Objective: To determine if the benefits associated with RSB and PD SAFEx^TM on the motor symptoms of PD wash out over time.

Background: Parkinson’s disease (PD) is a progressive disorder resulting in poor quality of life. Unfortunately, medications –prescribed to manage PD motor symptoms offer short-term effects (half life 1.5hrs) and eventually become less effective. As a result, exercise is often prescribed as an adjunct therapy to medications. Animal models suggest vigorous exercise and sensory training may be most likely to have a chronic effect on PD due to lasting improvements seen post-cessation of exercise (8-weeks post intervention)^1-3. Currently, Rock Steady Boxing (RSB) is the most popular vigorous exercise program available for PD. Similarly, one of the most cited sensory programs for PD is PD SAFEx^TM. However, studies investigating the effects of RSB and PD SAFEx^TM on PD motor symptoms have mainly focused on short-term improvement rather then chronic effects. Thus an investigation of the chronic effects of both therapies on PD motor symptoms is needed.

Method: In this 20-week study single-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into two treatment groups, (n=20) RSB or (n=20) PD SAFEx^TM where participants completed 10-weeks of the intervention. Motor symptoms were assessed at pre-assessment (week-0), post-assessment (week-10) and washout (week-20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III) by a blinded clinician. Data was analyzed using SPSS and repeated measures ANOVA was conducted.

Results: Motor severity was equivalent in the participants randomized into the RSB and PD SAFEx^TM groups at pre-assessment t(39)=1.7,p=0.097. The RSB group showed significant worsening of motor symptoms at washout compared to pre-assessment (F(1,19)=3.6,p<0.033). In contrast, PD SAFEx^TM showed significant improvement to motor severity from pre-to washout (F(1,19)=5.33m,p<0.002). Furthermore, there was no difference between post-assessment and washout for PD SAFEx^TM group (F(1,19)=.88,p=0.86).

Conclusion: RSB resulted in typical progression, with a minimal chronic effect on motor symptoms. Whereas the benefits associated with PD SAFEx^TM persisted 10-weeks post-intervention. Thus, careful evaluation of chronic benefits of exercise intervention may be critical in the long-term management of PD.

References: Ahlskog, J. E. (2011). Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology, 77(3), 288–294. Grazielle, P., Desidério, D., Alves, L., Carvalho, D., Allodi, S., & Lourenço, C. (2016). Journal of the Neurological Sciences Neurotrophic factors in Parkinson ’ s disease are regulated by exercise : Evidence-based practice ☆. Journal of the Neurological Sciences, 363, 5–15. Hou, L., Chen, W., Liu, X., Qiao, D., & Zhou, F. M. (2017). Exercise-induced neuroprotection of the nigrostriatal dopamine system in Parkinson’s disease. Frontiers in Aging Neuroscience, 9(358).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/are-effects-of-rock-steady-boxing-and-pd-safextm-on-the-motor-symptoms-of-parkinsons-disease-maintained-long-term-a-single-blinded-randomized-controlled-trial/