Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms: A Randomized Clinical Trial

To directly compare the effects of agility exergaming (EXE) and stationary cycling (CYC) exercise training on Parkinson's disease (PD) patients' mobility and clinical symptoms.

Randomized clinical trial.

Outpatient physiotherapy clinic in a hospital.

Seventy-four stage 2-3, nondemented PD patients were included in this study.

The groups were as follows: EXE (n = 25), CYC (n = 25), and a wait-listed control group (CON; n = 24). The EXE and CYC groups exercised 5×/week for 5 weeks, matched at 80% of the age-predicted maximal heart rate.

The primary outcome was the Movement Disorders Society Unified Parkinson's Disease Rating Scale (UPDRS-II) score. Secondary outcomes were Parkinson's Disease Quastionnaire-39 (PDQ-39), the Beck Depression Inventory (BDI), the Schwab and England Activities of Daily Living (SE-ADL) scale, Euro-Quality of Life-5 Dimensions (EQ-5D) questionnaire, the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Tinetti Assessment Tool (TAT), the Dynamic Gait Index, the 6-min walk test (6MWT), and standing posturography.

After treatment, UPDRS-II scores improved (mean change: EXE, -4.5 points; CYC, -3.2 points). The results for the other outcomes (EXE and CYC, respectively) were: PDQ, 13 and 17%; BDI, -2.5 and -2.1 points; 6MWT, 129.6 and 141.6 m; and EQ-5D, 12 and 9% (all p < 0.05, but there was no difference between groups). EXE vs. CYC resulted in improved SE-ADL (8.4 and 4.0 points, effect size [ES]: 0.12), BBS (8.8 and 4.2 points, ES: 0.44), and 2 measures of posturography (ES: 0.11 and 0.21) (p < 0.05). BESTtest, TAT, the Dynamic Gait Index, and 4 out of 6 posturography measures did not change (p > 0.05).

Two highly different exercise programs resulted in similar improvement of most motor and clinical symptoms in PD patients.