Journal
PARKINSONISM & RELATED DISORDERS
Volume 87, Issue -, Pages 13-19Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2021.04.005
Keywords
Parkinson's disease; Exercise; Grip force; Load force
Categories
Funding
- National Institutes of Health [R01NS673717]
- Bell Family Endowed Chair
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High intensity aerobic exercise, whether forced or voluntary, significantly improves symptoms and manual dexterity in PD patients by enhancing connectivity between basal ganglia and cortical areas, leading to improved motor control and execution abilities.
Introduction: Parkinson's disease (PD) disrupts the control and coordination of grasping forces, likely due to a disruption in basal ganglia circuitry and diminished activity within the supplementary motor area (SMA). High intensity aerobic exercise has been shown to enhance connectivity between basal ganglia nuclei and cortical areas, including the SMA. The aim of this project was to determine the effects of high intensity lower extremity exercise on motor control patterns underlying a manual dexterity task. Methods: PD participants completed eight weeks of high intensity aerobic exercise under forced or voluntary exercise (FE or VE) modalities. Grasping forces for each limb were quantified during a functional bimanual dexterity task. Data were collected while OFF antiparkinsonian medication at baseline, end of treatment (EOT), and eight weeks after exercise cessation (EOT+8). Results: Eight weeks of high intensity exercise improved MDS-UPDRS Motor III clinical ratings by more than 4 points (similar to 15%) for the FE and VE groups. Time to complete the task decreased nearly 30% across both groups as well. The control and coordination of grasping forces, simultaneity of force initiation, and rate of grip and load force exhibited significant improvements following exercise. In general, improvements in biomechanical outcomes were sustained following exercise cessation. Conclusion: High intensity aerobic exercise, achieved via a forced or voluntary mode, improved PD symptoms and bimanual dexterity. Sustained improvement of upper extremity motor control following exercise cessation indicates high intensity exercise enhances CNS functioning and suggests exercise may be a candidate for altering PD progression.
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