained by blinded assessors, were determined at 4, 10, and 16 months. The primary outcome measures were overall physical function (Continuous Scale-Physical Functional Performance [CS-PFP]), balance (Functional Reach Test [FRT]), and walking economy (oxygen uptake [mL/kg/min]). Secondary outcome measures were symptom severity (Unified Parkinson's Disease Rating Scale [UPDRS] activities of daily living [ADL] and motor subscales) and quality of life (39-item Parkinson's Disease Quality of Life Scale [PDQ-39]). RESULTS: Of the 121 participants, 86.8%, 82.6%, and 79.3% completed 4, 10, and 16 months, respectively, of the intervention. At 4 months, improvement in CS-PFP scores was greater in the FBF group than in the control group (mean difference=4.3, 95% confidence interval [CI]=1.2 to 7.3) and the AE group (mean difference=3.1, 95% CI=0.0 to 6.2). Balance was not different among groups at any time point. Walking economy improved in the AE group compared with the FBF group at 4 months (mean difference=-1.2, 95% CI=-1.9 to -0.5), 10 months (mean difference=-1.2, 95% CI=-1.9 to -0.5), and 16 months (mean difference=-1.7, 95% CI=-2.5 to -1.0). The only secondary outcome that showed significant differences was UPDRS ADL subscale scores: the FBF group performed better than the control group at 4 months (mean difference=-1.47, 95% CI=-2.79 to -0.15) and 16 months (mean difference=-1.95, 95% CI=-3.84 to -0.08). LIMITATIONS: Absence of a non-exercise control group was a limitation of the study. CONCLUSIONS: Findings demonstrated overall functional benefits at 4 months in the FBF group and improved walking economy (up to 16 months) in the AE group.

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Research works printed but not linked: 8

  1. Rodriguez, 2006, Balance & Function Protocol Instructor's Manual
  2. 2008, PASS 2008
  3. Fahn, 1987, Unified Parkinson's Disease Rating Scale, 153
  4. Schenkman, 1994, Axial Mobility Exercise Program: An Exercise Program to Improve Functional Ability
  5. Chandler, 1993, Axial Mobility Exercise Program: An Exercise Program to Improve Functional Ability. Participant's Manual
  6. Laub, 1995, The Axial Mobility Exercise Program
  7. Stelzner, 2004, Instructor's Adherence Protocol, Instructor's Guidelines for Assisting Participants
  8. SAS/BASE, SAS/STAT, 2002

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Metadata

Authors
Schenkman, M., Hall, D. A., Barón, A. E., Schwartz, R. S., Mettler, P., & Kohrt, W. M.
Affiliations
  • University of Colorado Anschutz (US)
  • Rush University Medical Center (US)
  • Colorado School of Public Health (US)
Corresponding author
Schenkman, Margaret
ORCID
Venue
Physical Therapy
Publisher
Oxford University Press (OUP)
Published
2012-11-01
Volume
92
Issue
11
Pages
1395-1410
ISSN
  • 0031-9023 (ISSN-L)
  • 1538-6724
DOI
10.2522/ptj.20110472
PMC
PMC3488266
OpenAlex
W2129106050
Cited by
224
References
72
Citations by year
2026: 8 · 2025: 14 · 2024: 21 · 2023: 15 · 2022: 16 · 2021: 13 · 2020: 14 · 2019: 14 · 2018: 19 · 2017: 16 · 2016: 17 · 2015: 23 · 2014: 17 · 2013: 14 · 2012: 2
FWCI
44.60
Type
journal article
Language
en
Open access
Locations
  • Physical Therapy (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (TL1TR001081)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK048520)
  • National Institute of Neurological Disorders and Stroke (K23NS052487, NS052487)
  • National Center for Research Resources (TL1RR025778)
  • National Center for Advancing Translational Sciences
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD043770)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords
Parkinson's disease, exercise intervention, aerobic exercise, home-based exercise, supervised exercise, physical function, balance, walking economy, oxygen consumption, motor symptoms, activities of daily living, quality of life, Unified Parkinson's Disease Rating Scale, PDQ-39, functional reach test
MeSH terms
Activities of Daily Living, Disability Evaluation, Postural Balance, Exercise Therapy, Female, Humans, Male, Parkinson Disease, Quality of Life, Severity of Illness Index, Walking, Treatment Outcome, Physical Therapy Modalities

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