Intense Exercise Helps Early Parkinson’s Patients Retain Motor Skills, Phase 2 Trial Shows

High-intensity exercise is not only safe and feasible, but it can also delay disease progression in early stage Parkinson’s patients, results of a Phase 2 trial report.

The study, “Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease,” was published in the journal JAMA Neurology.

SPARX, or a Study in Parkinson Disease of Exercise (NCT01506479), was a Phase 2 multicenter trial led by researchers at the University of Colorado’s UC Health. It addressed if high-intensity exercise was safe for people in very early stages of the disease, and what physical intensity might be of most benefit to them.

It enrolled 128 people with early Parkinson’s disease, between 40 and 80 years old and diagnosed within five years. None were   taking any Parkinson’s medications.

Participants were randomly assigned to one of three groups — moderate exercise, vigorous exercise, or usual care — for six months.

Disease progression was assessed at the study’s start and again after six months using the Unified Parkinson’s Disease Rating Scale (UPDRS) Motor Score: the higher the score, the greater a patient’s motor disability.

Exercise intensity was measured using heart rate monitors at all workout sessions.

People in the moderate group engaged in treadmill exercises four times a week, bringing their heart rate up to 60 to 65 percent of maximum capacity. Those in the vigorous group also exercised on a treadmill with the same frequently, but brought their heart rates to 80 to 85 percent of maximum.

At six months, the UPDRS score for the high-intensity exercise group had barely changed, indicating these patients’ motor skills did not worsen.

But these scores rose on average by 8 percent among patients in the moderate exercise group, and by 15 percent in those given usual care, indicating a worsening in movement and motor skills in these people. 

No serious side effects were reported in any group, and adverse events were considered “anticipated,” the researchers wrote, including falls, pain, muscle and joint disorders.

These results show that high-intensity exercise can preserve movement abilities in early stage Parkinson’s patients and can do so safely if exercise programs are guided by specialists.

They also warrant further investigation in a Phase 3 trial evaluating more fully the benefits of regular high-intensity exercise in Parkinson’s patients, the team said.

“The study shows that neurologists can rest assured that it’s safe and feasible for their patients to exercise at a high intensity. That’s huge. We can get people started right away on exercise habits, when that is easier to do,” Margaret Schenkman, director of the Physical Therapy Program at the UC School of Medicine, and principal investigator for the SPARX study, said in a UC Health news release.

Previous studies have shown that exercise can help Parkinson’s patients maintain balance, mobility, and the ability to perform daily routines while preserving a better quality of life.

But studies to date have only tested moderate exercise programs, and most have not addressed whether exercise intensity might affect disease severity or its progression.