Structured Abstract
Parkinson's Disease Structured Abstract - P #9
Aerobic exercise may help clients with Parkinson's disease maintain functional ability
CITATION: Bridgewater, K. J., & Sharpe, M. H. (1996). Aerobic exercise and early Parkinson's disease. Journal of Neurological Rehabilitation, 10, 233-241.
LEVEL OF EVIDENCE: IIB2b
RESEARCH OBJECTIVE/QUESTION
The objective of this study was to investigate the effects of a 12-week aerobic exercise class on outcomes of participants with Parkinson's disease.
DESIGN
| |
RCT |
|
Single Case |
|
Case Control |
| |
Cohort |
x |
Before-After |
|
Cross Sectional |
Participants were assessed at baseline, given a 12-week intervention, assessed at posttest, and at 4 weeks after intervention.
SAMPLING PROCEDURE
Participants were recruited through newspaper advertisement and through the Parkinson Syndrome Society of South Australia.
SAMPLE
|
N = 26 |
Mean age: treatment grp = 67.3 (± 3.9), control grp = 66.5 (± 10.8) |
Male = 16 |
Female = 10 |
NUMBER OF PARTICIPANTS IN HOEHN & YAHR'S CLASSIFICATION OF PARKINSON'S DISEASE
STAGE I = 5
STAGE II = 13
STAGE III = 8
STAGE IV = 0
DESCRIPTION: 13 people were in each of the treatment and control groups. The control group contained nonexercising participants. Mean duration of illness was 4 years.
EXCLUSION/INCLUSION CRITERIA: All participants had to have the ability to move to and from a recumbent position on the floor. Participants with any spinal, cardiorespiratory, or neurologic pathology in addition to the diagnosis of Parkinson's disease were excluded.
OUTCOMES
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Life roles |
x |
Tasks |
|
Activities |
| |
Abilities/habits |
x |
Capacities |
OUTCOME AREAS
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Outcome Area |
Measures |
Reliability |
Validity |
|
Functional ability |
Northwestern University Disability Scale (NUDS) |
NR for any measure |
NR for any measure |
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Severity of clinical signs and motor impairment |
Webster Rating Scale for Parkinsonian Disabilities |
|
|
NR=Not Reported
INTERVENTION
Description
Progressive exercise consisted of
- 15 minutes of warm-up calisthenic exercises done to music with an emphasis on rhythmic movements.
- 20-30 minutes of aerobic exercise
- 5-10 minutes of cool-down stretching
Who delivered
Exercise classes were given by a PT who was certified as a fitness instructor. A second PT assisted.
Setting
NR, but all classes took place in a room with air conditioning.
Frequency
Twice a week
Duration
12 weeks, with a 4-week follow-up to assess variables.
RESULTS
Participants in the treatment and control groups had significantly different scores on the NUDS over the 18-week project period (F(2,76) = 6.47; p = .003). Participants in the treatment group reported improvement over the 18-week period; this result was nearly significant (p = .051). The control group reported significant losses in functional ability on the NUDS over this period (p < .05). No changes were found in the clinical signs of motor impairment as assessed by a neurologist blind to the participants' group assignment.
CONCLUSIONS
Biases - co-intervention, sample size
The authors concluded that functional ability did not improve as a result of exercise; however, scores on the functional ability measure improved in the treatment group and their result was nearly significant (p = .051). It is also important to note that participants in the control group reported decreased functional ability over the 18-week period, which suggests that the treatment may serve an important role in maintaining abilities. A small sample size may have contributed to Type II error.
COMMENTARY
This study supports the use of an aerobic exercise program to improve the functional ability of clients with early Parkinson's disease.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Susan Murphy, ScD, OTR/L, and Linda Tickle-Degnen, PhD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
