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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait

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Author(s):
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Silva-Batista, Carla [1, 2] ; de Lima-Pardini, Andrea Cristina [3] ; Nucci, Mariana Penteado [4] ; Coelho, Daniel Boari [5, 6] ; Batista, Alana [4] ; Pimentel Piemonte, Maria Elisa [7] ; Barbosa, Egberto Reis [8] ; Teixeira, Luis Augusto [6] ; Corcos, Daniel M. [9] ; Amaro Jr, Edson ; Horak, Fay B. [10] ; Ugrinowitsch, Carlos [1, 11]
Total Authors: 12
Affiliation:
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[1] Univ Sao Paulo, Sch Phys Educ & Sport, Lab Strength Training, Sao Paulo, SP - Brazil
[2] Univ Sao Paulo, Exercise Neurosci Res Grp, Sao Paulo, SP - Brazil
[3] Queens Univ, Ctr Neurosci Studies, Kingston, ON - Canada
[4] Univ Sao Paulo, Dept Radiol, Sao Paulo, SP - Brazil
[5] Fed Univ ABC, Biomed Engn, Sao Bernardo Do Campo, SP - Brazil
[6] Univ Sao Paulo, Sch Phys Educ & Sport, Human Motor Syst Lab, Sao Paulo, SP - Brazil
[7] Univ Sao Paulo, Fac Med Sci, Sao Paulo, SP - Brazil
[8] Univ Sao Paulo, Dept Neurol, Movement Disorders Clin, Sch Med, Sao Paulo, SP - Brazil
[9] Northwestern Univ, Dept Phys Therapy & Human Movement Sci, Chicago, IL 60611 - USA
[10] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 - USA
[11] Horak, Fay B., Oregon Hlth \& Sci Univ, Dept Neurol, Portland, OR 97201 USA.Silva-Batista, Carla, Univ Sao Paulo, Sch Phys Educ & Sport, Lab Strength Training, Sao Paulo, SP - Brazil
Total Affiliations: 11
Document type: Journal article
Source: MOVEMENT DISORDERS; JUN 2020.
Web of Science Citations: 0
Abstract

Background Exercises with motor complexity induce neuroplasticity in individuals with Parkinson's disease (PD), but its effects on freezing of gait are unknown. The objective of this study was to verify if adapted resistance training with instability - exercises with motor complexity will be more effective than traditional motor rehabilitation - exercises without motor complexity in improving freezing-of-gait severity, outcomes linked to freezing of gait, and brain function. Methods Freezers were randomized either to the adapted resistance training with instability group (n = 17) or to the active control group (traditional motor rehabilitation, n = 15). Both training groups performed exercises 3 times a week for 12 weeks. The primary outcome was the New Freezing of Gait Questionnaire. Secondary outcomes were freezing of gait ratio (turning task), cognitive inhibition (Stroop-III test), motor signs (Unified Parkinson's Disease Rating Scale part-III {[}UPDRS-III]), quality of life (PD Questionnaire 39), anticipatory postural adjustment (leg-lifting task) and brain activation during a functional magnetic resonance imaging protocol of simulated anticipatory postural adjustment task. Outcomes were evaluated before and after interventions. Results Only adapted resistance training with instability improved all the outcomes (P < 0.05). Adapted resistance training with instability was more effective than traditional motor rehabilitation (in improving freezing-of-gait ratio, motor signs, quality of life, anticipatory postural adjustment amplitude, and brain activation;P < 0.05). Our results are clinically relevant because improvement in the New Freezing of Gait Questionnaire (-4.4 points) and UPDRS-III (-7.4 points) scores exceeded the minimally detectable change (traditional motor rehabilitation group data) and the moderate clinically important difference suggested for PD, respectively. The changes in mesencephalic locomotor region activation and in anticipatory postural adjustment amplitude explained the changes in New Freezing of Gait Questionnaire scores and in freezing-of-gait ratio following adapted resistance training with instability, respectively. Conclusions Adapted resistance training with instability is able to cause significant clinical improvement and brain plasticity in freezers. (c) 2020 International Parkinson and Movement Disorder Society (AU)

FAPESP's process: 18/16909-1 - Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease
Grantee:Carla da Silva Batista
Support type: Scholarships abroad - Research Internship - Post-doctor
FAPESP's process: 16/13115-9 - Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease
Grantee:Carla da Silva Batista
Support type: Scholarships in Brazil - Post-Doctorate