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An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease

DOI: 10.3390/brainsci3010087

Keywords: Parkinson’s disease, exercise, rehabilitation

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Abstract:

Parkinson’s disease (PD) is a neurological disorder that is manifested in the form of both motor and non-motor symptoms such as resting tremor, bradykinesia, muscular rigidity, depression, and cognitive impairment. PD is progressive in nature, ultimately leading to debilitating disruption of activities of daily living. Recently, a myriad of research has been focused on non-pharmacological interventions to alleviate the motor and non-motor symptoms of the disease. However, while there is a growing body of evidence supporting exercise as a viable therapy option for the treatment of Parkinson’s disease, there is a lack of literature enumerating a specific exercise sequence for patients with PD. In this literature review, we analyze the success of specific modalities of exercise in order to suggest an optimal exercise regimen for Parkinson’s disease patients.

References

[1]  Dorsey, E.R.; Constantinescu, R.; Thompson, J.P.; Biglan, K.M.; Holloway, R.G.; Kieburtz, K.; Marshall, F.J.; Ravina, B.M.; Schifitto, G.; Siderowf, A.; Tanner, C.M. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 2007, 68, 384–386, doi:10.1212/01.wnl.0000247740.47667.03.
[2]  Hornykiewicz, O. The discovery of dopamine deficiency in the parkinsonian brain. J. Neural Transm. Suppl. 2006, 70, 9–15, doi:10.1007/978-3-211-45295-0_3.
[3]  Tolosa, E.; Pont-Sunyer, C. Progress in defining the premotor phase of Parkinson’s disease. J. Neurol. Sci. 2011, 310, 4–8, doi:10.1016/j.jns.2011.05.027.
[4]  Fertl, E.; Doppelbauer, A.; Auff, E. Physical activity and sports in patients suffering from Parkinson’s disease in comparison with healthy seniors. J. Neural Transm. Park. Dis. Dement. Sect. 1993, 5, 157–161, doi:10.1007/BF02251206.
[5]  Leroi, L.; Pantula, H.; McDonald, K.; Harbishettar, V. Neuropsychiatric symptoms in Parkinson’s disease with mild cognitive impairments and dementia. Park. Dis. 2012, 2012, doi:10.1155/2012/308097.
[6]  Brod, M.; Mendelsohn, G.A.; Roberts, B. Patients’ experiences of Parkinson’s disease. J. Gerontol. B Psychol. Sci. Soc. Sci. 1998, 53, 213–222.
[7]  Koller, W.C.; Silver, D.E.; Lieberman, A. An algorithm for the management of Parkinson’s disease. Neurology 1994, 44, S1–S52, doi:10.1212/WNL.44.1.1.
[8]  Deane, K.H.; Jones, D.; Playford, E.D.; Ben-Shlomo, Y.; Clarke, C.E. Physiotherapy for patients with Parkinson’s Disease: A comparison of techniques. Cochrane Database Syst. Rev. 2001, doi:10.1002/14651858.CD002817.
[9]  Deane, K.H.; Jones, D.; Ellis-Hill, C.; Clarke, C.E.; Playford, E.D.; Ben-Shlomo, Y. A comparison of physiotherapy techniques for patients with Parkinson’s disease. Cochrane Database Syst. Rev. 2001, doi:10.1002/14651858.CD002815.
[10]  Nutt, J.G.; Wooten, G.F. Diagnosis and initial management of Parkinson’s disease. N. Engl. J. Med. 2005, 353, 1021–1027, doi:10.1056/NEJMcp043908.
[11]  Goodwin, V.A.; Richards, S.H.; Taylor, R.S.; Taylor, A.H.; Campbell, J.L. The effectiveness of exercise interventions for people with Parkinson’s disease: A systematic review and meta-analysis. Mov. Disord. 2008, 23, 631–640, doi:10.1002/mds.21922.
[12]  Kuroda, K.; Tatara, K.; Takatorige, T.; Shinsho, F. Effect of physical exercise on mortality in patients with Parkinson’s disease. Acta Neurol. Scand. 1992, 86, 55–59.
