# Exercise as it relates to Disease/Resistance training effects on functional capacity in older individuals with Parkinson's
## What is the background to this research?

* Parkinson's is a disease that attacks the nervous system, affecting an individual's movements, worsening over time. Symptoms cause shaking and the inability to control motor function.
* This paper analyses the implementation of a 6-month low – volume resistant training program, on 54 elderly patients over the age of 60. All of which have early to advanced stages of Parkinson’s disease.
* The importance of this article is to assist in the search for beneficial reliefs to help fight the symptoms of Parkinson’s disorder. Currently, there is no cure for Parkinson’s disease, so the implementation of different methods of reversing or reducing the effects of Parkinson’s will assist in refining the search for the cure of this disease.

## Where is the research from?

* This design was implemented and evaluated by The Japanese Geriatrics Society.
* Japan has a 5% Parkinson affected population for people over the age of 60 years. With Japan's population of people over the age of 60 being 41 million, it makes the elderly population of japan with Parkinson’s disease 2 million people. This displays a heavy prevalence of Parkinson’s disease in the Japanese community which would have a mass effect on the population. This article is therefore important in assisting the community in the search to help those 2 million people affected in its given country.
* The Japanese Geriatric society holds a reputation due to its long-lasting record of article publications (since 1959) and studies associating with health among the elderly community. This reputation is represented by the Asia/Oceania Regional Congress, being held in a high standard among the Japanese community, demonstrated by being honored in hosting the IAGG Asia/Oceania Reginal Congress.
* The Japanese Geriatric Society is also in association with Japan Socio-Gerontological studies, Society of Gerontology, The Japanese psychogeriatric Society and The Japanese Society of Care and Management. Due to the high affiliation with recognized institutions based in Japan, there can be a conflict of bias-based around the Japanese community over the rest of the world's population.

## What kind of study was it?

* This study was completed as a randomized controlled trial.
* 54 patients were randomly assigned into two groups, a control group and a resistance group.
* Randomised controlled trials, also known as RCTs are highly recommended due to its efficiency and gold standard for reducing bias within a trial.

## What did the research involve?

* For the study the 13 men and 14 women were split into a control group (group A), with 14 men and 13 women being split into a resistance group (group B).
* Group B contributed in two sessions of resistant training exercise a week over a 6-month period.
* Group A contributed to their normal routine without continuing with resistant training.
* Both Group A and Group B were tested pre and post 6 month period for handgrip strength, aerobic endurance, flexibility, balance, gait speed and flexibility.
* Limitations can be identified in the methodology with the groups being randomized and not specified.
* This can prove a complication due to each individual's medications and daily procedures not being taken into account in results nor identified.
* As this study is of its own research and found results, there is no other research or article that can be used to direct the article to conclude peak accuracy in results.

## What were the basic results?

* At the end of the 6 month training period, it indicated that Group B participants on average improved all flexibility, aerobic resistance, gait speed, grip strength and balance. While the participants in Group A had functionality reduction with all tests performed.
* The results were interpreted by comparing the scores of pre and post-assessments of both groups, represented as a P-value.
* The results presented under-explain the scores with only giving a brief explanation of findings being displayed as a P-value, without giving any further information making it hard to decipher between the effectiveness of the study.

## what conclusions can we take from this research?

* The conclusions drawn from the results show that there was a benefit of the low-volume resistant training in terms of functionality for elderly people with Parkinson's, however, it is unclear at how dramatic of a difference between Group A and Group B may conclude.

## practical advice

* The study demonstrated an improvement in function of movement of participants committing to resistant training, also, showing a reduction of functionality of those participants who did not contribute to this. This can be very helpful globally, to help define interventions for elderly patients with Parkinson’s.
* This study could have been enhanced with the use of tables and data being represented as its original measurements. This would assist the reader in gaining insight into how significant of a difference there was between the control group and the resistant training group.
* This would also be beneficial by being able to observe each individual's records during the first test to ensure that the difference was not significant between either group.

## Further information

* Given that the study is a new article (being published in 2019), it is supported by many older studies, suggesting that the participation in consistent resistance training among people with Parkinson’s disease will aid improvements in the functionality of movements.
* For further information on the articles associated with the Japanese Geriatric Society, which include studies in associating mental and physical health, the website to access is https://www.jpn-geriat-soc.or.jp/en/
* Other studies that support article suggesting that resistance training helps improve people with Parkinson’s include; https://www.sciencedirect.com/science/article/pii/S0003999303000467

## References

* ↑ Lucas Marsili, 2018, Diagnostic Criteria for Parkinson’s Disease: From James Parkinson to the Concept of Prodromal Disease
* 1 2 3 Leon Cp, Odilon Abrahin, Rejane P Rodrigues, Maria Cr da Silva, 2019, Low-volume resistance training improves the functional capacity of older individuals with Parkinson's disease
* 1 2 3 4 The Japanese Geriatric Society, 2019, welcome to the japan geriatric society, Home
* ↑ Yuriko Doi, Tetsuji Yokoyama, 2011, How Can the National Burden of Parkinson’s Disease Comorbidity and Mortality Be Estimated for the Japanese Population?
* ↑ Japanese geriatric society, 2019, about us
* ↑ Peter Markus Spieth, 2016, Randomized controlled trials – a matter of design
* ↑ Mark A Hirsch, 2003, The effects of balance training and high-intensity resistance training on persons with Parkinson’s disease