Ingo Froböse

Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease

Forced exercise training presents a valid method of improving symptoms of Parkinsons disease such as rigor, dyskinesia and gait dysfunctions. Brain imaging data suggest that use of active assistive forced exercise could improve Parkinsonian symptoms more effectively than passive assistive forced exercise. However, the long-term effects of active versus passive assistive forced exercise on the symptoms of Parkinsons disease are unknown. Here, 24 patients showing bilateral effects of Parkinsons disease underwent a 12 week intervention of either passive or active assistive forced exercise. We analyzed tremor scores, gait patterns, and scores on the Unified Parkinsons Disease Rating Scale-III from three timepoints--before beginning the intervention, upon completion of the intervention, and twelve weeks after completion of the intervention. Participation in both passive and active assistive forced exercise increased gait velocity (0.5 km/h), swing phase (2%), monopedal stance phase (2%), elongated stride length (11 cm) and decreased double stance phase (4%). However, with participation in active assistive forced exercise, postural and kinetic tremor were also reduced and gait velocity and stride length were increased long-term. Given these findings, we conclude that future treatment for patients bilaterally affected by Parkinsons disease should carefully consider the type of assistive forced exercise intervention to be used.