Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression
Introduction: There are scant data to demonstrate that the long-term non-pharmaceutical interventions can slow the progression of motor and non-motor symptoms and lower drug dose in Parkinson's disease (PD).Methods: After randomization, the Exercise-only (E, n = 19) group completed an initial 3...
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oai:doaj.org-article:ca2a5c2e004f41528381db311518bb6b2021-11-19T13:18:40ZDetraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression1664-229510.3389/fneur.2021.737726https://doaj.org/article/ca2a5c2e004f41528381db311518bb6b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.737726/fullhttps://doaj.org/toc/1664-2295Introduction: There are scant data to demonstrate that the long-term non-pharmaceutical interventions can slow the progression of motor and non-motor symptoms and lower drug dose in Parkinson's disease (PD).Methods: After randomization, the Exercise-only (E, n = 19) group completed an initial 3-week-long, 15-session supervised, high-intensity sensorimotor agility exercise program designed to improve the postural stability. The Exercise + Maintenance (E + M, n = 22) group completed the 3-week program and continued the same program three times per week for 6 years. The no exercise and no maintenance control (C, n = 26) group continued habitual living. In each patient, 11 outcomes were measured before and after the 3-week initial exercise program and then, at 3, 6, 12, 18, 24, 36, 48, 60, and 72 months.Results: The longitudinal linear mixed effects modeling of each variable was fitted with maximum likelihood estimation and adjusted for baseline and covariates. The exercise program strongly improved the primary outcome, Motor Experiences of Daily Living, by ~7 points and all secondary outcomes [body mass index (BMI), disease and no disease-specific quality of life, depression, mobility, and standing balance]. In E group, the detraining effects lasted up to 12 months. E+M group further improved the initial exercise-induced gains up to 3 months and the gains were sustained until year 6. In C group, the symptoms worsened steadily. By year 6, levodopa (L-dopa) equivalents increased in all the groups but least in E + M group.Conclusion: A short-term, high-intensity sensorimotor agility exercise program improved the PD symptoms up to a year during detraining but the subsequent 6-year maintenance program was needed to further increase or sustain the initial improvements in the symptoms, quality of life, and drug dose.Tibor HortobágyiTibor HortobágyiTibor HortobágyiTibor HortobágyiDávid SiposDávid SiposGábor BorbélyGyörgy ÁfraEmese Reichardt-VargaGergely SánthaWard NieboerKatalin TamásiJózsef TollárJózsef TollárJózsef TollárJózsef TollárFrontiers Media S.A.articlefollow-upsensorimotor trainingbalance trainingposturequality of lifeNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021) |
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follow-up sensorimotor training balance training posture quality of life Neurology. Diseases of the nervous system RC346-429 |
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follow-up sensorimotor training balance training posture quality of life Neurology. Diseases of the nervous system RC346-429 Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Dávid Sipos Dávid Sipos Gábor Borbély György Áfra Emese Reichardt-Varga Gergely Sántha Ward Nieboer Katalin Tamási József Tollár József Tollár József Tollár József Tollár Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| description |
Introduction: There are scant data to demonstrate that the long-term non-pharmaceutical interventions can slow the progression of motor and non-motor symptoms and lower drug dose in Parkinson's disease (PD).Methods: After randomization, the Exercise-only (E, n = 19) group completed an initial 3-week-long, 15-session supervised, high-intensity sensorimotor agility exercise program designed to improve the postural stability. The Exercise + Maintenance (E + M, n = 22) group completed the 3-week program and continued the same program three times per week for 6 years. The no exercise and no maintenance control (C, n = 26) group continued habitual living. In each patient, 11 outcomes were measured before and after the 3-week initial exercise program and then, at 3, 6, 12, 18, 24, 36, 48, 60, and 72 months.Results: The longitudinal linear mixed effects modeling of each variable was fitted with maximum likelihood estimation and adjusted for baseline and covariates. The exercise program strongly improved the primary outcome, Motor Experiences of Daily Living, by ~7 points and all secondary outcomes [body mass index (BMI), disease and no disease-specific quality of life, depression, mobility, and standing balance]. In E group, the detraining effects lasted up to 12 months. E+M group further improved the initial exercise-induced gains up to 3 months and the gains were sustained until year 6. In C group, the symptoms worsened steadily. By year 6, levodopa (L-dopa) equivalents increased in all the groups but least in E + M group.Conclusion: A short-term, high-intensity sensorimotor agility exercise program improved the PD symptoms up to a year during detraining but the subsequent 6-year maintenance program was needed to further increase or sustain the initial improvements in the symptoms, quality of life, and drug dose. |
| format |
article |
| author |
Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Dávid Sipos Dávid Sipos Gábor Borbély György Áfra Emese Reichardt-Varga Gergely Sántha Ward Nieboer Katalin Tamási József Tollár József Tollár József Tollár József Tollár |
| author_facet |
Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Tibor Hortobágyi Dávid Sipos Dávid Sipos Gábor Borbély György Áfra Emese Reichardt-Varga Gergely Sántha Ward Nieboer Katalin Tamási József Tollár József Tollár József Tollár József Tollár |
| author_sort |
Tibor Hortobágyi |
| title |
Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| title_short |
Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| title_full |
Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| title_fullStr |
Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| title_full_unstemmed |
Detraining Slows and Maintenance Training Over 6 Years Halts Parkinsonian Symptoms-Progression |
| title_sort |
detraining slows and maintenance training over 6 years halts parkinsonian symptoms-progression |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/ca2a5c2e004f41528381db311518bb6b |
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