A High-Intensity Multicomponent Agility Intervention Improves Parkinson Patients’ Clinical and Motor Symptoms

Abstract

ObjectiveTo determine the effects of a high-intensity exercise therapy using sensorimotor and visual stimuli on nondemented Parkinson disease (PD) patients’ clinical symptoms, mobility, and standing balance. DesignRandomized clinical intervention, using a before-after trial design. SettingUniversity hospital setting. ParticipantsA total of 72 PD patients with Hoehn and Yahr stage of 2-3, of whom 64 were randomized, and 55 completed the study. InterventionPD patients were randomly assigned to a no physical intervention control (n=20 of 29 completed, 9 withdrew before baseline testing) or to a high-intensity agility program (15 sessions, 3 weeks, n=35 completed). Main Outcome MeasuresPrimary outcome was the Movement Disorders Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) motor experiences of daily living (M-EDL). Secondary outcomes were Beck Depression score, Parkinson Disease Questionnaire-39 (PDQ-39), EuroQoL Five-Dimension (EQ5D) Questionnaire visual analog scale, Schwab and England Activities of Daily Living (SE ADL) Scale, timed Up and Go (TUG) test, and 12 measures of static posturography. ResultsThe agility program improved MDS-UPDRS M-EDL by 38% compared with the 2% change in control (group by time interaction, P=.001). Only the intervention group improved in PDQ-39 (6.6 points), depression (18%), EQ5D visual analog scale score (15%), the SE ADL Scale score (15%), the TUG test (39%), and in 8 of 12 posturography measures by 42%-55% (all P<.001). The levodopa equivalent dosage did not change. ConclusionA high-intensity agility program improved nondemented, stage 2-3 PD patients’ clinical symptoms, mobility, and standing balance by functionally meaningful margins at short-term follow-up.