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Resistance Training Tied to Improvements in Parkinson’s Symptoms


Resistance training (RT) may help improve some symptoms of Parkinson’s disease (PD), but is not superior to other physical activities, new research shows.

A meta-analysis that included 18 randomized controlled trials and over 1,000 patients with PD found that those who underwent RT had significantly greater improvements in motor impairment, muscle strength, and mobility/balance than their peers who underwent passive interventions. or placebo.

However, there was no significant difference between patients who participated in RT and those who participated in other active physical interventions, including yoga.



Romina Golan

Overall, the results highlight the importance of these patients getting some form of exercise, said study lead author Romina Gollan, MSc, research assistant in the Department of Medical Psychology at the University of Cologne, Germany. Medscape Medical News. “Patients should definitely do exercises, including weight training, if they want to. But the type of exercise is of secondary importance,” she said.

The results were presented at the International Congress on Parkinson’s Disease and Movement Disorders (MDS) 2022.

Positive but inconsistent

Previous reviews have suggested that LT has a positive effect on motor function in PD. However, the results of the included studies were inconsistent; The researchers note that several reviews have examined the non-motor outcomes of LT in this population.

After conducting a literature search of studies investigating the effect of RT on Parkinson’s disease, the investigators included 18 randomized controlled trials in their current review. Among 1134 participants, the median age was 66 years, the median Hoehn & Yahr stage was 2.3 (range 0–4), and the median duration of PD was 7.5 years.

The study was grouped into two meta-analysis arms: one looked at RT versus a passive or placebo intervention, and the other assessed RT versus active physical interventions such as yoga.

According to Gollan, during RT, participants use all their strength to do a rep, working their muscles to get past a certain threshold. By contrast, the placebo intervention is “very low intensity” and includes a much lower threshold, she added.

Passive interventions include things like stretching when the stimulus is “not strong enough for the muscles to adapt” and build strength, Gollan noted.

Passive intervention may also include “usual treatment” or a normal daily routine.

Patient preference is important

A meta-analysis comparing RT groups with passive control groups showed a significant significant effect on muscle strength (standard mean difference [SMD], -0.84; 95% CI, -1.29 to -0.39; P = 0.0003), movement disorders (SMD, -0.81; 95% CI, -1.34 to -0.27; P = 0.003), mobility and balance (SMD, -1.80; 95% CI, -3.13 to -0.49; P = 0.007).

The review also showed a significant but small effect on quality of life.

However, a meta-analysis that evaluated RT versus other physical interventions showed no significant differences between groups.

Gollan noted that although there were some assessments of cognition and depression, there were too few data to determine the effect of RT on these outcomes.

“We need more research, especially randomized controlled trials, to explore the effects of RT on non-motor outcomes such as depression and cognitive function,” she said.



Dr. Ann-Christine Folkerts

Co-investigator Ann-Christine Folkerts, PhD, who leads the Medical Psychology Working Group at the University of Cologne, noted that while exercise is generally beneficial for patients with PD, patient preference should be taken into account when choosing an activity.

It’s important that patients choose exercises they enjoy “because otherwise they probably won’t stick to treatment,” Folkerts said. Medscape Medical News. “It’s important to have fun.”

She added that specific goals or targets should also be taken into account, such as improving quality of life or balance.

Simplification?

Comments for Medscape Medical NewsAlice Neubur, MD, professor in the Department of Rehabilitation Sciences and head of the neurorehabilitation research group at the University of Leuven, Belgium, disagreed that exercise type is of secondary importance in PD.

“In my opinion, this is of paramount interest, especially in the middle and late stages,” said Newbur, who was not involved in the study.

She noted that it is difficult to conduct a meta-analysis of RT compared to other interventions because studies comparing different types of exercise are “quite sparse.”

“Another problem is that the dose can be different, so you’re comparing apples to pears,” Newbur said.

She agreed that all patients should exercise because it is “better than no exercise” and they should be “free to choose the regimen that interests them.”

However, she stressed that exercise requires significant effort on the part of PD patients, requires “sustainable motivation” and should become a habit. This makes “exercise targeting” very important, as the target changes with the course of the disease, Newbur said.

For example, for an early-stage patient who can still move reasonably well, both RT and endurance training can improve fitness and health; but in the intermediate stage, patients may be better off working on balance and walking quality “to prevent the risk of falls and development of freezing,” she noted.

Later, when the movement becomes very difficult, “the exercise menu becomes even more limited,” Neubur said.

The bottom line is that the message that “any movement matters” is an oversimplification, she added.

The study was funded by a grant from the German Federal Ministry of Education and Research. Investigators and Nieuwboer did not report any related financial relationship.

International Congress on Parkinson’s Disease and Movement Disorders (MDS) 2022: Abstract 237. Submitted September 15, 2022.

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