Associations of Motor Symptom Severity and Quality of Life to Motor Task Performance in Upper and Lower Extremities Across Task Complexity in Parkinson's Disease.

The authors examined the associations between the performance of upper- and lower-extremity motor tasks across task complexity and motor symptom severity, overall disease severity, and the physical aspects of quality of life in persons with Parkinson's disease. The performance was assessed for three lower-extremity tasks and two upper-extremity tasks of different levels of complexity. The motor symptoms and overall disease severity correlated significantly with all motor tasks with higher correlation coefficients in the complex tasks. Thus, the strength of the association between disease severity or severity of motor symptoms and motor performance is task-specific, with higher values in complex motor tasks than in simpler motor tasks. Mobility-related and activity-of-daily-living-related quality of life correlated with lower-extremity tasks of low and medium complexity and with the complex upper-extremity task, respectively; this suggests that Parkinson's Disease Questionnaire-39 is capable of differentiating between the impact of gross and fine motor function on quality of life.

The impact of high intensity physical training on motor and non-motor symptoms in patients with Parkinson's disease (PIP): a preliminary study.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disease caused by loss of dopaminergic nigrostriatal neurons. Several studies have investigated various physical interventions on PD. The effects of a high intensity exercise program with focus on resistance; cardio; equilibrium; and flexibility training have not been evaluated previously. OBJECTIVE: The aim of this study was to investigate the effects of a complex, high intensity physical training program, with a long duration, on motor and non-motor symptoms in patients with PD. METHOD: 24 patients with PD Hoehn and Yahr stage 1-3 were non-randomly allocated to an intervention group (n = 12) and a control group (n = 12). The intervention group underwent 32 weeks of high intensity personalized physical training twice a week, with an optional extra training session once a week. The control group received general recommendations regarding physical activity. The primary outcomes were the change in Unified Parkinson's Disease Rating Scale Subscores (UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39). RESULTS: At week 32, the training significantly improved both UPDRS motor subscores (p = 0.045), activities of daily living subscores (ADL) (p = 0.006), mentation subscores (p = 0.004) and complication subscores (p = 0.019). The effect on the PDQ39 total score was not statistically significant. The intervention group however experienced a substantial improvement of the PDQ39 items emotional well-being (-11.0) and bodily discomfort (-7.14). CONCLUSION: The results suggest that a personal high intensity exercise program may favorably influence both motor and non-motor symptoms in patients with mild to moderate PD. More studies with both higher methodology in study design and a follow-up examination are recommended.