[13]  Allen, N.E.; Sherrington, C.; Suriyarachchi, G.D.; Paul, S.S.; Song, J.; Canning, C.G. Exercise and motor training in people with Parkinson’s disease: A systematic review of participant characteristics, intervention delivery, retention rates, adherence, and adverse events in clinical trials. Parkinsons Dis. 2012, 2012, doi:10.1155/2012/854328.
[14]  Ashworth, N.L.; Chad, K.E.; Harrison, E.L.; Reeder, B.A.; Marshall, S.C. Home versus center based physical activity programs in older adults. Cochrane Database Syst. Rev. 2005, doi:10.1002/14651858.CD004017.pub2.
[15]  Chen, H.; Zhang, S.M.; Schwarzschild, M.A.; Hernán, M.A.; Ascherio, A. Physical activity and the risk of Parkinson disease. Neurology 2005, 64, 664–669, doi:10.1212/01.WNL.0000151960.28687.93.
[16]  Thacker, E.L.; Chen, H.; Patel, A.V.; McCullough, M.L.; Calle, E.E.; Thun, M.J.; Schwarzchild, M.A.; Ascherio, A. Recreational physical activity and risk of Parkinson’s disease. Mov. Disord. 2008, 23, 69–74, doi:10.1002/mds.21772.
[17]  Xu, Q.; Park, Y.; Huang, X.; Hollenbeck, A.; Blair, A.; Schatzkin, A.; Chen, H. Physical activities and future risk of Parkinson disease. Neurology 2010, 75, 341–348, doi:10.1212/WNL.0b013e3181ea1597.
[18]  Logroscino, G.; Sesso, H.D.; Paffenbarger, R.S., Jr.; Lee, I.M. Physical activity and risk of Parkinson’s disease: A prospective cohort study. J. Neurol. Neurosurg. Psychiatr. 2006, 77, 1318–1322, doi:10.1136/jnnp.2006.097170.
[19]  Smith, A.D.; Zigmond, M.J. Can the brain be protected through exercise? Lessons from animal model of Parkinsonism. Exp. Neurol. 2003, 184, 31–39, doi:10.1016/j.expneurol.2003.08.017.
[20]  Faherty, C.J.; Sheperd, K.R.; Herasimtschuk, A.; Smeyne, R.J. Environmental enrichment in adulthood eliminates neuronal death in experimental Parkinsonism. Brain Res. Mol. Brain Res. 2005, 134, 170–179.
[21]  Green, H.J.; Fraser, I.G. Differential effects of exercise intensity on serum uric acid concentration. Med. Sci. Sports Exerc. 1988, 20, 55–59, doi:10.1249/00005768-198802000-00008.
[22]  Constantinescu, R.; Zetterberg, H. Urate as a marker of development and progression in Parkinson’s disease. Drugs Today 2011, 47, 369–380.
[23]  Cipriani, S.; Chen, X.; Schwarzschild, M.A. Urate: A novel biomarker of Parkinson’s disease risk, diagnosis and prognosis. Biomark. Med. 2010, 4, 701–712.
[24]  Schlesinger, I.; Schlesinger, N. Uric acid in Parkinson’s disease. Mov. Disord. 2008, 23, 1653–1657, doi:10.1002/mds.22139.
[25]  Tillerson, J.L.; Cohen, A.D.; Caudle, W.M.; Zigmond, M.J.; Schallert, T.; Miller, G.W. Forced nonuse in unilateral parkinsonian rats exacerbates injury. J. Neurosci. 2002, 22, 6790–6799.
[26]  Fisher, B.E.; Wu, A.D.; Salem, G.J.; Song, J.; Lin, C.H.; Yip, J.; Cen, S.; Gordon, J.; Jakowec, M.; Petzinger, G. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson’s disease. Arch. Phys. Med. Rehabil. 2008, 89, 1221–1229, doi:10.1016/j.apmr.2008.01.013.
[27]  Pohl, M.; Rockstroh, G.; Rückriem, S.; Mrass, G.; Mehrholz, J. Immediate effects of speed-dependent treadmill training on gait parameters in early Parkinson’s disease. Arch. Phys. Med. Rehabil. 2003, 84, 1760–1766, doi:10.1016/S0003-9993(03)00433-7.
