Physical activity levels, exercise habits may affect Parkinson’s outcomes

High regular physical activity levels and exercise habits over time appeared significantly correlated with better outcomes in Parkinson’s disease, according to results of an observational cohort study published in Neurology.

“The Parkinson’s Progression Markers Initiative (PPMI) is a large international multicenter study that has been under way since 2012; it aims to gain greater understanding of the disease course of PD and identify the disease’s modifiers,” Kazuto Tsukita, MD, of the department of neurology at Kyoto University Graduate School of Medicine in Japan, and colleagues wrote. “The PPMI study includes longitudinal and comprehensive evaluations of background factors, motor function and cognitive function as well as regular physical activity levels as measured by the Physical Activity Scale for the Elderly (PASE) questionnaire, which is a widely validated self-report questionnaire designed to quantify regular physical activity levels of individuals aged over 65 years.

“Therefore, using the PPMI study data, we aimed to examine the long-term effects of regular physical activity and exercise habits on the disease course of PD,” they added.

Tsukita and colleagues employed multivariate linear mixed-effects models to examine the interaction effects of regular physical activity and moderate-to-vigorous exercise levels, according to the PASE questionnaire. Specifically, they examined the effects on the progression of clinical parameters following adjustment for age, sex, levodopa-equivalent dose and disease duration among 237 patients with early PD (median age, 63 years; 69.2% men).

Results showed no significant effect of regular physical activity and moderate-to-vigorous exercise levels at baseline on subsequent clinical PD progression. However, researchers noted a significant association between average regular overall physical activity levels over time and slower deterioration of postural and gait stability, activities of daily living and processing speed among patients with PD. They also observed a preferential association between moderate-to-vigorous exercise levels and slower decline of postural and gait stability. Work-related activity levels appeared primarily linked to slower deterioration of processing speed. They confirmed the robustness of these results using multiple imputation and propensity score matching.

“We believe that our finding has the potential of changing the attitude of physicians regarding exercise counseling in patients with PD,” Tsukita and colleagues wrote. “Furthermore, the present study could serve as a guide for future randomized controlled trials with greater emphasis on sustained exercise in patients with PD.”