Objective:

We describe our 2-year experience implementing a sport based approach in patients with Parkinson’s Disease (PD).

Background: PD is a progressive neurological disorder. The course of the disease is associated with a decline in postural control, gait, quality of life and increased risk for falling. Although pharmacological therapy is recommended for symptomatic control, there is no disease modifying treatment yet. Clinical exercise that involves an aerobic component, power training, dual tasking and balance is widely suggested as a complement to pharmacological treatment. It is also recognized as a promising therapeutic intervention with a disease-modifying effect. Benefits appear to be even greater training at high compared to moderate intensities. Motivation is vital in order to achieve long-term adherence. Applying a sports based approach can potentiate both the benefits of exercise as a therapeutic intervention and patients’ adherence.

Method: sixteen selected (n=16) individuals with PD participated in a 3 months duration sport oriented physical therapy treatment, considering their sport preference. The main goals of intervention were based on the activity limitations found during the initial assessment, and a sport based tailor made training program was designed to approach those problems. Most frequently implemented sports were soccer and basketball.

Results: 81% of patients (13/16) improved their gait speed by an average of 0.23 m/s. The Timed Up and Go test improved in 11/16 patients (69%) by an average of -15%. Functional Gait Assessment increased at least 2 points in 8/16 patients. All but one patient improved their endurance measured with 2MWT, average 18.5 m.

Conclusion: A sport basedapproach was safe and well accepted by all patients, who reported to be highly motivated by the practice of sport of their preference. We found improvements in gait speed, functional gait while dual tasking and endurance.  One of the limitations was a small sample size (n=16). It would be interesting to carry out a similar program in a larger sample in order to confirm the positive results.

An important challenge in the field is long-term adherence to exercise. Not only because of patient related factors, but also environmental factors, such as lack of offer to carry out an appropriate and challenging exercise program beyond the setting of a healthcare facility.

References: Tollar et al (2018). Two-Year Agility Maintenance Training Slows the Progression of Parkinsonian Symptoms.
Garcia Ruiz ert al (2022). On Disease Modifying and Neuroprotective Treatments for Parkinson’s Disease: Physical Exercise.
Hoang et al (2022). An intensive exercise-based training program reduces prefrontal activity during usual walking in patients with Parkinson’s disease.
Schootemeijer et al (2020). Barriers and Motivators to Engage in Exercise for Persons with Parkinson’s Disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sport-based-approach-in-patients-with-parkinsons-disease/