Session Information
Date: Wednesday, September 25, 2019
Session Title: Non-Pharmacological Interventions
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To evaluate the efficacy of exercises in early-stage Parkinson’s Disease by observing improvement in motor symptoms assessed by Unified Parkinson’s Disease Rating Scale (UPDRS) section III (motor section), improvement in non-motor symptoms assessed by UPDRS section I (mentation), improvement in activities of daily living assessed by UPDR sections II (Activities of daily living, ADL) and VI (Schwab and England ADL Scale).
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Currently, high treatment cost, disease burden, and inadequate treatment response have made Parkinson’s Disease more challenging. Among all the treatment options exercise is a cost-effective way with many positive effects in the PD population. Exercise has effects like increased effectiveness of levodopa, neuroplasticity and may even retard the disease progression. The key unmet need in PD research is to address those areas which can delay the disease progression or modify it. Recently, a review also mentioned the need for research to study the efficacy of exercise in early stage PD as exercise posses neuroplastic and neurorestorative effects in modifying PD progression [1].
Method: PARK-EASE trial was conducted in individuals with newly diagnosed Parkinson’s Disease on a stable dose of PD medications with Hoehn and Yahr stage ≤ 2. Twenty-two participants were randomized to intervention group (strengthening, stretching, aerobic, agility, trunk exercises) and control group (stretching exercises were done passively by care partner). Main outcome measures were UPDRS I, II, III, VI at baseline and 4 weeks.
Results: The intervention group showed statistically more significant (p-value < 0.05) improvement in UPDRS I, II, III. The intervention group also had significant improvement in UPDRS-VI (p = 0.04) but the control group had no change in UPDRS-VI. Improvement in the ADL section was more than the motor section of UPDRS.
Conclusion: This is a first randomized controlled trial to study the structured-exercises efficacy in early-stage PD. Results from this trial showed that structured exercises are efficacious in improving the ADL, motor symptoms and mentation in early-stage PD. Exercises are efficacious in improving non-motor symptoms than motor symptoms. Results also signify to institute structured exercises as an early rehabilitation intervention in early stages of PD.
References: 1. Chung, C. L., Wong-Yu, I. S., Mak, M. K. & Shen, X. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nat. Rev. Neurol. 13, 689 (2017). PARK-EASE trial was presented in the 47th Annual National Conference of Indian Association of Physical Medicine and Rehabilitation, 2019 (IAPMRCON 2019). PARK-EASE trial has been accepted for presentation in 4th Annual Conference of Movement Disorders Society of India (MDSICON 2019) which will be held from 22nd – 24th February 2019 in New Delhi, India.
To cite this abstract in AMA style:
R. Swarnakar, S. Wadhwa, S. V, V. Goyal, V. Sreenivas. Park-Ease Trial: A Randomized Controlled Trial to Study the Efficacy of Exercises in Early-Stage Parkinson’s Disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/park-ease-trial-a-randomized-controlled-trial-to-study-the-efficacy-of-exercises-in-early-stage-parkinsons-disease/. Accessed December 2, 2023.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/park-ease-trial-a-randomized-controlled-trial-to-study-the-efficacy-of-exercises-in-early-stage-parkinsons-disease/