Objective: To quantify individual response patterns of motor symptoms to alternating exercise modalities, along non-motor functioning and blood biomarkers of neuroplasticity and neurodegeneration.

Background: Physical exercise receives increasing interest as an augmentative non-pharmacological intervention in Parkinson’s disease (PD).  Hight Intensity Interval Training shows promise as an efficient intervention approach. While the optimal mode and intensity is still unknown, detailed individual response patterns of outcomes may provide insight into variability of intervention effects.

Method: People with PD performed high intensity interval training (HIIT) and continuous aerobic exercise (CAE) using a crossover single-case experimental design with 3 sessions per week in a 4-week intervention period. Repeated assessment of outcome measures was conducted (bi) weekly. Outcomes were motor and non-motor symptoms, as well as blood-based biomarkers Brain Derived Neurotrophic Factor and NeuroFilament. Trajectories of outcome measures were visualized in time series plots and interpreted relative to the minimal clinically important difference (MCID) and smallest detectable change (SDC) or as a change in the positive or negative direction using trend lines.

Results: Data of 3 participants were analyzed and engaging in physical exercise seemed beneficial for reducing motor symptoms. Participant 1 demonstrated improvement in motor function, independent of exercise modality; while for participant 2 such a clinically relevant (positive) change in motor function was only observed in response to CAE. Participant 3 showed improved motor function after HIIT but no comparison could be made with CAE because of drop-out. Heterogeneous responses on secondary outcome measures were found, not only between exercise modalities but also among participants.

Conclusion: While this study underpins the positive impact of physical exercise in management of PD, large variability in individual response patterns to the interventions HIIT and CAE among participants were seen. This makes it difficult to identify clear exercise-induced adaptations in functioning and blood biomarkers. Further research is needed to overcome methodological challenges in measuring individual response patterns using single-subject experimental designs.

References: E.E.H. van Wegen, M.A. Hirsch, W.D.J. van de Berg, C. Vriend, M.B. Rietberg, M.A. Newman,
T. Vanbellingen, O.A. van den Heuvel, High-Intensity Interval Cycle Ergometer Training in
Parkinson’s Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject
Research Design, Front Neurol 11 (2020) 569880.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/high-intensity-interval-training-for-people-with-parkinsons-disease-individual-response-patterns-of-non-motor-symptoms-and-blood-based-biomarkers-a-crossover-single-case-experimental-des/