Effect of long-term locomotion and balance exercise on functional mobility considering the Parkinson’s disease subtypes: a pilot study

Abstract

BACKGROUND: Different clinical subtypes (i.e., Postural Instability and Gait Difficulty -PIGD and Tremor Dominant -TD) have been highlighted in Parkinson's disease (PD). Although physical exercise improves motor symptoms in PD, the knowledge about the effect of physical exercise considering the PD subtype is limited. AIM: To compare the effects of long-term locomotion and balance exercise on lower limb functional strength and functional mobility in PD subtypes. METHOD: Eight individuals PIGD and 10 TD participated in this study. All individuals participated in the interventions with exercises focused on improving locomotion and balance. 48 sessions of exercise were performed three times per week for 60 minutes each session. Functional Mobility was analyzed by the Timed Up and Go test (TUG) in a single (ST) and double-task (DT – i.e., subtraction by three). Lower limb functional strength was analyzed by the 30s sit-to-stand test. Both tests were performed at baseline (pre-test) and post-intervention (post-test). Statistical analysis was performed by two-way ANOVA, with Group (PIGD vs. TD) and Moment (pre vs. post-test) factors, with repeated measures for the second factor. RESULTS: PIGD decreased the time to perform TUG_ST in the post-test compared to the pre-test (p=0.001). Both groups decreased the time in TUG_DT and increased the number of repetitions in sit-to-stand test in the post-test in relation to the pre-test (p<0.05). CONCLUSION: Long-term locomotion and balance exercise programs can improve functional mobility mainly in PIGD. A possible explanation is due to the greater room for improvement of PIGD subtypes and exercise specificity.