[28]  Ridgel, A.L.; Peacock, C.A.; Fickes, E.J.; Kim, C.H. Active-assisted cycling improves tremor and bradykinesia in Parkinson’s disease. Arch. Phys. Med. Rehabil. 2012, 93, 2049–2054, doi:10.1016/j.apmr.2012.05.015.
[29]  Herman, T.; Giladi, N.; Gruendlinger, L.; Hausdorff, J.M. Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson’s disease: A pilot study. Arch. Phys. Med. Rehabil. 2007, 88, 1154–1158, doi:10.1016/j.apmr.2007.05.015.
[30]  Cakit, B.D.; Saracoglu, M.; Genc, H.; Erdem, H.R.; Inan, L. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson’s disease. Clin. Rehabil. 2007, 21, 698–705, doi:10.1177/0269215507077269.
[31]  Park, J.; Wu, Y.H.; Lewis, M.M.; Huang, X.; Latash, M.L. Changes in multifinger interaction and coordination in Parkinson’s disease. J. Neurophysiol. 2012, 108, 915–924, doi:10.1152/jn.00043.2012.
[32]  Nocera, J.R.; Altmann, L.J.P.; Sapienza, C.; Okun, M.S.; Hass, C.J. Can exercise improve language and cognition in Parkinson’s disease? A case report. Neurocase 2010, 16, 301–306, doi:10.1080/13554790903559663.
[33]  Schenkman, M.; Hall, D.; Kumar, R.; Kohrt, W.M. Endurance exercise training to improve economy of movement of people with Parkinson Disease: Three case reports. Phys. Ther. 2008, 88, 63–76, doi:10.2522/ptj.20060351.
[34]  Spina, R.J.; Ogawa, T.; Kohrt, W.M.; Martin, W.H.; Holloszy, J.O.; Ehsani, A.A. Differences in cardiovascular adaptations to endurance exercise training between older men and women. J. Appl. Physiol. 1993, 75, 849–855.
[35]  Poulin, M.J.; Paterson, D.H.; Govindasamy, D.; Cunningham, D.A. Endurance training of older men: Responses to submaximal exercise. J. Appl. Physiol. 1992, 73, 452–457.
[36]  Bergen, J.L.; Toole, T.; Elliott, R.G., III; Wallace, B.; Robinson, K.; Maitland, C.G. Aerobic exercise intervention improves aerobic capacity and movement initiation in Parkinson’s disease patients. NeuroRehabilitation 2002, 17, 161–168.
[37]  Cantello, R.; Tarletti, R.; Civardi, C. Transcranial magnetic stimulation and Parkinson’s disease. Brain Res. Rev. 2002, 38, 309–327, doi:10.1016/S0165-0173(01)00158-8.
[38]  Miyai, I.; Fujimoto, Y.; Ueda, Y.; Yamamoto, H.; Nozaki, S.; Saito, T.; Kang, J. Treadmill training with body weight support: Its effect on Parkinson’s disease. Arch. Phys. Med. Rehabil. 2000, 81, 849–852, doi:10.1053/apmr.2000.4439.
[39]  Miyai, I.; Fujimoto, Y.; Yamamoto, H.; Ueda, Y.; Saito, T.; Nozaki, S.; Kang, J. Long-term effect of body weight-supported treadmill training in Parkinson’s disease: A randomized controlled trial. Arch. Phys. Med. Rehabil. 2002, 83, 1370–1373, doi:10.1053/apmr.2002.34603.
[40]  Toole, T.; Maitland, C.G.; Warren, E.; Hubmann, M.F.; Panton, L. The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism. NeuroRehabilitation 2005, 20, 307–322.
[41]  Paul, S.S.; Sherington, C.; Fung, V.S.; Canning, C.G. Motor and cognitive impairments in Parkinson’s disease: Relationships with specific balance and mobility tasks. Neurorehabil. Neural Repair 2013, 27, 63–71, doi:10.1177/1545968312446754.
[42]  Ashburn, A.; Stack, E.; Pickering, R.M.; Ward, C.D. Predicting fallers in a community-based sample of people with Parkinson’s disease. Gerontology 2001, 47, 277–281, doi:10.1159/000052812.
[43]  Ashburn, A.; Fazakarley, L.; Ballinger, C.; Pickering, R.; McLellan, L.D.; Fitton, C. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson’s disease. J. Neurol. Neurosurg. Psychiatr. 2007, 78, 678–684.
