Exercise for People in Early- or Mid-Stage Parkinson Disease: A 16-Month Randomized Controlled Trial

Margaret Schenkman; Deborah A. Hall; Anna E. Barón; Robert S. Schwartz; Pamela Mettler; Wendy M. Kohrt

doi:10.2522/ptj.20110472

Figures

Figure 1.

CONSORT diagram of flow of participants in the study. The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease. Not all participants completed all of the time points, resulting in some fluctuating numbers in the flow diagram; this fluctuation was taken care of by the analysis approach.

Figure 2.

Walking economy at speeds from 0.8 mph to 4 mph. The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease (PD). Oxygen uptake (V̇o₂, in mL/min/kg) is presented for each group at 4 time points (baseline, 4, 10, and 16 months), illustrating the improvement (less oxygen required) for the AE group, but not for the other 2 groups. Walking speeds (increased by 0.5 mph for 4 speeds) are determined for each participant by the maximum walking speed achieved during the graded exercise test.

Tables

Table 1.

Baseline Characteristics^{^a}

↵^a The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease (PD). Subtotals less than the total number of participants indicate some data were not provided by the participants. UPDRS=United Parkinson's Disease Rating Scale, ADL=activities of daily living, CS-PFP=Continuous Scale—Physical Functional Performance Test; FRT=Functional Reach Test, V̇o₂=oxygen uptake, PDQ-39=39-item Parkinson's Disease Questionnaire.
^b P value from chi-square test.
^c Exact chi-square P value.
^d P value from analysis of variance.

Table 2.

Linear Model–Based Means^{^a}

↵^a The model likelihood ratio chi square <.001 for all models. Models include the following design variables and covariate adjustments: sex (categorical, 2 levels), time (categorical, 4 levels), group × time interactions (6 dummy variables), levodopa equivalents (continuous). The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease (PD). UPDRS=United Parkinson's Disease Rating Scale, ADL=activities of daily living, CS-PFP=Continuous Scale—Physical Functional Performance Test, FRT=Functional Reach Test, V̇o₂=oxygen uptake, PDQ-39=39-item Parkinson's Disease Questionnaire, SE=standard error.

Table 3.

Estimated Mean Differences Between Groups (Treatment Effect)^{^a}

↵^a The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease (PD). UPDRS=United Parkinson's Disease Rating Scale, ADL=activities of daily living, CS-PFP=Continuous Scale—Physical Functional Performance Test, FRT=Functional Reach Test, V̇o₂=oxygen uptake, PDQ-39=39-item Parkinson's Disease Questionnaire, SE=standard error, 95% CI=95% confidence interval.

Table 4.

Estimated Slope Differences Between Groups^{^a}

↵^a The control group participated in a home-based program of exercises recommended by the National Parkinson Foundation,¹⁸ the AE group participated in a standard aerobic endurance program, and the FBF group participated in a flexibility/balance/function program specifically designed for people with Parkinson disease (PD). UPDRS=United Parkinson's Disease Rating Scale, ADL=activities of daily living, CS-PFP=Continuous Scale—Physical Functional Performance Test, FRT=Functional Reach Test, PDQ-39=39-item Parkinson's Disease Questionnaire, SE=standard error, 95% CI=95% confidence interval.