Objective: To align the 2021 Parkinson’s Exercise Guidelines with current evidence and stakeholder feedback.

Background: In 2021, the Parkinson’s Foundation, in partnership with the American College of Sports Medicine, created new Parkinson’s disease (PD) exercise recommendations to ensure that people with Parkinson’s are receiving safe and effective exercise programs and instruction. As is customary to review clinical guidelines every three years,  we deemed it necessary to update our recommendations based on new research, stakeholder feedback, and other established guidelines.

Method: We adapted the Delphi method to synthesize opinions and generate consensus. An internal committee of four subject-matter experts conducted a focused literature search to identify and correct gaps in the recommendations. The revised professional-facing guidelines were then examined by a panel of 11 international subject-matter experts and individuals with PD. The internal committee refined the guidelines based on the panelists’ feedback, after which a public comment period was initiated.

Results: There was a high degree of agreement among subject-matter experts on the importance of safety, with referral to a physical therapist and modifications based on the client’s ability, medication status, and stage of disease incorporated into the guidelines. The balance, agility, and multitasking (BAM) domain was expanded to more accurately describe this distinctive aspect of exercise prescription, and a narrative related to time management was added, encouraging exercise professionals to consider activities that combine domains to efficiently meet the recommendations. The current literature dictated changes to the time component of strength training, flexibility, and BAM, and the panelists provided valuable suggestions of PD-related considerations and examples of relevant activities across domains. In addition, formatting was improved for clarity and flow, and concepts were widely simplified, particularly related to the intensity of aerobic and strength training.

Conclusion: Subject-matter experts achieved a consensus on comprehensibility and alignment with the current evidence, providing exercise professionals with optimal guidance to design and lead exercise for people with Parkinson’s.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-exercise-guidelines-from-outdated-to-updated/