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Volume 45 Number 1, 2008
   Pages 117 — 124

Abstract - Pilot safety and feasibility study of treadmill aerobic exercise in Parkinson disease with gait impairment

Frank M. Skidmore, MD;1-2 Shawnna L. Patterson, MD, PhD;1 Lisa M. Shulman, MD;2 John D. Sorkin, MD, PhD;3 Richard F. Macko, MD1-3*

1Department of Neurology, Baltimore Department of Veterans Affairs Medical Center (VAMC), and Exercise and Robotics Rehabilitation Research and Development Center, Baltimore, MD; 2Department of Neurology, University of Maryland School of Medicine, Baltimore, MD; 3Department of Medicine, Division of Gerontology, University of
Maryland School of Medicine, and Geriatrics Research, Education, and Clinical Center, Baltimore VAMC, Baltimore, MD

Abstract — This pilot study evaluated the safety and feasibility of a 3-month progressive treadmill aerobic exercise (TM-AEX) program for persons with Parkinson disease with gait impairment. Eight subjects underwent a treadmill stress test to determine eligibility. Of these subjects, three were referred for further cardiac evaluation and five were enrolled. In 136 TM-AEX sessions, 11 falls or near falls and 9 episodes (8 asymptomatic) of systolic blood pressure drops >20 mmHg occurred. Harness supports prevented injury from falls. TM-AEX significantly improved the subjects' total Unified Parkinson's Disease Rating Scale scores and peak ambulatory workload capacities. This study suggests that an aerobic exercise program is feasible for persons who have Parkinson disease with gait impairment; however, precautions must be taken to prevent falls. Systolic blood pressure instability during exercise points to the need for autonomic dysfunction monitoring. Our data indicate that TM-AEX may reduce symptom severity and improve fitness. Further studies are needed for a better understanding of the risks and benefits of TM-AEX in this population.

Key words: aerobic exercise, autonomic instability, falls, fitness, gait dysfunction, Parkinson disease, peak ambulatory work capacity, postural instability, rehabilitation, safety, treadmill exercise, VO2 peak.

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