Is Physical Exercise Beneficial for Persons with Parkinson??s Disease?

Department of Public Health, Lakehead University, Thunder Bay, Ontario, Canada.
Clinical Journal of Sport Medicine (Impact Factor: 2.27). 10/2006; 16(5):422-5. DOI: 10.1097/01.jsm.0000244612.55550.7d
Source: PubMed


To review existing studies evaluating the effectiveness of physical exercise on mortality, strength, balance, mobility, and activities of daily living (ADL) for sufferers of Parkinson's disease (PD).
The following databases were searched (1) Cochrane Database of Systematic Reviews, (2) Cumulative Index to Nursing and Allied Health Literature (CINAHL), (3) PubMed and (4) Medline/NARIC (National Rehabilitation Information Center) using combinations of key words Parkinson's disease and physical exercise. Only articles written in English were included. References cited were also examined.
Studies were eligible if (1) only patients with PD were included in the intervention study (there were many studies that evaluated the benefits of exercise after stroke, cardiac arrest, sports injuries, surgery, and arthritis, but only a few for patients with PD), (2) the intervention included some form of physical or therapeutic exercise, (3) the effects of the physical exercise were evaluated, and (4) the studies were published in a refereed journal. Because few studies were found that dealt with PD patients exclusively, all studies that evaluated the effectiveness of physical exercise for only PD patients were included. Seven studies met our criteria and were selected. Three of the selected studies were randomized controlled studies, 1 was an open trial, and the other 3 relied on patients' own assessments.
Outcomes in the studies were measured in terms of physical improvements in patients with PD, such as improved axial rotation, functional reach, flexibility, balance, muscle strength, short-step gait, and mobility. All studies reviewed show that exercise improves overall performance in PD patients. Improvements were measured using standardized tests and other measurement scales.
The results of the present research synthesis support the hypothesis that patients with PD improve their physical performance and activities of daily living through exercise. Future studies should include the development of standardized exercise programs specific for problems associated with PD as well as standardized testing methods for measuring improvements in PD patients. There is also a need for longer term studies (over 1 year) to assess if improvements achieved during the intervention stage are retained long term.

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    • "Exercise reduces the level of systemic inflammation by increasing the release of adrenaline, cortisol, growth hormone, prolactin, and other factors that have immunomodulatory effects and decreasing expression of toll-like receptors at the surface of monocytes, which have been suggested to be involved in mediating systemic inflammation [97–99]. Many results of the present research synthesis support the fact that the patients with PD improve their physical performance, activities of daily living [100, 101], and the effect of pharmacologic therapy [102] through exercise. The transcriptional coactivator PGC1α controls muscle plasticity and suppresses chronic systemic inflammation via repressing FOXO3 activity, increasing vascularization, ROS detoxification, and mitochondrial and metabolic gene expression [95]. "
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    ABSTRACT: Metabolic syndrome is becoming commoner due to a rise in obesity rates among adults. Generally speaking, a person with metabolic syndrome is twice as likely to develop cardiovascular disease and five times as likely to develop diabetes as someone without metabolic syndrome. Increasing oxidative stress in metabolic syndrome and Parkinson's disease is mentioned in the comprehensive articles; however, the system review about clear relation between metabolic syndrome and Parkinson's disease is deficient. In this review, we will focus on the analysis that the metabolic syndrome may be a risk factor for Parkinson's disease and the preventions that reduce the incident of Parkinson's disease by regulating the oxidative stress.
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    • "The exact pathophysiological mechanism of exercise and types of specific exercises beneficial to persons with PD is still open to question [9]. Although there are limited exercise studies involving persons with Parkinson's [10], some [11] postulate that the benefit of exercise is associated with synaptic plasticity, cascading effect of growth factors, and by reducing ancillary conditions (e.g., hypertension) that may adversely impact the brain. One limiting factor in studying the effect of exercise has been the ability of the patient with PD to maintain sufficient exercise intensity to produce appreciable benefit to the patient. "
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    • "Exercise produces a plethora of benefits in those who have been diagnosed with Parkinson's disease (PD) [1] [2] [3]. In fact, many national and international panels on the topic have recommended the use of exercise to improve outcomes, activities of daily living and motor performance in those with PD [4] [5] [6]. "
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