Benefits of physical therapy on executive functions in older people with Parkinson's disease

ArticleinBrain and Cognition 69(2):435-41 · December 2008with41 Reads
DOI: 10.1016/j.bandc.2008.09.008 · Source: PubMed
Abstract
The benefits of physical exercise on cognitive functioning have been reported in the literature, but the potential benefits to slow the eventual decline in executive functioning (EF) caused by neurodegeneration from Parkinson's Disease (PD) have rarely been studied. Thus the objective of this study was to analyze the effects of a multimodal physical exercise program on EF in older people with Parkinson's disease. The EF of the older people was evaluated by neuropsychological testing, and for confounding variables such as attention, depressive symptoms and anxiety, before and after intervention. The 20 participants were assigned into Control (CG) and Trained (TG) Groups. The TG participated in generalized physical training for 6 months. The ANOVA showed a significant interaction (p<.05) that indicated a beneficial contribution of training on EF. No significant interactions were found in the results for confounding variables between groups and pre- and post-intervention, which supports the beneficial findings of physical exercise training on EF.
    • "In that context, we can ask the question of the relevance of time-limited stimulation programs to prevent the effects of neurodegeneration on cognition. Indeed, a positive impact of mental or physical training programs on cognition and the brain was reported in normal aging (Valenzuela & Sachdev, 2007; Voelcker-Rehage & Niemann, 2013), mild cognitive impairment (Buschert et al., 2011), Alzheimer (Groot et al., 2016), and Parkinson (Tanaka et al., 2009) patients. However, the duration of these benefits after the program cessation is not well established, and we cannot reject the hypothesis of a short-term beneficial impact once the program ended. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction. Cognitive reserve (CR) was proposed to explain how individual differences in brain function help to cope with the effects of normal aging and neurodegenerative diseases. Education, professional solicitations, and engagement in leisure and physical activities across the lifetime are considered as major determinants of this reserve. Method. Using multiple linear regression analyses, we tested separately in healthy elderly and Parkinson’s disease (PD) populations to what extent cognitive performance in several domains was explained by (a) any of these four environmental lifespan variables; (b) demographic and clinical variables (age, gender, depression score, and, for the PD group, duration of disease and dopaminergic drugs). We also tested for an interaction, if any, between these lifespan variables and brain pathology indexed by global atrophy measured from high-resolution anatomical magnetic resonance imaging. Results. Age was negatively associated with cognitive performance in the PD group. In healthy elderly participants, we observed significant positive associations between cognitive performance and (a) education, (b) leisure activities, and (c) professional solicitation (decisional latitude). Furthermore, participants with greater brain atrophy benefited more from CR. In PD patients, education and professional solicitations contributed to cognitive performance but to a lesser extent than in controls. CR factors modulated the relationship between cognition and brain atrophy only in patients with a slight or moderate brain atrophy. Conclusions. Education is the CR factor that contributed the most to late cognitive functioning in both groups, closely followed by leisure activity in normal aging and professional solicitations in PD. Our results also provide evidence suggesting that the effects of CR does not express similarly in normal aging and PD. From a broader perspective, these results seem to indicate that CR factors the most consistently practiced across lifespan (education and professional solicitation) are those that are the more strongly associated to late cognitive efficiency.
    Full-text · Article · Aug 2016
    • "However, the pooled effect sizes of exercise on global cognition, which was assessed through ADAS-Cog improvement in two of the included studies, appeared to be only mild [103]. Exercise and physical activities have merit for improving motor manifestations of PD [104, 105], and accumulating evidence has suggested that such approach may also have benefits for cognitive functioning in PD patients [106][107][108][109][110]. For instance, in a study that investigated the impact of Tango in non-demented PD patients, improved spatial cognition was observed and maintained 10-12 weeks post-intervention [110]. "
    [Show abstract] [Hide abstract] ABSTRACT: Alzheimer's disease (AD) and Parkinson's disease (PD) are the two most common neurodegenerative disorders encountered in clinical practice. Whilst dementia has long been synonymous with AD, it is becoming more widely accepted as part of the clinical spectrum in PD (PDD). Neuropsychiatric complications, including psychosis, mood and anxiety disorders, and sleep disorders also frequently co-exist with cognitive dysfunctions in AD and PDD patients. The incidence of such symptoms is often a significant source of disability, and may aggravate pre-existing cognitive deficits. Management of AD and PDD involves both pharmacological and non-pharmacological measures. Although research on pharmacological therapies for AD and PDD has so far had some success in terms of developing symptomatic treatments, the benefits are often marginal and non-sustained. These shortcomings have led to the investigation of non-pharmacological and novel treatments for both AD and PD. Furthermore, in light of the diverse constellation of other neuropsychiatric, physical, and behavioural symptoms that often occur in AD and PD, consideration needs to be given to the potential side effects of pharmacological treatments where improving one symptom may lead to the worsening of another, rendering the clinical management of these patients challenging. Therefore, the present article will critically review the evidence for both pharmacological and non-pharmacological treatments for cognitive impairment in AD and PD patients. Treatment options for other concomitant neuropsychiatric and behavioural symptoms, as well as novel treatment strategies will also be discussed.
    Article · Dec 2015
    • "The literature on physical exercise and cognition in Parkinson's is less abundant. A systematic review (Murray et al., 2014 ) on randomized and non-randomized trials, covering the period 1966– 2013, revealed only four studies which have specifically evaluated the effect of physical exercise on executive functions in patients with PD (Cruise et al., 2011; McKee & Hackney, 2013; Ridgel, Kim, Fickes, Muller, & Alberts, 2011; Tanaka et al., 2009). Unfortunately, however, none of these studies used the Stroop test, but one (Ridgel et al., 2011 ) employed the TMT and found a significant improvement in the flexibility score (difference in reaction time between TMT B and A) after acute bouts of AET in PD using passive leg cycling. "
    [Show abstract] [Hide abstract] ABSTRACT: Aerobic exercise training (AET) has been shown to provide health benefits in individuals with Parkinson's disease (PD). However, it is yet unknown to what extent AET also improves cognitive and procedural learning capacities, which ensure an optimal daily functioning. In the current study, we assessed the effects of a 3-month AET program on executive functions (EF), implicit motor sequence learning (MSL) capacity, as well as on different health-related outcome indicators. Twenty healthy controls (HC) and 19 early PD individuals participated in a supervised, high-intensity, stationary recumbent bike-training program (3 times/week for 12weeks). Exercise prescription started at 20min (+5min/week up to 40min) based on participant's maximal aerobic power. Before and after AET, EF tests assessed participants' inhibition and flexibility functions, whereas implicit MSL capacity was evaluated using a version of the Serial Reaction Time Task. The AET program was effective as indicated by significant improvement in aerobic capacity in all participants. Most importantly, AET improved inhibition but not flexibility, and motor learning skill, in both groups. Our results suggest that AET can be a valuable non-pharmacological intervention to promote physical fitness in early PD, but also better cognitive and procedural functioning. Copyright © 2015 Elsevier Inc. All rights reserved.
    Full-text · Article · Aug 2015
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