Exercise Interventions in Parkinson's Disease

Longer-term Exercise Interventions in People With Parkinson's Disease

This study sets out to determine the effect of exercise performed over a longer period of time (6 months), delivered using community facilities, on motor and non motor symptoms, health and well being in people with Parkinson's Disease.

Participation in exercise is beneficial for health and well being, but the effect over a longer period of time in people with Parkinson's disease (PD) has not been established. People with PD currently only receive short-term support for exercise therapy interventions funded from the National Health Service; it is therefore unsurprising that people with PD are observed to have low levels of physical activity that decrease over time.

Using mixed methodology the investigators will explore the effect of exercise delivered over a longer period of time (six months) in people with PD. The investigators will examine the views of people participating in the program.

Aims

Using a randomized controlled trial with one intervention arm and an active comparator control group with blinded assessments and semi-structured interview techniques the investigators will determine in people with PD:

1. The effect of longer-term exercise participation on motor symptoms
2. The effect of longer-term exercise participation on non motor symptoms, fitness, health and well being.
3. Participants views of the process and sustainability of community provision of exercise over a longer period of time.

Inclusion Criteria:

• Parkinson's disease diagnosed by neurological examination; idiopathic PD defined by the UK Parkinson's Disease Society Brain Bank Criteria
• Able to walk ≥ 100m
• maintained a stable medical regime for 12 weeks prior to initiation of the study, and anticipated to maintain a stable regime for the course of study (as determined by the referring clinician).

Exclusion Criteria:

• Dementia
• History of additional prior neurological condition
• Severe depression or psychosis or a mental state that would preclude consistent active involvement with the study over its duration
• Cardiac precautions that would prevent the subject from completing the exercise program or the full battery of outcome measures
• Any known contraindication to exercise
• Reduced cognition of any cause [Minimental state examination [(MMSE) < 23]
• An orthopaedic condition that independently limits walking;