Effects of Intensity-matched Agility and Cycling Exercise Training on PD Patients' Clinical Symptoms, Posture, and Mobility

Study Overview
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Brief Summary
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Determine the short-term and lasting effects of intensity-matched exercise programs on level 2-3 PD patients' clinical symptoms, postural control, and mobility. Hypothesis The inclusion of a Borg-scale/heart-rate matched active control group will allow us to test the idea that, in addition to a fitness element, the reflexive movements that chellenge PD patients' sensorimotor system will improve patients' clinical symptoms, posture, and mobility more than fitness training and that such lasting effects will be superior in the agility compared with the fitness-control group. This hypothesis emered from the idea that the favorable results in the currently under review paper may be in part due to a simple conditioning effect instead of a specific motor learning effect caused by the xbox training. If feasible, i.e., if there is a lerge enough pool of patients to randomize, a balance training group will be also added to test the idea that the reflexive actions evoked by the agility program by xbox exergaming still produce superior adaptations vs. the balance group because xbox forces patients to rapidly and reflexively execute movements (respond to cues, prompts), while balance training allows patients to stop, go, stop, and go and disrupt the continous execution of linked movements. The disruptions of movement chains could arise from small losses of balance on the unstabel surfaces, need for patients to re-initiate every movement element of a sequence, planning each movement element. It is not clear yet how it woul be possible to match all three intervention groups on Borg/heart rate intensity.

Detailed Description
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Agility: Xbox based high intensity program, as detailed in the submitted manuscript. Borg scale after after each exercise block is recorded. Heart rate continuosly measured. These data are used to set intensity in the fitness group. Fitness: A stationary bicycle ergometer program that includes visual stimulation in the form of watching nature programs and movies to account for visual stimulus in Agility group. Mean heart rate and Borg scale readings from Agility group will form the target intensity. Control: No-exercise, measurment-only control group.

Official Title
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Effects of Intensity-matched Agility and Cycling Exercise Training on PD Patients' Clinical Symptoms, Posture, and Mobility

Conditions
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Parkinson Disease, Balance, Rehabilitation, Motor Function

Intervention / Treatment
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* Other: Single-blind RTC of PD patients
* Other: cycling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parkinson's disease, Hoenh Yahr scale of 2-3, instability problem, Exclusion Criteria: • Severe heart problems, severe demeanor, alcoholism, drug problems,

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: High intensity agility group<br>Exercise therapy | Other: Single-blind RTC of PD patients<br>* The groups participate in observation for 5 weeks. Two groups take part in a motion therapy over the 5-week period.<br>|
| Experimental: Non-agility cycling group<br>Parkinson's Bicycle Group, which takes 1 hour of exercise every day for 5 weeks | Other: cycling<br>* Patients must undergo a daily exercise cycle of 1 hour during the intervention<br>|
| No Intervention: No-exercise control group<br>Control Parkinson's disease control group thad will not receive exercise treatment | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EQ5D-5L | Questionnaire | 0-5 scale (5 weeks-long, the higher score is better) | 
| Borg test | Fatigue questionnaire | 0-40 point (5 week-long, higher score is better) | 
| PDQ-39 | special Parkinson's Disease test - motor and no-motor function | 0-39 scale (5week-long, higher score is better) | 
| SPPB test (gait, balance, leg stregth) | Walking and balance testing | 0-12 scale (5 week-long, higher score is better) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sensorimotor training, quality of life, posture