Physiotherapy led palliative exercise programme for people with advanced Parkinson’s disease (PEP-PD): A feasibility study

BACKGROUND:

Parkinson’s disease (PD) is a progressive neurological disorder affecting 1.2 million people in Europe. Exercise is a cornerstone treatment in the non-pharmacological management of PD. There is a dearth of exercise research looking at the advanced stages of PD.

PURPOSE:

The study aim was to examine the feasibility of a lower limb strength-based progressive exercise programme for people with advanced PD in a hospice setting.

METHODS:

A group exercise feasibility study was designed and evaluated. The intervention was a 40–60 minute progressive, lower limb strength training programme delivered weekly over six weeks, at an Irish hospice out-patient clinic. A twice weekly home exercise programme supplemented the supervised exercise sessions. Primary outcome measure was the Six Minute Walk Test (6MWT). Secondary outcome measures included the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Parkinson’s Disease Questionnaire 39 (PDQ-39) and predicted one repetition maximum (p1-RM).

RESULTS:

Fourteen participants took part in the PEP-PD exercise programme with stage 3-4 PD as per Hoehn and Yahr staging of PD, average time since diagnosis was 14.1 years. Thirteen participants attended the exercise intervention and pre and post assessments. Nine participants completed the six month follow up.

No significant improvement was demonstrated in the SMWT over time [F(2,16) = 1.442, p = 0.266] or the MDS-UPDRS or PDQ-39. A significant improvement was noted in all p1-RM assessments (p <  0.05) of the lower limb.

CONCLUSIONS:

The results suggest the PEP-PD exercise programme is feasible for this population and improves lower limb strength. However these improvements did not translate into functional gains.