Supervised aerobic-strength exercise reduces postural sway and improves dual-task gait in Parkinson's disease

Parkinson's disease (PD) impairs balance and gait, increases fall risk, and reduces quality of life. While levodopa remains the primary treatment, it has limited effects on postural instability. Exercise training offers complementary benefits. This study examined the effects of supervised aerobic-strength exercise on postural stability and gait in PD patients, focusing on differences between ON and OFF medication states and relationships between static balance and dynamic balance during normal and dual-task walking. Fifteen PD patients completed a 4-month exercise training, with pre- and post-intervention assessments in both medication states using trunk accelerometry for static balance assessment during stance with eyes open and closed on firm and foam surfaces; and a markerless camera system for dynamic balance assessment during walking. The MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Berg Balance Scale (BBS) were utilized. Post-intervention, motor MDS-UPDRS scores improved significantly in both ON (p = 0.013) and OFF (p < 0.001) states. BBS scores increased (p = 0.005), and several postural parameters decreased in the OFF state in multiple conditions. During dual-task walking, stance time decreased in both ON (p = 0.048) and OFF (p = 0.026) states, while walking speed increased ON medication (p = 0.018). Trunk sway reduction correlated positively with stance time during dual-task walking. However, correlations between postural and gait changes without dual-task were either absent or inverse. These findings suggest that aerobic-strength exercise enhances postural stability and dual-task gait performance, particularly OFF medication. The distinct correlations between changes in postural and gait parameters indicate that specific tasks uniquely affect motor function outcomes, highlighting the need to fine-tune examination strategies in movement disorder research.