{"id":42204,"date":"2021-09-28T11:07:11","date_gmt":"2021-09-28T17:07:11","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=42204"},"modified":"2021-10-21T15:28:26","modified_gmt":"2021-10-21T21:28:26","slug":"can-exercise-help-patients-gain-ground-on-parkinsons-disease","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/can-exercise-help-patients-gain-ground-on-parkinsons-disease\/","title":{"rendered":"Can exercise help patients gain ground on Parkinson\u2019s disease?\u00a0\u00a0\u00a0"},"content":{"rendered":"
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\"A
Research underway at the University of Colorado suggests that a powerful counter to Parkinson’s disease may be exercise. Photo: Getty Images.<\/figcaption><\/figure>\n

In medicine\u2019s ongoing battle with disease, technology plays a major, ever-evolving role. Advances abound in the form of new drugs, medical devices and gene therapies. But a decidedly low-tech treatment strategy for at least one disease simply requires putting one foot in front of the other \u2013 literally.<\/p>\n

The target is Parkinson\u2019s disease, a progressive movement disorder that affects around 1 million people in the United States and 10 million worldwide<\/a>. While there is no cure, there are drugs to treat the symptoms of Parkinson\u2019s, including tremors, rigidity, and impairment of fine motor movements. But a growing body of evidence suggests that a powerful counter to this movement disorder may be, well, movement.<\/p>\n

A new nationwide trial that includes the University of Colorado is putting that idea to the test. Study in Parkinson Disease of Exercise (SPARX3)<\/a> is a randomized clinical trial investigating whether regular, moderate and high-intensity exercise can slow the progression of symptoms in patients in the early stages of Parkinson\u2019s disease who have not yet begun drug treatment.<\/p>\n

\"Dr.
Dr. Cory Christiansen is principal investigator for the SPARX3 trial at the University of Colorado. Photo by University of Colorado.<\/figcaption><\/figure>\n

Groundwork previously laid<\/strong><\/h2>\n

The study, which is underway at 29 sites in North America, builds on the findings of SPARX2. That trial concluded in 2016, with results published in 2018 in JAMA Neurology<\/em><\/a>. SPARX2 was led at CU by Dr. Margaret Schenkman<\/a>, then director of the Physical Therapy Program and a pioneering investigator in using physical therapy to treat Parkinson\u2019s disease.<\/p>\n

SPARX2 divided early-onset Parkinson\u2019s disease patients into two groups that followed four-day-a-week, 30-minute treadmill exercise regimens. One group elevated their heart rate to 65% of the maximum, the other to 85% of the maximum. A control group did not engage in a formal exercise program for the six- month study duration.<\/p>\n

The study demonstrated that the approach was both safe and feasible for the people in the two exercise groups. It also showed that those in the two groups showed slower advance of the disease than those who did not exercise, as measured by the Unified Parkinson\u2019s Disease Rating Scale<\/a> (UPDRS).<\/p>\n

A deeper look at possible benefits<\/strong><\/h2>\n

The findings spurred SPARX3, a much larger study with greater geographical reach. This time, patients will be randomly assigned to two groups for 30 minutes of treadmill exercise, four days a week. The exercise heart rates for the groups will again be 65% and 85% of the maximum. The aims: further test the effectiveness of exercise in blunting the advance of the disease and which, if either, approach is more effective in doing so.<\/p>\n

\u201cWe\u2019re not suggesting that exercise will eliminate Parkinson\u2019s disease,\u201d said Dr. Cory Christiansen<\/a>, assistant professor of Physical Medicine and Rehabilitation with the CU School of Medicine<\/a>, \u201cbut the results of SPARX2 signaled that exercise can slow the rate of disease progression.\u201d<\/p>\n

Christiansen is principal investigator for SPARX3 at CU and part of a diverse investigative team (see box)<\/em>. He co-authored the JAMA Neurology <\/em>article on the SPARX2 trial and counts Dr. Schenkman, who is now retired, as a mentor.<\/p>\n

\"Dr.
Dr. Margaret Schenkman, recently retired as director of the Physical Therapy Program at CU, helped to pioneer the study of exercise as a way to slow the progression of Parkinson\u2019s disease. Photo by University of Colorado.<\/figcaption><\/figure>\n

The much larger and farther-reaching SPARX3 trial will help to show if the study\u2019s exercise approach is \u201cgeneralizable to a broad population\u201d with regional differences, Christiansen added.<\/p>\n

\u201cWe might discover factors that differ between groups,\u201d he said. For example, people in Colorado are generally very active compared to other states, he noted.<\/p>\n

Careful patient selection and execution<\/strong><\/h2>\n

Nationally, Northwestern University leads SPARX3, with a target enrollment of 370; at CU the goal is 24 patients, Christiansen said. Study coordinator Katherine Balfany said that to be included, patients must be:<\/p>\n