Vigorous exercise could delay Parkinson's disease

Three intense workouts a week could slow the progression of Parkinson's disease, according to a study.

A team of researchers at Northwestern Medicine and the University of Colorado School of Medicine have found that vigorous exercise in the early stage of the degenerative disease can decrease worsening of motor symptoms.

The symptoms of the disease include progressive loss of muscle control, trembling, stiffness, slowness and impaired balance. As the disease progresses, it may become difficult to walk, talk and complete simple tasks. Most people who develop Parkinson's are 60 and older.

"If you have Parkinson's disease and you want to delay the progression of your symptoms, just a stroll isn't sufficient. You should exercise three times a week with your heart rate between 80 to 85 percent maximum. It is that simple," said lead author Margaret Schenkman.

Previously, it was thought high-intensity exercise was too physically stressful for individuals with Parkinson's disease.

Parkinson's symptoms include progressive loss of muscle control, trembling, stiffness, slowness and impaired balance. As the disease progresses, it may become difficult to walk, talk and complete simple tasks. Most people who develop Parkinson's are 60 and older.

Because medications for Parkinson's have adverse side effects and reduced effectiveness over time, new treatments are needed.

The randomized clinical trial included 128 participants ages 40 to 80 from Rush University Medical Center, Northwestern University and the University of Pittsburgh in addition to the University of Colorado Anschutz in Aurora.

Participants enrolled in the Study in Parkinson Disease of Exercise (SPARX) were at an early stage of the disease and not taking



Parkinson's medication, ensuring the results of the study were related to the exercise and not affected by medication.

"The earlier in the disease you intervene, the more likely it is you can prevent the progression of the disease," said co-lead author Daniel Corcos.

"We delayed worsening of symptoms for six months; whether we can prevent progression any longer than six months will require further study."

Scientists examined the safety and effects of exercise three times weekly for six months at high intensity, 80 to 85 percent of maximum heart rate, and moderate intensity, 60 to 65 percent of maximum heart rate. They compared the results to a control group who did not exercise.

After six months, participants were rated by clinicians on a Parkinson's disease scale ranging from 0 to 108. The higher the number, the more severe the symptoms.

Participants in the study had a score of about 20 before exercise. Those in the high intensity group stayed at 20. The group with moderate exercise got worse by 1.5 points.

The group that did not exercise worsened by three points. Three points out of a score of 20 points is a 15 percent change in the primary signs of the disease and considered clinically important to patients. It makes a difference in their quality of life.

"We catch people early in the disease and are slowing them from getting worse, which is significant, particularly for a disorder that is chronic and progressive," Schenkman said.

Schenkman and colleagues confirmed it was safe for the participants to do high-intensity exercise by giving them a cardiologist-supervised graded exercise test to evaluate the heart's response to exercise.

The findings have been published in JAMA Neurology.