Abstract
Introduction. Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson's disease (PD). Methods. Thirty-eight participants with idiopathic PD were randomized to either an aerobic exercise group (n = 23) or a nonexercise control group (n = 15). The aerobic exercise group completed a 60-minute cycling session three times per week for eight weeks while the nonexercise control group received no intervention. All participants completed the University of Pennsylvania Smell Identification Test (UPSIT) at baseline, end of treatment, and a four-week follow up. Results. Change in UPSIT scores between the exercise and nonexercise groups from baseline to EOT (p = 0.01) and from baseline to EOT+4 (p = 0.02) favored the aerobic exercise group. Individuals in the nonexercise group had worsening olfaction function over time, while the exercise group was spared from decline. Discussion. The difference in UPSIT scores suggested that aerobic exercise may be altering central nervous system pathways that regulate the physiologic or cognitive processes controlling olfaction in individuals with PD. While these results provide promising preliminary evidence that exercise may modify the disease process, further systematic evaluation is necessary.
Highlights
Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson’s disease (PD)
While a trend was present for the Voluntary Exercise Cycling (VE) group to be exercising at a greater intensity as measured by heart rate reserve (HRR), there was no significant difference between exercise intensity for the VE and forced exercise (FE) groups with means of 57.9 and 48.9 percent of HRR, respectively (p = 0.06)
There was a significant difference in cadence between the VE and FE groups, with means of 69.7 and 82.9 rpms, respectively (p < 0.01); an analysis of covariance (ANCOVA) model, using cadence as the dependent variable, revealed a nonsignificant interaction between cadence and change in University of Pennsylvania Smell Identification Test (UPSIT) score between groups (p = 0.13 at end of treatment (EOT); p = 0.59 at EOT+4)
Summary
Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson’s disease (PD). The difference in UPSIT scores suggested that aerobic exercise may be altering central nervous system pathways that regulate the physiologic or cognitive processes controlling olfaction in individuals with PD. While these results provide promising preliminary evidence that exercise may modify the disease process, further systematic evaluation is necessary. It has been proposed that olfaction dysfunction in Parkinson’s disease evolves from Lewy bodies formed in the olfactory bulb and progresses to brain stem nuclei such as the locus coeruleus and substantia nigra and eventually to the cerebral cortex [6]. Neurotransmitters such as acetylcholine, norepinephrine, serotonin, and, to a lesser extent, dopamine, all of which are typically altered in Parkinson’s disease, impact olfaction through various direct and indirect pathways [7]
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