[44]  Bloem, B.R.; Beckley, D.J.; van Dijk, J.G.; Zwinderman, A.H.; Remler, M.P.; Roos, R.A. Influence of dopaminergic medication on automatic postural responses and balance impairment in Parkinson’s disease. Mov. Disord. 1996, 11, 509–521, doi:10.1002/mds.870110506.
[45]  Toole, T.; Hirsch, M.A.; Forkink, A.; Lehman, D.A.; Maitland, C.G. The effects of a balance and strength training program on equilibrium in Parkinsonism: A preliminary study. NeuroRehabilitation 2000, 14, 165–174.
[46]  Smania, N.; Corato, E.; Tinazzi, M.; Stanzani, C.; Fiaschi, A.; Girardi, P.; Gandolfi, M. Effect of balance training on postural instability in patients with idiopathic Parkinson’s disease. Neurorehabil. Neural Repair 2010, 24, 826–834, doi:10.1177/1545968310376057.
[47]  Dibble, L.E.; Addison, O.; Papa, E. The effects of exercise on balance in persons with Parkinson’s disease: A systematic review across the disability spectrum. J. Neurol. Phys. Ther. 2009, 33, 14–26.
[48]  Allen, N.E.; Sherrington, C.; Paul, S.S.; Canning, C.G. Balance and falls in Parkinson’s disease: A meta-analysis of the effect of exercise and motor training. Mov. Disord. 2011, 26, 1605–1615, doi:10.1002/mds.23790.
[49]  Hirsch, M.A.; Toole, T.; Maitland, C.G.; Rider, R.A. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson’s disease. Arch. Phys. Med. Rehabil. 2003, 84, 1109–1117, doi:10.1016/S0003-9993(03)00046-7.
[50]  Pompeu, J.E.; Mendes, F.A.; Silva, K.G.; Lobo, A.M.; Oliveira Tde, P.; Zomignani, A.P.; Piemonte, M.E. Effect of Nintendo Wii?-based motor and cognitive training on activities of daily living in patients with Parkinson’s disease: A randomised clinical trial. Physiotherapy 2012, 98, 196–204, doi:10.1016/j.physio.2012.06.004.
[51]  Li, F.; Harmer, P.; Fitzgerald, K.; Eckstrom, E.; Stock, R.; Galver, J.; Maddalozzo, G.; Batya, S.S. Tai Chi and postural stability in patients with Parkinson’s disease. N. Engl. J. Med. 2012, 366, 511–519, doi:10.1056/NEJMoa1107911.
[52]  Tousignant, M.; Corriveau, H.; Roy, P.M.; Desrosiers, J.; Dubuc, N.; Hebert, R. Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: A randomized controlled trial. Disabil. Rehabil. 2012, doi:10.3109/09638288.2012.737084.
[53]  Li, F.; Harmer, P.; Fisher, K.J.; Xu, J.; Fitzgerald, K.; Vongjaturapat, N. Tai Chi-based exercise for older adults with Parkinson’s disease: A pilot-program evaluation. J. Aging Phys. Act. 2007, 15, 139–151.
[54]  Hackney, M.E.; Earhart, G.M. Tai Chi improves balance and mobility in people with Parkinson disease. Gait Posture 2008, 28, 456–460, doi:10.1016/j.gaitpost.2008.02.005.
[55]  Cano-de-la-Cuerda, R.; Pérez-de-Heredia, M.; Miangolarra-Page, J.C.; Mu?oz-Hellín, E.; Fernández-de-las-Pe?as, C. Is there muscular weakness in Parkinson’s disease? Am. J. Phys. Med. Rehabil. 2010, 89, 70–76, doi:10.1097/PHM.0b013e3181a9ed9b.
[56]  Durmus, B.; Baysal, O.; Altinayar, S.; Altay, Z.; Ersoy, Y.; Ozcan, C. Lower extremity isokinetic muscle strength in patients with Parkinson’s disease. J. Clin. Neurosci. 2010, 17, 893–896, doi:10.1016/j.jocn.2009.11.014.
[57]  Koller, W.; Kase, S. Muscle strength testing in Parkinson’s disease. Eur. Neurol. 1986, 25, 130–133, doi:10.1159/000115998.
