Objective: For adults living with early onset Parkinson’s disease (EOPD) to evaluate the feasibility, safety and acceptability of a gym-based resistance strength training exercise program implemented in the community.

Background: People diagnosed with EOPD can face particular challenges living with symptoms such as bradykinesia, dystonia, weakness and fatigue [1-5]. There are few research trials on exercise for EOPD and clinical guidelines on how to manage motor and non-motor symptoms in EOPD have not yet been developed. This phase 1 trial tests the feasibility (including safety) and acceptability of gym-based strength training for young adults with EOPD.

Method: We included 10 people with living with EOPD and 5 exercise trainers [2]. The trainers all received a three-hour education workshop prior to the intervention and were supervised by physiotherapists for at least 50% of sessions for each person with PD. People with EOPD were offered 16, one-hour sessions of targeted strength training, over eight weeks. The primary outcome was feasibility (safety, attendance, adherence, acceptability). Secondary outcomes included motor disability (motor section of the UPDRS), upper and lower body strength (measured on gym equipment), and wellbeing (EuroQOL-VAS). Semi-structured interviews were also conducted online with participants and exercise trainers after the training.

Results: Four women and six men with EOPD and eight exercise trainers were recruited. The participants with EOPD attended 113/160 scheduled sessions (70.6%) and adhered to 99/113 programs (87.6%). There were no serious adverse events.  Upper limb strength improved significantly in people with EOPD (+43%, p = 0.009), while changes in lower limb strength (+32%, p = 0.088), UPDRS-III (-8%, p = 0.150), and VAS (+4%, p = 0.295) were not significant. Some themes arising from qualitative interviews included (i) gym-based progressive resistance strength training can be enjoyable and beneficial in adults with early onset Parkinson’s  (ii) barriers to regular gym exercise exist in some people with early onset PD, related to lifestyle, personal factors and access to exercise facilities (iii) overall, the gym program was reported to be safe and worthwhile by exercise trainers and participants.

Conclusion: A strength focused community gym program was feasible and acceptable for EOPD provided trainers were educated about PD and supported by health professionals expert in PD.

References: 1. MORRIS ME, Menz, H.N., McGinley, J.L.., Watter, J.J., Iansek, R. (2015). A Randomised Controlled Trial to Reduce Falls in People with Parkinson’s Disease. Neurorehabilitation and Neural Repair, 2015: 29(8), 777-785. PMID: 25567121.

2. Harris DM, Thwaites C, Callisaya ML, Blazé R, MORRIS ME. Gym-Based Modified Powerlifting Exercises for People with Early Onset Parkinson’s Disease: Study Protocol. medRxiv. 2024:2024.05.06.24306601.

3. Tamplin J, Haines S, … MORRIS ME. (2024). ParkinSong Online: Feasibility of Telehealth Delivery and Remote Data Collection for a Therapeutic Group Singing Study in Parkinson’s. Neurorehabilitation and Neural Repair, 2024: 38(2), 122-133. PMID: 38156662

4. MORRIS ME., …., Hackney, M. E., Mc Convey, V. B. (2021). Online Dance Therapy for People with Parkinson’s Disease: Feasibility and Impact on Consumer Engagement. Neurorehabilitation and Neural Repair, 3 1076-1087. PMID: 34587834

5. MORRIS, ME, Taylor, N. F., Watts, J. J., Evans, A., Horne, M., Kempster, P., . . . Menz, H. B. (2017). A Home Program of Strength Training, Movement Strategy Training and Education did not Prevent Falls in People with PD: A Randomized Trial. Journal of Physiotherapy, 63(2), 94-100. PMID: 28342682

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