Exercise Training, Parkinson Disease
Conditions
Keywords
High intensity interval training
Brief summary
Aerobic exercise is recommended for individuals with Parkinson's disease (PD) and can improve quality of life, both physically and mentally. The most efficacious program to achieve these exercise benefits is unknown. Recently, high-intensity interval training (HIIT) has been shown to be safe and more effective in many high-risk populations with limited exercise tolerance. Shorter bouts of exercise are likely better tolerated in PD due to difficulty sustaining muscle contractions. The goal of this project is to determine whether HIIT produces superior cardiorespiratory, neuromuscular, biomechanical, and clinical adaptations than conventional continuous moderate intensity training (CMIT) in PD.
Detailed description
The specific research aims are to compare, in PD, the effects of HIIT or CMIT on: 1) maximal exercise capacity; 2) neural and non-neural factors contributing to muscle strength, power and fatigability; 3) biomechanical measures of postural stability and gait; and 4) Clinical markers (Mini-BESTest and Unified Parkinson's Disease Rating Scale (UPDRS)). The investigators hypothesize that, HIIT will produce greater improvements in: 1) exercise capacity; 2) muscle strength, power and reduced fatigability; 3) stability and gait velocity; and 4) clinical markers. Methods: This pilot project will involve a randomized trial of 30 individuals with PD comparing the effects of HIIT and CMIT. Training will be completed thrice weekly for 10 weeks. Participants will include men and women between 50-85 years of age, who are able to stand unsupported for 1 min, walk 18m without use of an aid, and mount a stationary bike. Participants will be randomized to either HIIT (10, 1-minute cycling intervals at 90% of peak power output, each separated by 1-min at 10% peak power output) or CMIT (30-50min cycling at 60% of peak power output). Participants will undergo the following pre- and post-training assessments: Cardiovascular testing will examine hemodynamic and efferent muscle sympathetic responses to static handgrip exercise and post-exercise circulatory occlusion; Neuromuscular testing will examine muscle activity (electromyography) during voluntary and electrically stimulated contractions of the knee extensors; Biomechanical testing will examine whole-body stability, gait, and balance patterns; and Clinical risk assessments (Mini-BESTest and UPDRS).
Interventions
OTHERHigh Intensity Interval Training
Participants will complete exercise training 3x/week for 10 weeks. Exercise will consist of 10, 1-minute cycling intervals at 90% of peak power output, each separated by 1-min at 10% peak power output.
OTHERContinuous Moderate Intensity Training
Participants will complete exercise training 3x/week for 10 weeks. Exercise will consist of 30-50 minutes of cycling at 60% peak power output.
Sponsors
Parkinson Society Canada
YMCA
University of Guelph
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The collection of study outcomes will be completed by individuals blinded to group allocation.
Intervention model description
Participants will be randomized to 10 weeks of either high intensity interval training or continuous moderate intensity training. Training will be conducted in parallel.
Eligibility
Sex/Gender
ALL
Age
45 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Men and women between 45-85 years of age * Clinical diagnosis of Parkinson disease * Able to stand unsupported for 1 minute * Able to walk 18 metres without aid * Able to mount a stationary bike
Exclusion criteria
* History of dementia * History of stroke * Type 1 diabetes * Autonomic neuropathy * Currently involved in formal exercise training (\>3 day per week).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximal exercise capacity | Change from baseline following 10 weeks of aerobic exercise training | VO2 max |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Handgrip strength | Change from baseline following 10 weeks of aerobic exercise training | Maximal handgrip strength |
| Blood Pressure | Change from baseline following 10 weeks of aerobic exercise training | Systolic and Diastolic Blood Pressure |
| Heart Rate | Change from baseline following 10 weeks of aerobic exercise training | Cardiovascular measure |
| Mini-Balance Evaluation Systems Test (Mini-BESTest) | Change from baseline following 10 weeks of aerobic exercise training | Rating scale consisting of 14 items that are each scored from 0-2, where 0 indicates the lowest level of function and 2 the highest level of function. The test has a maximum score of 28 points. |
| Unified Parkinson's Disease Rating Scale (UPDRS) | Change from baseline following 10 weeks of aerobic exercise training | We will use the rating scale to examine 3 segments. 1) MENTATION, BEHAVIOR AND MOOD - 4 questions scored between 0 and 4; 2) ACTIVITIES OF DAILY LIVING - 13 questions scored between 0 and 4; and 3) MOTOR EXAMINATION - 14 questions scored between 0 and 4. In each case, a score of 0 indicates normal responses. |
Countries
Canada
Outcome results
None listed