[58]  Nogaki, S.H.; Fukusako, T.; Sasabe, F.; Negoro, K.; Morimatsu, M. Muscle strength in early Parkinson’s disease. Mov. Disord. 1995, 10, 225–226, doi:10.1002/mds.870100218.
[59]  Nogaki, H.; Kakinuma, S.; Morimatsu, M. Movement velocity dependent muscle strength in Parkinson’s disease. Acta Neurol. Scand. 1999, 99, 152–157, doi:10.1111/j.1600-0404.1999.tb07337.x.
[60]  Stevens-Lapsley, J.; Kluger, B.M.; Schenkman, M. Quadriceps muscle weakness, activation deficits, and fatigue with Parkinson disease. Neurorehabil. Neural Repair 2012, 26, 533–541.
[61]  Schilling, B.K.; Karlage, R.E.; LeDoux, M.S.; Pfeiffer, R.F.; Weiss, L.W.; Falvo, M.J. Impaired leg extensor strength in individuals with Parkinson disease and relatedness to functional mobility. Parkinsonism Relat. Disord. 2009, 15, 776–780.
[62]  Stelmach, G.E.; Worringham, C.J. The preparation and production of isometric force in Parkinson’s disease. Neuropsychologia 1988, 26, 93–103, doi:10.1016/0028-3932(88)90033-4.
[63]  Robichaud, J.A.; Pfann, K.D.; Vaillancourt, D.E.; Comella, C.L.; Corcos, D.M. Force control and disease severity in Parkinson’s disease. Mov. Disord. 2005, 20, 441–450, doi:10.1002/mds.20350.
[64]  Kunesch, E.; Schnitzler, A.; Tyercha, C.; Knecht, S.; Stelmach, G. Altered force release control in Parkinson’s disease. Behav. Brain Res. 1995, 67, 43–49, doi:10.1016/0166-4328(94)00111-R.
[65]  Pedersen, S.W.; Oberg, B.; Larsson, L.E.; Lindval, B. Gait analysis, isokinetic muscle strength measurement in patients with Parkinson’s disease. Scand. J. Rehabil. Med. 1997, 29, 67–74.
[66]  Reck, C.; Florin, E.; Wojtecki, L.; Groiss, S.; Voges, J.; Sturm, V.; Schnitzler, A.; Timmermann, L. Differential distribution of coherence between beta-band subthalamic oscillations and forearm muscles in Parkinson’s disease during isometric contraction. Clin. Neurophysiol. 2009, 120, 1601–1609.
[67]  Bridgewater, K.J.; Sharpe, M.H. Trunk muscle performance in early Parkinson’s disease. Phys. Ther. 1998, 78, 566–576.
[68]  Jordan, N.; Sagar, H.J.; Cooper, J.A. A component analysis of the generation and release of isometric force in Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry 1992, 55, 572–576, doi:10.1136/jnnp.55.7.572.
[69]  Brown, P.; Corcos, D.M.; Rothwell, J.C. Does parkinsonian action tremor contribute to muscle weakness in Parkinson’s disease? Brain 1997, 120, 401–408.
[70]  Kakinuma, S.; Nogaki, H.; Pramanik, B. Morimatsu M. Muscle weakness in Parkinson’s disease: Isokinetic study of the lower limbs. Eur. Neurol. 1998, 39, 218–222.
[71]  Hortobágyi, T.; Mizelle, C.; Beam, S.; DeVita, P. Old adults perform activities of daily living near their maximal capabilities. J. Gerontol. A Biol. Sci. Med. Sci. 2003, 58, M453–M460, doi:10.1093/gerona/58.5.M453.
[72]  Dibble, L.E.; Hale, T.F.; Marcus, R.L.; Droge, J.; Gerber, J.P.; LaStayo, P.C. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov. Disord. 2006, 21, 1444–1452, doi:10.1002/mds.20997.
[73]  Hass, C.J.; Collins, M.A.; Juncos, J.L. Resistance training with creatine monohydrate improves upper body strength in patients with Parkinson’s disease. Neurorehabil. Neural Repair 2007, 21, 107–115, doi:10.1177/1545968306293449.
