Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Neurological Institute, Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA.
Health Soc Care Community. 2022 Nov;30(6):e6122-e6134. doi: 10.1111/hsc.14049. Epub 2022 Oct 10.
Participation in supervised, laboratory-based aerobic exercise protocols holds promise in slowing the progression of Parkinson's disease (PD). Gaps remain regarding exercise adherence and effectiveness of laboratory protocols translated to community-based programs. The aim of the project was to monitor exercise behaviour and evaluate its effect on disease progression over a 6 month period in people with PD participating in a community-based Pedalling for Parkinson's (PFP) cycling program. A pragmatic, observational study design was utilised to monitor exercise behaviour at five community sites. The Movement Disorders Society-Unified Parkinson's disease Rating Scale Motor III (MDS-UPDRS-III) and other motor and non-motor outcomes were gathered at enrollment and following 6 months of exercise. Attendance, heart rate, and cadence data were collected for each exercise session. On average, people with PD (N = 41) attended nearly 65% of the offered PFP classes. Average percent of age-estimated maximum heart rate was 69.3 ± 11.9%; average cadence was 74.9 ± 9.0 rpms. The MDS-UPDRS III significantly decreased over the 6-month exercise period (37.2 ± 11.7 to 33.8 ± 11.7, p = 0.001) and immediate recall significantly improved (42.3 ± 12.4 to 47.1 ± 12.7, p = 0.02). Other motor and non-motor metrics did not exhibit significant improvement. Participants who attended ~74% or more of available PFP classes experienced the greatest improvement in MDS-UPDRS III scores; of those who attended less than 74% of classes, cycling greater than or equal to 76 rpms lead to improvement. Attendance and exercise intensity data indicated that a laboratory-based exercise protocol can be successfully translated to a community setting. Consistent attendance and pedalling at a relatively high cadence may be key variables to PD symptom mitigation. Improvement in clinical ratings coupled with lack of motor and non-motor symptom progression over 6 months provides rationale for further investigation of the real-world, disease-modifying potential of aerobic exercise for people with PD.
参与监督下的基于实验室的有氧运动方案有望减缓帕金森病（PD）的进展。关于运动依从性和实验室方案在社区为基础的项目中的有效性仍存在差距。该项目的目的是在参与社区为基础的 Pedalling for Parkinson's（PFP）骑行计划的 PD 患者中，监测运动行为并在 6 个月的时间内评估其对疾病进展的影响。采用实用的观察性研究设计，在五个社区地点监测运动行为。在入组时和进行 6 个月的运动后，收集运动障碍协会统一帕金森病评定量表运动 III（MDS-UPDRS-III）和其他运动和非运动结果。为每次运动课程收集出勤率、心率和踏频数据。平均而言，PD 患者（N=41）参加了近 65%的提供的 PFP 课程。平均达到年龄估计最大心率的百分比为 69.3±11.9%；平均踏频为 74.9±9.0rpm。在 6 个月的运动期间，MDS-UPDRS III 显著降低（37.2±11.7 至 33.8±11.7，p=0.001），即时回忆显著改善（42.3±12.4 至 47.1±12.7，p=0.02）。其他运动和非运动指标没有显著改善。参加了~74%或更多可用 PFP 课程的参与者，MDS-UPDRS III 评分的改善最大；那些参加不到 74%课程的人，踏频大于或等于 76rpm 会导致改善。出勤率和运动强度数据表明，基于实验室的运动方案可以成功地转化为社区环境。一致性的出勤率和相对较高的踏频可能是 PD 症状缓解的关键变量。6 个月内临床评分的改善以及运动和非运动症状的进展缺乏，为进一步研究有氧运动对 PD 患者的现实世界、疾病修饰潜力提供了理由。
