Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression

Frontiers in Neurology

Ward Nieboer¹  Katalin Tamási³  József Tollár⁴  Tibor Hortobágyi⁵  Dávid Sipos⁶  Emese Reichardt-Varga⁷  György Áfra⁷  Gergely Sántha⁷  Gábor Borbély⁷ 

[1] Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary;Departments of Epidemiology and Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;Digital Development Center, Széchényi István University, Györ, Hungary;Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany;Faculty of Health Sciences, Department of Medical Imaging, University of Pécs, Pécs, Hungary;Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary;Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary;

关键词: follow-up;    sensorimotor training;    balance training;    posture;    quality of life;   

DOI  :  10.3389/fneur.2021.737726

来源: DOAJ

【 摘 要 】

Introduction: There are scant data to demonstrate that the long-term non-pharmaceutical interventions can slow the progression of motor and non-motor symptoms and lower drug dose in Parkinson's disease (PD).Methods: After randomization, the Exercise-only (E, n = 19) group completed an initial 3-week-long, 15-session supervised, high-intensity sensorimotor agility exercise program designed to improve the postural stability. The Exercise + Maintenance (E + M, n = 22) group completed the 3-week program and continued the same program three times per week for 6 years. The no exercise and no maintenance control (C, n = 26) group continued habitual living. In each patient, 11 outcomes were measured before and after the 3-week initial exercise program and then, at 3, 6, 12, 18, 24, 36, 48, 60, and 72 months.Results: The longitudinal linear mixed effects modeling of each variable was fitted with maximum likelihood estimation and adjusted for baseline and covariates. The exercise program strongly improved the primary outcome, Motor Experiences of Daily Living, by ~7 points and all secondary outcomes [body mass index (BMI), disease and no disease-specific quality of life, depression, mobility, and standing balance]. In E group, the detraining effects lasted up to 12 months. E+M group further improved the initial exercise-induced gains up to 3 months and the gains were sustained until year 6. In C group, the symptoms worsened steadily. By year 6, levodopa (L-dopa) equivalents increased in all the groups but least in E + M group.Conclusion: A short-term, high-intensity sensorimotor agility exercise program improved the PD symptoms up to a year during detraining but the subsequent 6-year maintenance program was needed to further increase or sustain the initial improvements in the symptoms, quality of life, and drug dose.

【 授权许可】

Unknown