Progressive Resistance Exercise and its Effects on Movement and Cognition in Parkinson’s Disease

The effect of 24 months of progressive resistance exercise (PRE) on movement and cognition was examined in patients with mild to moderate Parkinson’s disease (PD) using a randomized, controlled, 24-month clinical trial. The dissertation consists of a general introduction and four papers that are intended for publication as independent articles. The general introduction discusses PD in detail, i.e., its etiology, diagnosis, and treatment. The first paper is a mechanistic review of PRE and PD. The second paper reports electromyographic (EMG) activation during fast and moderate speed point-to-point elbow flexion movements. The methodology used in the second paper, i.e., EMG activation, forms the methodological basis for the third paper. The third paper reports the effect of PRE on fast point-to-point elbow flexion movements in subjects with PD. Finally, the fourth paper reports the effects of PRE on cognitive functions including attention and working memory in subjects with PD. The third and the fourth papers of this dissertation report outcomes obtained from the first clinical trial to examine the effects of progressive resistance exercise in Parkinson’s disease. The findings provide the strongest evidence to date for the efficacy of PRE in mitigating motor and non-motor symptoms observed in PD. The findings of the experiments in this dissertation show that PRE improves bradykinesia and strength. In addition, PRE is capable of causing central changes that favorably alter the corticospinal output arriving at the muscle. Furthermore, physical activity, i.e., PRE or FC, can also improve cognition and offset the cognitive decline that is often observed in PD. In conclusion, engaging in twice a week of high intensity PRE with a personal trainer can provide improvement in bradykinesia and strength, while engaging in either FC or PRE can provide improvement in cognitive function. The findings also provide strong evidence for the use of PRE as an adjunct treatment in PD.