Can exercise preserve motor and non-motor function in Parkinson’s?

Abstract for 5th World Parkinson Congress

Title: Can exercise preserve motor and non-motor function in Parkinson’s?

Authors: Arthur Waters, Steve Meadows, Glen Davison, Anna Ferrusola-Pastrana, Chris Fullerton

Background:

Parkinson’s is a chronic neurodegenerative disease, which usually leads to disability and disengagement with active lifestyles. There is good evidence that exercise is effective at improving and sustaining cognitive and physical function in people with Parkinson’s (PwP). Few studies have assessed long-term effects of exercise and it remains unclear the optimal dose for PwP. In October 2016, a collaboration with Parkinson’s Equip and Medway Working Age Group (MWAG), a University of Kent Research Team started a community-based exercise programme for PwP. Using data collected over one-year, we evaluate the effects of multi-modal exercise on physical function, cognition, and wellbeing outcomes in PwP. We also describe the process evaluation of the venture to help understand its feasibility.

Methods:

22 participants (18 male, 4 female: age 65 ± 8 years) attended a once-a-week multi-modal group exercise session (60 minutes). Health and functional assessments were completed at the start and repeated every three months for one year. Measurements: resting heart rate (RHR) & blood pressure (BP), height, weight, BMI, waist circumference, Six-minute walking test (6MWT), timed up and go (TUG), 1-minute sit-to-stands (STS) and bilateral grip strength (GS).

Cognitive function was subsequently added and assessed with the Clock Drawing Test (CDT), Mini-Mental Parkinson’s (MMP), the Trail Making Test A (TMT-A) and B (TMT-B); plus quality of life with the brief Older Peoples Quality of Life Questionnaire (OPQOL-Brief).

Process evaluation was conducted using focus group interviews and questionnaires.

Results:

Scores for 6MWT, TUG and bilateral GS did not significantly change (P = 0.175, 0.143 and 0.333, respectively). The number of STS significantly increased during one year, specifically between baseline and the first three months (P = 0.012).

Scores for CDT, TMT-A, TMT-B and OPQOL-Brief did not significantly change across three different assessments, equivalent to half a year (P = 0.769, 0.205, 0.134 and 0.091, respectively). MMP increased significantly between baseline and the last assessment (P = 0.017).

Conclusion:

A once-a-week multi-modal group exercise programme for PwP showed an improvement in STS and MMP scores (notably, MMP scores significantly increased from 26.21 to 28.89), but no other significant changes (i.e. no decline) in health and physical function over one year. That functional and cognitive performance were increased or maintained is a positive outcome given the progressive nature of PD.

Outcomes from qualitative data capture the psychosocial factors that support engagement with the programme, how exercise helps PwP, and evidence about ‘real-world’ feasibility. This project is ongoing (now running for 2–years), which is a testament to its sustainability as a collaboration between a support group for PwP and a higher education institute.