Overview
The aim of this study is to examine the effects of a specialized multi-modal intervention in patients with moderate to advanced Parkinson's disease (PD). The hypothesis is that a specialized motor- and cognitive exercise program in addition to usual care can improve gait and balance better than usual care alone.
48 patients with PD and a symptom duration of 4 or more years will be randomized 1:1 to either a control arm or to an intervention arm. The control arm will have usual management of their PD. The intervention arm will receive exercises aimed at both motor and cognitive impairments of PD over the course of 12 weeks.
The study has been designed in partnership with the Copenhagen Trial Unit (CTU), Copenhagen Univeristy Hospital, to ensure both internal and external validity. To increase reproducibility, detailed protocols for all training modalities will be shared along with the study results.
This study is a feasibility study with the intention of a following international multi-center study to corroborate the results. Both feasibility outcomes for the intervention itself and clinical outcomes for the participants will be published.
Description
Intervention: The exercise program will consist of gait and balance training, lower body strength training and dual task training while treadmill walking. The program will include an individualized and progressive exercise program 3 times x 1 hour a week for 12 weeks with the following exercise modalities:
- Treadmill training for gait and balance training combined with dual task motor cognitive training.
- Progressive gait and motor-cognitive balance exercises
- Progressive resistance training including leg press.
The program will be conducted under supervision by a physiotherapist or an exercise physiologist. Usual treatment is permitted during the trial, both pharmacological and non-pharmacological. The treatment is preferably stable during the intervention and follow-up, but necessary changes will be registered.
All participants will be examined at baseline, after 12 weeks and again 6 and 12 months after baseline.
Eligibility
Inclusion Criteria:
- Diagnosis of PD according to MDS-PD criteria
- Aged ≥ 18 years
- Informed consent
- PD symptoms ≥ 4 years
- Independent gait
Exclusion Criteria:
- Diagnosis of PD Dementia according to the MDS-PD Dementia criteria
