Review of studies considering the effect of forced exercise on symptoms of Parkinson's disease.

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Date: Winter 2019
Publisher: American Kinesiotherapy Association
Document Type: Article
Length: 8,307 words
Lexile Measure: 1770L

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Abstract :

Forced exercise ("FE") is exercise at an elevated pace beyond the subject's preferred rate, while the subject achieves a specified aerobic intensity range. Investigations have demonstrated favorable effects of FE on symptoms of Parkinson's Disease ("PD"). FIRST PURPOSE: To analyze investigations into the effects of FE on PD symptoms to identify their contributions toward, and limitations with respect to, identifying therapeutically prescriptive FE activities. SECOND PURPOSE: To summarize accompanying etiological theories and investigations regarding possible neurological dynamics that may cause favorable effects on PD symptoms. METHODS: Fifteen studies (the "FE/PD Studies") were identified for review through a search of electronic databases. A sophisticated rubric (the "FE/PD Studies Rubric") was developed to archive key aspects of the FE/PD Studies for analysis. CONCLUSIONS: The FE/PD Studies Rubric facilitated analysis of the FE/PD Studies by (i) cadence type and forms of equipment, (ii) duration and frequency, (iii) pace, and (iv) forms of exercise. On a qualified basis: Eight weeks of FE may dramatically improve PD symptoms in subjects off-medication; one FE bout may dramatically improve PD symptoms in subjects off-medication; three to six FE sessions will less dramatically improve symptoms of PD in subjects on medication; variable cadence may be a contributing factor. Further, studies indicate that FE and PD medication produce similar activation patterns of neurological functional connectivity. Claims that FE and medication may use the same pathways to produce relief of PD symptoms may be misplaced, given activation patterns and connectivity only partially explain the full neurological dynamic at work. The etiology behind the favorable effects of FE on symptoms of PD may be found in the sequence of neurological events preceding FE, including the provocative effect of FE. There is a need for systematic iterative studies to identify optimal therapeutically prescriptive FE activities, and a process is proposed. Any results should be considered within a broad context of therapeutic, medicinal and surgical alternatives. Key Words: forced exercise, Parkinson's disease, therapeutic exercise, rehabilitation

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Gale Document Number: GALE|A618950527