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Effectiveness of Balance Exercise and Brisk Walking on Alleviating Nonmotor and Motor Symptoms in People With Mild-to-Moderate Parkinson Disease: A Randomized Clinical Trial With 6-Month Follow-up.

Archives of physical medicine and rehabilitation
October 1, 2024
Margaret K Y Mak et al. (4 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

To investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance, gait functions, walking capacity, and balance confidence in individuals with mild-to-moderate Parkinson's disease.

Results Summary

The combined balance and brisk walking program improved nonmotor and motor symptoms, walking capacity, balance, and gait functions post-training, with sustained benefits for motor outcomes at 6-month follow-up. Significant improvements were observed in mini-BEST score, comfortable gait speed, 6-minute walk test, and dual-task timed-Up-and-Go time.

Population

Individuals with mild-to-moderate Parkinson's disease (n=99).

Effective Dosage

90-minute supervised sessions (weekly for weeks 1-6, monthly for weeks 7-26) plus unsupervised home exercises 2-3 times/week.

Duration

6 months (with 6-month follow-up).

Interactions

None mentioned.

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
balance and brisk walking group (B&B)
decrease
nonmotor symptoms
individuals with mild-to-moderate PD
-
alleviates
#1
balance and brisk walking group (B&B)
decrease
motor symptoms
individuals with mild-to-moderate PD
-
alleviates
#2
balance and brisk walking group (B&B)
increase
walking capacity
individuals with mild-to-moderate PD
-
improves
#3
balance and brisk walking group (B&B)
increase
balance
individuals with mild-to-moderate PD
-
improves
#4
balance and brisk walking group (B&B)
increase
gait functions
individuals with mild-to-moderate PD
-
improves
#5
balance and brisk walking group (B&B)
increase
mini-BEST score
individuals with mild-to-moderate PD
-
significant between-group improvements
#6
balance and brisk walking group (B&B)
increase
comfortable gait speed (CGS)
individuals with mild-to-moderate PD
-
significant between-group improvements
#7
balance and brisk walking group (B&B)
increase
6-minute walk test (6MWT)
individuals with mild-to-moderate PD
-
significant between-group improvements
#8
balance and brisk walking group (B&B)
decrease
dual-task timed-Up-and-Go (DTUG) time
individuals with mild-to-moderate PD
-
significant between-group improvements
#9
balance and brisk walking group (B&B)
decrease
motor symptoms
individuals with mild-to-moderate PD
-
positive carryover effects
#10
balance and brisk walking group (B&B)
increase
walking capacity
individuals with mild-to-moderate PD
-
positive carryover effects
#11
balance and brisk walking group (B&B)
increase
balance
individuals with mild-to-moderate PD
-
positive carryover effects
#12
balance and brisk walking group (B&B)
increase
gait functions
individuals with mild-to-moderate PD
-
positive carryover effects
#13
Abstract

OBJECTIVE: To investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance and gait functions, walking capacity, and balance confidence in Parkinson disease (PD) at posttraining and 6-month follow-up. DESIGN: Two-arm, assessor-blinded randomized controlled trial SETTING: University research laboratory and the community PARTICIPANTS: Ninety-nine eligible individuals with mild-to-moderate PD INTERVENTIONS: Participants were randomized to balance and brisk walking group (B&B, n=49) or active control group (n=50). B&B received ten 90-minute sessions of balance exercises and brisk walking supervised by physical therapists for 6 months (week 1-6: weekly, week 7-26: monthly), whereas control practiced whole-body flexibility and upper limb strength exercise at same dosage (180 min/wk). Both groups performed unsupervised home exercises 2-3 times/wk during intervention and continued at follow-up. MAIN OUTCOME MEASURES: Primary outcomes were Movement Disorder Society Unified Parkinson Disease Rating Scale nonmotor (MDS-UPDRS-I) and motor (MDS-UPRDS-III) scores. Secondary outcomes were mini-Balance Evaluation Systems Test (mini-BEST) score, comfortable gait speed (CGS), 6-minute walk test (6MWT), dual-task timed-Up-and-Go (DTUG) time, and Activities-Specific Balance Confidence Scale score. RESULTS: Eighty-three individuals completed the 6-month intervention with no severe adverse effects. The mean between-group (95% CI) difference for the MDS-UPDRS nonmotor score was 1.50 (0.19-2.81) at 6 months and 1.09 (-0.66 to 2.85) at 12 months. The mean between-group (95% CI) difference for the MDS-UPDRS motor score was 3.75 (0.69-6.80) at 6 months and 4.57 (1.05-8.01) at 12 months. At 6 and 12 months, there were significant between-group improvements of the B&B group in mini-BEST score, CGS, 6MWT, and DTUG time. CONCLUSIONS: This combined balance and brisk walking exercise program alleviates nonmotor and motor symptoms and improves walking capacity, balance, and gait functions posttraining, with positive carryover effects for all except nonmotor outcomes, at 6-month follow-up in mild-to-moderate PD.

Medical Subject Headings (MeSH)
HumansParkinson DiseaseMaleFemalePostural BalanceAgedExercise TherapyMiddle AgedWalkingFollow-Up StudiesSingle-Blind MethodSeverity of Illness IndexGaitTreatment Outcome
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality88/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.50
Weight Score2.76
Normalized Score0.88
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Effectiveness of Balance Exercise and Brisk Walking on Allev... | Panacea Index