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The Effect of Resistance Training in Parkinson Disease: A Pilot Study

Not Applicable
Completed
Conditions
Parkinson Disease
Interventions
Other: Gym Group
Other: Control Group
Other: Free Weights Group
Registration Number
NCT02674724
Lead Sponsor
University of Sao Paulo General Hospital
Brief Summary

To investigate if resistance training exercises performed twice a week with or without gym equipment assistance in a 12-week period could improve balance in patients with Parkinson Disease (PD).

Methods: Sixty three patients with idiopathic PD (Hoehn and Yahr stage II - III) and preserved cognitive function will participate in this study. Patients will be randomized among three intervention groups: resistance training with free weights, resistance training with gym equipment and control group. Investigators will use static platform balance variables to assess the primary end-point outcome measures. For the secondary outcomes measures, most common clinical functional balances tests for PD will be applied: Berg Balance Scale (BBS), Mini-BESTest - Balance Evaluation (Mini-BESTest), Timed Up and Go test (TUG) and variables from dynamic posturography.

Detailed Description

Parkinson's disease is a progressive neurodegenerative disease that affects motor functions and is characterized by bradykinesia, resting tremor, rigidity, and postural instability. Despite of pharmacological treatments, patients remain with deficits in balance, gait, autonomic system functions and cognition which impact on their quality of life.

The effects of resistance training on PD are still controversial when balance and improvement on functional tests are the targets.

Since the results of previous studies about resistance training on balance are still controversial, more interventions are required to address the question if strengthening exercise may improve or not the balance of PD patients. Our exercises will target the trunk, leg and shoulder muscles because of their contribution on patient's posture.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
63
Inclusion Criteria
  • Age between 50 to 75 years old;
  • Hoehn and Yahr stages II or III;
  • Idiopathic Parkinson disease diagnosed according to the United Kingdom Parkinson's Disease Society Brain Research Centre Criteria, Institute of Neurology, London;
  • Ability to walk independently without walking devices aid;
  • Absence of orthopedic injuries or pain in joints that could interfere on training program;
  • Stable medication regimen for PD treatment at recruitment stage;
  • Mini Mental State Examination Scale (MMSE) ≥ to 27 for literate patients and schooling ≥ of 4 years of formal education;
  • No cardiovascular instability;
  • No pacemaker, decompensated metabolic disease, vestibular dysfunction, and stroke;
  • Availability to come to the clinic twice a week;
  • Not participating in other physical rehabilitation programs during and six months prior to the study.
Exclusion Criteria
  • Patients will be excluded if they refuse to participate, do not sign the consent form, have a diagnosis of secondary parkinsonism or present cognitive impairment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Gym GroupGym GroupWith gym equipments, twice per week for 12 weeks.
Control GroupControl GroupThe control group will be instructed to perform stretching exercises at home in the same 12-week period, according to an illustrated booklet.
Free Weights GroupFree Weights GroupWith dumbbells, elastics, twice per week for 12 weeks.
Primary Outcome Measures
NameTimeMethod
Postural sway on Static Posturography12 weeks

Static Posturography is a technique used to objectively assess postural sway with patients standing still on a fixed platform that measures center of pressure displacement. Tests were standardized such as the feet position, the eye gaze and environment light, with three trials of 60-second test in eyes - open, eyes closed and eyes open in dual task condition. Investigators will analyze the anteroposterior displacement, medial-lateral displacement, area, velocity and path length.

Secondary Outcome Measures
NameTimeMethod
Balance on Berg Balance Scale12 weeks

Berg Balance Scale is used to assess balance and falls in elderly using different tasks. It consists of 14 tasks scoring from zero to four, zero means that the patient is unable to perform the task and four means that the task is performed independently.

Balance Evaluation on Mini-BESTest12 weeks

The Mini-BESTest contains 14 items that assess dynamic balance focusing on anticipatory postural adjustments, postural responses, sensory orientation and stability in gait. Items are scored from 0 to 2 (normal performance in balance).

Functional balance and gait on Timed Up and Go test (TUG)12 weeks

The TUG test measures individual speed while performing the sequence: rising from a chair, walking for three meters of distance, turning around and returning to the starting position, sitting on a chair. When the examination exceeds 13 seconds, patients have higher risk of falls.

Quality of life on PDQ-39 Questionnaire12 weeks

The PDQ-39 assess quality of life of Parkinson's disease patients over the last month. Contains 39 items and eight dimensions (Mobility, Activities of daily living, Emotional well-being, Stigma, Social support, Cognitions and Bodily discomfort).

Functional balance on Dynamic Posturography12 weeks

Dynamic posturography is a quantitative method to assess balance. This system have sensors located below two platforms and measures vertical and horizontal forces produced by the center of gravity during a pre-determined task (sit to stand, tandem walk and step over).

Trial Locations

Locations (1)

Department of Neurology of University of Sao Paulo

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Sao Paulo, Brazil

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