Effects of Resistance and Aerobic Exercises on Walking and Sarcopenic Parameters in Parkinson's Disease

Comparison of the Effects of Resistance and Aerobic Exercises Added to Conventional Rehabilitation Program on Walking and Sarcopenic Parameters in Patients With Sarcopenic Parkinson's Disease

The aim of this study was to investigate the effects of resistance and aerobic exercises on the following outcomes in patients with sarcopenic Parkinson's disease: Timed Up and Go Test (TUG), gait speed, Short Physical Performance Battery (SPPB), handgrip strength, Five-Times Sit-to-Stand Test, and MDS-UPDRS Part II scores.

Female and male patients aged between 40 and 85 years, who meet the inclusion criteria, will be recruited from the Outpatient Clinic of Physical Medicine and Rehabilitation (PMR), Ahi Evran University Kırşehir Training and Research Hospital. A total of 30 participants will be enrolled in the study.

This is a prospective, randomized, controlled trial. Assessments will be performed at baseline (week 0), at the end of treatment (week 6), and at follow-up (week 12). Outcome measures will include:

Handgrip strength Timed Up and Go Test (TUG) 4-meter gait speed test Short Physical Performance Battery (SPPB) Five-Times Sit-to-Stand Test (5CST) MDS-UPDRS Part II questionnaire

In addition, at baseline, ultrasonographic measurement of anterior thigh muscle thickness will be performed. This value, expressed in millimeters, will be divided by the body mass index (BMI) to calculate the STAR (Sonographic Thigh Adjustment Ratio) index.Participants will be randomized into three treatment groups:

Group 3 (Conventional Rehabilitation Program):

Patients will receive a standard physical therapy program, 5 days per week, for 1 hour per session. The protocol will include range of motion exercises for upper and lower extremities, stretching, walking, balance and coordination training, proprioceptive exercises, postural exercises, obstacle negotiation training, and turning-in-place exercises.

Group 2 (Conventional Rehabilitation + Resistance Training):

In addition to the conventional program, patients will perform resistance exercises for major muscle groups of the upper and lower extremities using elastic resistance bands, 3 days per week.

Group 1 (Conventional Rehabilitation + Treadmill Training):

In addition to the conventional program, patients will undergo treadmill exercise consisting of a 5-minute warm-up, 15 minutes of main exercise, and 5 minutes of cool-down. Walking speed will be individually adjusted according to participant tolerance, and exercise intensity will be monitored using the Borg Rating of Perceived Exertion (RPE) scale. Treadmill speed will be progressively increased in subsequent sessions under controlled conditions.

Inclusion Criteria:

• Male and female patients aged 40-85 years with a clinical diagnosis of Parkinson's disease.
• Diagnosis of sarcopenia according to the EWGSOP2 criteria.
• Hoehn & Yahr stage 2-3.
• Ability and willingness to provide written informed consent according to the approved study consent form.

Exclusion Criteria:

• Failure to meet diagnostic criteria for sarcopenia.
• Hoehn & Yahr stage 1 or 4.
• History of malignancy.
• Epilepsy.
• History of cardiac pacemaker implantation.
• Presence of congestive heart failure.
• Orthopedic conditions affecting walking or balance.
• Respiratory disorders impairing exercise capacity.
• Uncontrolled hypertension.
• Inability to cooperate with study procedures.
• History of neuromuscular or vestibular disorders affecting gait or balance parameters.
• Lack of willingness to participate in the study.