Objective: To assess whether exercise alone, or exercise combined with photobiomodulation (PBM) can improve the health-related quality of life (QoL) for people with Parkinson’s disease (PD).

Background: The motor, and the often more impactful non-motor symptoms of PD have an enormous effect on QoL. While the frontline PD medications, (e.g., levodopa and dopamine agonists) can suppress some motor symptoms, they have no impact on non-motor symptoms. PBM is the use of specific wavelengths of non-thermal light that modify cellular and sub-cellular processes. Small clinical trials have shown PBM can reduce both clinical motor signs and some non-motor symptoms (e.g., cognition, sense of smell) in PD. In addition, vigorous exercise, can have a positive impact on non-motor symptoms.

Method: Active PBM treatment consisted of transcranial irradiation with an LED helmet plus abdominal irradiation with a laser. Sham devices were identical but produced no light. All participants also enrolled in vigorous exercise programs during all stages.

Stage 1: double-blinded and randomized, active PBM (n=32) vs. sham PBM (n=31), 8 weeks, followed by 4 weeks no treatment.

Stage 2: all received active PBM (12 drop outs, n=51), 8 weeks, followed by 4 weeks no treatment.

Stage 3: either continued active PBM + exercise (n=17), or exercise alone (n=26), range 18 to 52 weeks, average 34 weeks

QoL data was collected by structured and unstructured participant reflections, group focus sessions and one-on-one interviews, evaluated using thematic analysis.

Results: In Stage 1, both the sham group and the active group gave equally positive accounts of their experience with the treatments. No member of the sham group was aware that they did not have active treatment. At the end of Stage 3 there was a significant difference between those who continued with PBM and those who did not, with greater improvements in QoL for the continuing group. There were accounts of declining QoL in the exercise alone group.

Conclusion: This is the largest study to date using PBM to treat PD. Both exercise alone and exercise + PBM improved reported QoL over 8 weeks. After an extended period of using PBM + exercise, there was a greater improvement in QoL when PBM was combined with exercise, compared to exercise alone.

References: (ClinicalTrials.gov: NCT06036433)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quality-of-life-improvements-in-parkinsons-disease-for-those-treated-with-photobiomodulation-plus-exercise-a-sham-controlled-study/