EXERCISE IMPROVES MOBILITY IN PD

New York, Oct 09 (Reuters)-A special exercise program can improve mobility in patients with early and mid stage Parkinson's disease, US researchers report in the October, 1998 issue of the Journal of the American Geriatrics Society.

Investigating the value of regular flexibility exercises, Dr. Margaret Schenkman, of Duke University Medical Center, in Durham, North Carolina, and colleagues, recruited 23 patients in the early and middle stages of the disease for a 10-week exercise program designed to improve coordination and flexibility. Another 23 Parkinson's patients who did not participate in the exercise program served as "control " subjects.

Patients enrolled in the exercise program met with a physical therapist three times a week. Their exercises were slow and gentle, and became progressively more complex. Patients learned to do the exercises on their own so that they could continue after the program ended.

Compared with the "controls," those who completed the exercise program showed significant improvements in the tests that measure mobility and coordination, the researchers report.

After completing the program, patients were better able to move from a lying to a standing position, make a 360 degree turn while standing, reach forward, and turn to look over their shoulders, Schenkman and colleagues found. In a ssecond phase of the study, the 23 "controls" completed the program and showed similar improvements.

"These improvements may be instrumental in preserving independence," Schenkman's team points out. For example, the researchers note that a number of participants reported that "for the first time in years, they were able to look over their shoulder to change lanes while driving a car."

In addition to moving with greater ease, many of the patients said they had less pain after completing the program. "The large number of patients that reported relief of pain with intervention further supports the value of physical intervention even early in the disease and should be specifically investigated," Schenkman and colleagues write.

In early stages of the disease, patients have more limited impairments, and are better able to exercise. In introduced early, exercise programs might delay further impairment, or even reverse it, the investigators suggest.

"Studies are warranted to determine which combinations of exercise...are most effective, in combination with pharmacological intervention, in restoring or preserving functional ability across a spectrum of required activities for people in the early and mid-stage of Parkinson's disease," the researchers conclude.

SOURCE: Journal of the American Geriatrics Society 1998; 46:1207-1216