A High-Intensity Exercise Boot Camp for Persons With Parkinson Disease: A Phase II, Pragmatic, Randomized Clinical Trial of Feasibility, Safety, Signal of Efficacy, and Disease Mechanisms

Merrill R. Landers PT, DPT, PhD, University of Nevada, Las Vegas
James W. Navalta PhD, University of Nevada, Las Vegas
Andrew S. Murtishaw PhD, Alzheimer's Association
Jefferson W. Kinney PhD, University of Nevada, Las Vegas
Sarah Pririo Richardson MD, University of New Mexico


Background and Purpose: The feasibility, safety, and efficacy of a high-intensity multimodal exercise program (aerobic, strengthening, and balance training) have not been well vetted in persons with Parkinson disease (PD). Thus, the primary aim was to determine whether a high-intensity multimodal exercise boot camp (HIBC) was both feasible and safe in persons with PD. The secondary aim was to determine whether the program would produce greater benefit than a usual care, low-intensity exercise program (UC). An exploratory aim was to determine whether these programs affected putative disease-modifying mechanisms. Methods: Twenty-seven participants (19 men and 8 women) were randomized into 8 weeks of either the HIBC or UC supervised by physical therapists. For feasibility, participation, and meeting, Centers for Disease Control and Prevention (CDC) exercise guidelines were assessed. For safety, adverse events were monitored. For efficacy, the following outcome domains were assessed before and after participation: balance, motor activity, endurance and fatigue, strength, mental health, and quality of life. For disease-modifying mechanisms, circulating brain-derived neurotrophic factor (BDNF) and its genotype, superoxide dismutase, and cytokines (tumor necrosis factor-[alpha], interleukin-6, and interleukin-10) were monitored. Results: The HIBC was better at attaining CDC guidelines (P = 0.013) and spent more minutes in higher-intensity exercise per week (P...) (see abstract in article).