[74]  Shulman, L.M.; Katzel, L.I.; Ivey, F.M.; Sorkin, J.D.; Favors, K.; Anderson, K.E.; Smith, B.A.; Reich, S.G.; Weiner, W.J.; Macko, R.F. Randomized clinical trial of 3 types of physical exercise for patients with Parkinson’s disease. Arch. Neurol. 2012, doi:10.1001/jamaneurol.2013.646.
[75]  Scandalis, T.A.; Bosak, A.; Berlinder, J.C.; Helman, L.L.; Wells, M.R. Resistance training and gait function in patients with Parkinson’s disease. Am. J. Phys. Med. Rehabil. 2001, 80, 38–43, doi:10.1097/00002060-200101000-00011.
[76]  Dibble, L.E.; Hale, T.F.; Marcus, R.L.; Gerber, J.P.; Lasayo, P.C. High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: A preliminary study. Parkinsonism Relat. Disord. 2009, 15, 752–757, doi:10.1016/j.parkreldis.2009.04.009.
[77]  Hass, C.J.; Buckley, T.A.; Pitsikoulis, C.; Barthelemy, E.J. Progressive resistance training improves gait initiation in individuals with Parkinson’s disease. Gait Posture 2012, 35, 669–673, doi:10.1016/j.gaitpost.2011.12.022.
[78]  Galv?o, D.A.; Taaffe, D.R. Resistance exercise dosage in older adults: Single- versus multiset effects on physical performance and body composition. J. Am. Geriatr. Soc. 2005, 53, 2090–2097, doi:10.1111/j.1532-5415.2005.00494.x.
[79]  Schilling, B.K.; Pfeiffer, R.F.; LeDoux, M.S.; Karlage, R.E.; Bloomer, R.J.; Falvo, M.J. Effects of moderate-volume, high-load lower-body resistance training on strength and function in persons with Parkinson’s disease: A pilot study. Parkinsons Dis. 2010, 2010, doi:10.4061/2010/824734.
[80]  Schenkman, M.; Hall, D.; Baron, A.E.; Schwartz, R.S.; Mettler, P.; Kohrt, W.M. Exercise for people in early- or mid-stage Parkinson disease: A 16-month randomized controlled trial. Phys. Ther. 2012, 92, 1395–1410, doi:10.2522/ptj.20110472.
[81]  Behrman, A.L.; Teitelbaum, P.; Cauraugh, J.H. Verbal instructional sets to normalise the temporal and spatial gait variables in Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry 1998, 65, 580–582, doi:10.1136/jnnp.65.4.580.
[82]  Fox, C.; Ebersbach, G.; Ramig, L.; Sapir, S. LSVT LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson’s Disease. Parkinsons Dis. 2012, 2012, doi:10.1155/2012/391946.
[83]  Farley, B.G.; Koshland, G.F. Training BIG to move faster: The application of the speed amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp. Brain Res. 2005, 167, 462–467, doi:10.1007/s00221-005-0179-7.
[84]  Ebersbach, G.; Ebersbach, A.; Edler, D.; Kaufhold, O.; Kusch, M.; Kupsch, A.; Wissel, J. Comparing exercise in Parkinson’s disease—The Berlin LSVT?BIG study. Mov. Disord. 2010, 25, 1902–1908, doi:10.1002/mds.23212.
[85]  Ellis, T.; de Goede, C.J.; Feldman, R.G.; Wolters, E.C.; Kwakkel, G.; Wagenaar, R.C. Efficacy of a physical therapy program in patients with Parkinson’s disease: A randomized controlled trial. Arch. Phys. Med. Rehabil. 2005, 86, 626–632, doi:10.1016/j.apmr.2004.08.008.
[86]  Comelia, C.L.; Stebbins, G.T.; Brown-Toms, N.; Goetz, C.G. Physical therapy and Parkinson’s disease: A controlled clinical trial. Neurology 1994, 44, 376–376, doi:10.1212/WNL.44.3_Part_1.376.
[87]  Sheldon, T.A.; Guyatt, G.H.; Haines, A. Getting research findings into practice. When to act on the evidence. BMJ 1998, 317, 139–142, doi:10.1136/bmj.317.7151.139.
[88]  Haynes, B.; Haines, A. Barriers and bridges to evidence based clinical practice. BMJ 1998, 317, 273–276, doi:10.1136/bmj.317.7153.273.

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