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Endurance Exercise Training to Improve Economy of Movement of People With Parkinson Disease: Three Case Reports

M Schenkman, PT, PhD, is Professor and Director, Physical Therapy Program, Department of Physical Medicine and Rehabilitation, and Assistant Dean for Allied Health, University of Colorado at Denver and Health Sciences Center, 4200 E Ninth Ave, Mailstop C-244, Denver, CO 80262-0244 (USA).
D Hall, MD, is Assistant Professor and Director, Movement Disorders Program, Department of Neurology, University of Colorado at Denver and Health Sciences Center.
R Kumar, MD, FRCPC, is Medical Director, Movement Disorders Center, Colorado Neurological Institute, Englewood, Colo.
WM Kohrt, PhD, is Professor of Medicine, Division of Geriatric Medicine, University of Colorado at Denver and Health Sciences Center.

margaret.schenkman{at}uchsc.edu

Background and Purpose: Even early in Parkinson disease (PD), individuals have reduced economy of movement. In this case report, the effects of endurance exercise training are examined on walking economy and other measures for 3 individuals in early and middle stages of PD.

Patients: The patients were 1 woman and 2 men with PD, aged 52 to 72 years, classified at Hoehn and Yahr stages 2 to 2.5.

Intervention: Each patient completed 4 months of supervised endurance exercise training and 12 months of home exercise, with monthly clinic follow-up sessions. Strategies were included to enhance adherence to exercise.

Outcomes: The main outcome measure was economy of movement (rate of oxygen consumption during gait) measured at 4 treadmill speeds. Secondary outcome measures included the Unified Parkinson's Disease Rating Scale (UPDRS), Continuous-Scale Physical Functional Performance Test (CS-PFP), Functional Reach Test (FRT), and Functional Axial Rotation Test (FAR). Economy of movement improved for all 3 patients after 4 months of supervised exercise and remained above baseline at 16 months. Two patients also had scores that were above baseline for UPDRS total score, CS-PFP, FRT, and FAR, even at 16 months.

Discussion and Conclusions: Evidence from these 3 individuals suggests that gains may occur with a treadmill training program that is coupled with specific strategies to enhance adherence to exercise.

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