Real Life Aerobic Walking Exercise in Parkinson's Disease (S7.006)

OBJECTIVE: To determine feasibility, safety, tolerance, and effects of overground aerobic walking in independently ambulatory, non-demented patients with Parkinson9s disease (PD). BACKGROUND: Physical Activity Guidelines for Americans issued by the U.S. Department of Health and Human Services recommend 150 minutes/week moderate-intensity aerobic physical activity for healthy adults (Class IA evidence). These guidelines state that adults with chronic medical conditions should perform physical activity according to their abilities, but are not specific. DESIGN/METHODS: Sixty non-demented, independently ambulatory patients with PD (median Hoehn-Yahr stage II) were enrolled in a 6-months Phase I/II study and exercised in community setting 3x/week, 45 minutes per session, wearing an electronic heart rate and walking speed monitor. RESULTS: Forty-nine participants (81%) completed the study with a mean (95% Confidence Interval) session attendance rate of 83.3 (77.5- 89.0 ) %, exercising at a mean heart rate reserve of 46.8 (44.0, 49.7) % or at 69.7 (67.1, 71.8) % of the age predicted maximum heart rate. Based on the baseline cycle ergometry, the mean exercise heart rate was 101.9 (99.0, 104.9) % of the heart rate at anaerobic (ventilatory) threshold, suggesting that subjects gave good effort. There were no serious adverse events. Four subjects dropped out due exercise related adverse events (knee pain=3, hip pain=1) of mild-moderate severity. Mean exercise heart rate, total dose (mean heart rate x time walked across all sessions) of exercise, and the mean walking speed (4.6 [4.3, 4.9] km/hr) correlated significantly with changes in VO2max (p<0.05). Significant improvements in aerobic fitness, gait speed, parkinsonism, fatigue, mood, executive control, and aspects of quality of life were observed. CONCLUSIONS: Our results suggest that patients with mild-moderate PD can safely exercise per the guidelines for the general adult population and experience various motor and non-motor benefits. Study Supported by: Department of Veterans Affairs, Rehabilitation R&D Branch Merit Review Award B6261R (EYU), and by National Center for Research Resources/National Institutes of Health grant UL1RR024979 (University of Iowa) Disclosure: Dr. Uc has nothing to disclose. Dr. Doerschug has nothing to disclose. Dr. Dawson has nothing to disclose. Dr. Kline has nothing to disclose. Dr. Newman has nothing to disclose. Dr. Darling has nothing to disclose.