Effects of 6-month, Multimodal Exercise Program on Clinical and Gait Parameters of Patients with Idiopathic Parkinson's Disease: A Pilot Study

This pilot study aimed to identify the effects of a 6-month, multimodal exercise program on clinical and gait parameters in patients with Parkinson's disease. Two groups of participants were enrolled in the study: Trained Group (TG) and Control Group (CG). Individuals in the TG exercised three times a week for 24 weeks (in a multimodal exercise program), while the CG participants maintained their regular activity level. Participants in both the TG and the CG were assessed at pre- and posttest by clinical rates and the spatiotemporal parameters of self-paced walking. The two groups were not significantly different in demographic, clinical, and gait data at baseline. There were no significant differences between groups for clinical data at posttest. The purposed multimodal exercise program has found improvement in some kinematic gait parameters for the TG. Further study in the form of randomized controlled trial would be required to establish effectiveness of the intervention. 1. Introduction Parkinson’s disease (PD) affects approximately 0.3% of the population worldwide, and from 1% to 2% of individuals are more than 60 years old [1]. In Brazil, a recent population-based cohort study showed PD to have a prevalence of 3.3% [2]. PD is a neurodegenerative pathology characterized by progressive degeneration of the dopamine-containing neurons in the substantia nigra pars compacta. The decreased amount of dopamine compromises the optimum amount of neuromotor impulses required for the accurate control of muscle activation. As a consequence, PD patients show motor disturbances (e.g., resting tremor, rigidity, postural instability, and gait disorders). The clinical parameters of PD patients tend to get worse progressively [3], even though therapeutic interventions have shown some benefits to patients [4, 5]. Gait disorders are one of the most incapacitating signs of PD. The negative impact of gait disorders includes immobility (causing loss of independence) and the risk of falling. Therefore, a large number of studies have been performed to measure gait parameters in PD patients. These studies have shown that Parkinsonian gait is characterized by shortened step and stride length and reduced velocity [6, 7]. While cadence typically is not modified, in some cases, as a possible adaptation to amplitude regulation disorder, it appears to increase [6]. These gait features progressively worsen with the advance of the disease, which severely limits patients’ mobility and quality of life [8, 9]. Researchers have examined empirical studies to establish effective