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Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease

DOI: 10.1155/2013/572134

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Abstract:

Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD). However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC) or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF). To determine the responsiveness to exercise, we calculated the standardized response means. -tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration ( ), stride velocity ( ), peak arm speed ( ), and horizontal trunk ROM during gait ( ). Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group ( ; ). Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions. 1. Introduction The progression of Parkinson’s disease (PD) inevitably results in problems of balance, contributing to injuries, loss of mobility, increased health costs, and decline in quality of life. Delaying and minimizing these inevitable complications of PD with physical therapy exercise would have a major impact on patients and their families’ quality of life, healthcare systems, and possibly even the course of disease progression. Exercise has received much attention in the past decade as a way to delay the onset of mobility disability and there are a steadily increasing number of randomized controlled trials demonstrating that varying types of exercise improve some aspects of balance or gait [1–12]. However, it is difficult to determine whether a specific type of exercise program is more effective than another. One recurring obstacle, which makes it difficult to compare treatment approaches, is that studies use different types of outcome measures [13]. In addition, exercise studies almost always compare their favored type of intervention with a placebo or no intervention, rather than a head-to-head comparison of different types of exercise programs. The difficulty in comparing 2 potentially effective rehabilitation interventions is the

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