Multimodal cognitive and physical exercise for individuals with mild Parkinson disease.

Research Report
Population: Adult

Sujata Pradhan, PT, PhD, Assistant Professor, University of Washington

Keywords: Participation, Parkinson’s Disease, Gaming

Purpose: The purpose of this study was to compare the effects of traditional forms of exercise to exercise using a gaming device (enriched environment) on measures of gait, balance, cognition and participation in individuals with Parkinson disease (PD). Subjects: 16 individuals with mild PD were randomly assigned to the two groups. Methods: The traditional exercise (TE) group engaged in exercises recommended by the American Parkinson disease association. The gaming group (GE) used the XBOX and Kinect to create an enriched environment (with auditory and visual feedback) with games that targeted speed of movement, balance, aerobic capacity and response inhibition. Both groups exercised for 18 one hour long sessions over 6 weeks. Results: Both groups showed functional improvements in self- selected gait speed based on the 10 meter test (sec) (TE – Pre-5.4, Post – 5.3, GE – Pre -5.7 Post – 5.3), fastest possible gait speed (TE – Pre-7.7, Post- 8.0, GE – Pre – 7.6, Post- 7.2) six minute walk test (6MWT feet – TE – Pre – 1828, Post – 1915, GE – Pre-1802 , Post – 1868). Both groups also showed a decline in disability as measured by the Parkinson disease questionnaire-39(TE – Pre – 19, Post – 17, GE – Pre – 16, Post – 14). Gains in the functional reach test (FRT – inches) were seen only in the GE group (TE – Pre- 12.3 Post-12.1, GE – Pre- 10, Post- 11). At 6 weeks follow up, individuals in GE continued to make improvements in the 6MWT (TE – 1848, GE – 1908) and maintain those made in the PDQ-39 (TE – 16, GE – 14), whereas those in the TE group did not. Conclusions: Although both groups showed functional improvements as well as decline in disability while in the exercise program, only individuals in the GE group maintained these gains at 6 weeks after termination of the program. Clinical relevance: Exercising in an enriched environment may help make comparable gains in function as well as a decline in disability as exercising in the traditional environment and may have long lasting benefits that may last even after the exercise is stopped.

Pradhan, Sujata , PT, PhD. Multimodal cognitive and physical exercise for individuals with mild Parkinson disease.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online.