Objective: The purpose of this study was to determine whether high-intensity exercise (boxing) and sensory exercise (PD SAFEx™) produce disease-modifying effects on motor symptoms following the cessation of training.

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that significantly impacts quality of life. While pharmacological treatments are considered the ‘gold standard’ in PD, they only mask the symptoms and can be plagued with decreasing efficacy and side effects over time. In contrast, exercise is frequently recommended as an adjunct therapy, and may have disease-modifying treatment (DMT) potential. More importantly, with growing popularity of exercise strategies high-intensity exercise programs and more moderately-paced sensory approaches to rehabilitation, the question of the sustainability of any DMT is important to consider, especially once the intervention has been withdrawn.

Method: In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized to boxing  (n=20) or PD SAFEx™ (n=20). Participants completed a 10-week intervention followed by an equivalent 10-week washout period. Motor symptoms were assessed at baseline, post-intervention, and washout using the Unified Parkinson’s Disease Rating Scale motor subsection (UPDRS-III) by a blinded clinician. Data was analyzed using repeated measures ANOVA.

Results:

Baseline motor severity did not differ between groups, t(39)=1.2, p=0.087. The sensory exercise group showed significant improvement from baseline to washout (F(1,19)=6.33, p<0.002), that was driven by an improvement immediately post-intervention with sustained improvements continuing between post-intervention and the 10-week washout (F(1,19)=0.88, p=0.75). Whereas, the boxing group was consistent with progression overtime (F(1,19)=2.8, p<0.029).

Conclusion: The sensory exercise group was able to sustain motor improvements for a 10-week period beyond the benefits immediately post-exercise, while the boxing group appears to reflect the typical, expected progression of disease. Sensory-cognitive based interventions may offer clinically meaningful and longer-lasting benefits, supporting its consideration as a useful DMT for the management of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/disease-modifying-outcomes-following-high-intensity-boxing-and-sensory-exercise-in-parkinsons-disease-results-from-a-double-blinded-randomized-controlled-trial/