Grant from the Michael J. Fox Foundation Funds Project
Researchers from the University of Maryland School of Medicine and the Baltimore VA Medical Center have launched a study to see if exercising several times a week will help people with Parkinson’s disease improve their walking and balance. A $750,000 grant from the Michael J. Fox Foundation is funding this multi-year project.
“Our main goal is to see if these exercises improve the mobility of Parkinson’s patients,” says Lisa M. Shulman, M.D., principal investigator and associate professor of neurology at the University of Maryland School of Medicine. Dr. Shulman is also co-director of the Parkinson’s Disease and Movement Disorders Center at the University of Maryland Medical Center.
She adds, “Parkinson’s patients tell us that when the disease begins to affect their ability to walk, their entire life is affected. They have trouble with daily activities such as dressing, housekeeping, shopping and getting around their community. That’s why we are so interested in studying if exercise can help these patients improve their gait and balance, because it is so fundamental to their daily lives.”
The project will enroll about 70 participants to compare the potential benefits of three types of exercise. The first group will walk on the treadmill at a comfortable pace, but with increasing duration as the training progresses. Researchers want to see if the repetitive gait training is sufficient to improve mobility. Participants in the second group will receive treadmill training with aerobic conditioning: trainers will safely and gradually increase the incline and speed of the treadmill in an attempt to improve the participants’ cardiovascular and aerobic conditioning. The third group will be using weights and stretching exercises to improve their muscle strength and range of motion. Participants will train three times a week for three months.
“Parkinson’s patients often ask their doctors if they should exercise and, if so, what kind of exercise they should do,” says Dr. Shulman. “However, there haven’t been any rigorous studies focusing on the effect of exercise in Parkinson’s disease. We are excited about this study because, at the end of our research, we hope finally to have some definitive answers for our patients.”
Researchers will use several timed tests of gait to measure progress. All participants will also be evaluated with specialized pedometers to see if there are any increases or decreases in their daily activity over the course of the study. As part of the research, the participants’ heart rates, oxygen use and blood pressure will be measured, monitored and compared after the study’s completion. Investigators will also evaluate muscle strength before and after the exercise program.
The Parkinson’s project builds on previous studies of treadmill training for stroke patients. This research, also conducted at the University of Maryland School of Medicine and the Baltimore VA Medical Center, examined whether the consistent, repetitive motion of walking could help the brain to “rewire” itself, developing new connections to compensate for the damaged ones, a concept known as brain plasticity.
“We have shown that regular exercise on a treadmill can improve stroke patients’ walking ability even years after they’ve had a stroke,” says study co-investigator Richard Macko, M.D., director of the Maryland Exercise and Robotics Center of Excellence at the Baltimore VA Medical Center and professor of neurology at the University of Maryland School of Medicine. “Now we are interested to see if this same concept will work for other neurological conditions such as Parkinson’s disease.”
The training will take place in the Baltimore VA’s Geriatric Research, Education and Clinical Center, a gym facility with special equipment for people who may have some physical limitations. Since Parkinson’s patients may already have some gait problems, they will wear a safety harness while walking on the treadmill and will be carefully supervised. The patients will walk for about a half-hour during each session, but the time will be individualized and adjusted over the course of the training.
The researchers are also interested to see if regular exercise provides emotional benefits as well. The study will evaluate whether the exercise has an effect on depression, apathy and fatigue -- emotional symptoms of Parkinson’s that may not respond well to traditional medications.
Parkinson’s disease affects about one million people in the United States. Most people begin to develop Parkinson’s symptoms in their late 50s or early 60s, although it can occur in younger people.
Parkinson’s disease affects the brain’s ability to produce dopamine, the neurotransmitter involved in the communication between the brain cells for motor control. Symptoms include rigidity of the limbs and difficulty initiating movement. Many patients have a tremor that may involve the arms or the legs. Problems with walking and balance are an increasing cause of disability over time.
Parkinson’s patients interested in enrolling in the exercise study should call 443-827-0677.
For patient inquiries, call 1-800-492-5538 or click here to make an appointment.