Parkinson's progression delayed through high-intensity exercise, study says

A new phase 2, multi-site trial conducted at the Northwestern Medicine and University of Colorado School of Medicine suggests that for people with early-stage Parkinson's disease, high-intensity exercise three times a week is safe and can delay the worsening of motor symptoms.

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This is a first-of-its-kind of study that tested the impacts of high-intensity exercise on patients affected with Parkinson's disease.

Parkinson’s disease is the second most common neurodegenerative disorder and the most common movement disorder that affects over a million people across the USA. Progressive loss of muscle control, stiffness, trembling, slowness, and impaired balance are the symptoms of the disease.

As the disease progresses, the patient encounters difficultly in walking, talking, and even completing simple tasks. Mostly, Parkinson's is seen in people over 60 years of age. High-intensity exercise was previously thought to be physically stressful for individuals with this condition.

If you have Parkinson's disease and you want to delay the progression of your symptoms, you should exercise three times a week with your heart rate between 80 to 85 percent maximum.”

Daniel Corcos, Northwestern University Feinberg School of Medicine

As medications for Parkinson's possess adverse side effects and decreased effectiveness over time, novel treatments are required.

The randomized clinical trial title The Study in Parkinson Disease of Exercise (SPARX), enrolled 128 patients aged between 40 and 80 from Northwestern University, the University of Colorado, Rush University Medical Center, and the University of Pittsburgh. All were in an early stage of the disease and not taking Parkinson's medication.

The safety and impacts of exercise were examined three times weekly for a period of six months at two conditions: (a) high intensity with 80% to 85% of the maximum heart rate and (b) moderate intensity with 60% to 65% of the maximum heart rate. The results were then compared with that of a control group that did not exercise.

At the end of six months, the patients were rated on a Parkinson's disease scale ranging from 0 to 108. As the number went higher, the severity of the symptoms increased.

Participants possessed a score of about 20 before exercise. After six months, those in the high-intensity group remained at 20 while the participants in the moderate group became worse by 1.5 points. The participants in the control group worsened by 3 points, indicating a 15% change in the primary signs of the disease. This affects their quality of life.

Thus, by providing the participants with a cardiologist-supervised graded exercise test in order to analyze the response of the heart response to exercise, the team confirmed that high-intensity exercise was safe for the participants.

"The earlier in the disease you intervene, the more likely it is you can prevent the progression of the disease," said Corcos.

According to him, further research is needed to confirm if the disease progression could be prevented any longer than six months. He added that the study is a part of the opinion that exercise is medicine.

Although prior studies in humans indicted that motor symptoms are improved by high-intensity exercise, the evidence was inadequate to determine if exercise intensity alters symptoms or disease progression. Also, most studies had not accurately calculated or controlled exercise intensity and none of them were conducted at the 80%–85% maximum heart rate.

According to Dr. Codrin Lungu, program director at the National Institute of Neurological Disorders and Strok, the SPARX study attempts to rigorously address these issues.

“The results are interesting and warrant further exploration of the optimal exercise regimes for Parkinson's." ---Dr. Codrin Lungu.