Technology Assisted Aerobic Exercise in Patients with Mild to Moderate Parkinson’s Disease: A Pilot Quality Assurance Study in a Community Setting | Chapter 9 | Medical Science: Updates and Prospects Vol. 1

 

Background: Physical inactivity is a significant health risk, particularly in the growing population of elders with chronic neurodegenerative conditions like Parkinson’s Disease (PD).

 

Purpose: The primary purpose of the study was to determine if individuals with mild to moderate PD could safely achieve intense levels of exercise using novel rehabilitation technology (AlterGR, GlideTrakTM or the NuStepTMT5XR/Vasper) without exacerbating pain or PD signs and symptoms

 

Methodology: Two quality assurance studies, QA I and II, were carried out in a Health and Wellness Centre with individuals >60 years of age, of any gender, with mild to moderate PD (Hoehn and Yahr I-III). Participants in QA1 were randomly assigned to daily, intense training (5 days, 40 minutes per session, 200 minutes) on the AlterGR or the GlideTrakTM, with a crossover after 3 months. In QA II, participants trained for 5 weeks, 2x/week, 20 minutes/session, 5 weeks (200minutes) on the NuStepTMT5XR/ Vasper. Mobility and balance measurements were made pre- and immediately post study:10-meter walk, Six-minute Walk, Timed Up and Go (TUG), and Five Times Sit to Stand (5XSST). Nonparametric Wilcoxon Tests were applied to test gain scores for statistical significance. At the end of the study, participants self-reported signs, symptoms, training challenges and technology preferences.

 

Results: In QA I, 11 participants safely completed all 5 sessions of body unweighted aerobic training on the AlterG R and the GlideTrakTM without adverse effects. Nine participants achieved a target heart rate of 60-80% of age-relevant maximum, and 2 achieved >3 /10 exertion. In QA II, 9 participants safely completed the training sessions on the NuStepTMT5XR /Vasper without adverse events. Seven participants achieved the target heart rate of 60-80% of age-relevant maximum with 2 achieving >3/10 exertion level. Participants training on the Alter GR or the NuStepTMT5XR /Vasper made significant gains in gait speed, endurance and balance, performing at normative values. Post AlterGR training, the participants net the minimal clinically important differences (MICD) in gait speed and endurance (0.22 m/sec and 82,2 meters). In QA II, the participants met all MCIDs for gain scores in gait speed (0.28m/sec), distance walked in 6 minutes (30.8 m) and balance (-4.1 sec TUG and – 2.9 sec 5XSST). Post study, participants self-reported mild to moderate discomfort (0.5-1.6 on a scale of 0-10), but improved energy and resilience.

 

Conclusion: Novel rehabilitative technology allowed participants with mild to moderate PD to exercise aerobically and improve performance without exacerbating pain or PD signs and symptoms. Participants expressed selective preferences, but recommended technology-assisted equipment to be incorporated into community fitness centres to enable patients with neurodegenerative disease to exercise safely and intensively to maintain health and wellness.

 

Author(s) Details

Nancy Byl
Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of California, San Francisco, California, United States.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v1/6546