Objective: To evaluate the effectiveness of a 6-month mobile technology-based brisk walking program on motor and non-motor symptoms and self-perceived ability in people with Parkinson’s disease (PD).

Background: The 6-month brisk walking programme using smartwatch heart rate monitor alleviated non-motor symptoms at 6-week after training [1] and motor symptoms at post-training in people with PD [2]. As sustained aerobic training is beneficial in delaying PD symptom and disability progressions [3], it is important to explore the longer-term effects of this exercise program.

Method: People with mild to moderate PD were randomized into balance and brisk walking (EXP) or active control (CON) group with flexibility and upper limb strength training. Participants received 10 training sessions in 6 months supervised by physiotherapists and practised home exercise regularly. The use of smartwatch system enabled the participants to self-monitor heart rate response accurately [4] and complete 150-min weekly moderate-intensity exercise [5] throughout the course. Movement Disorder Society Unified Parkinson Rating Scale motor and self-perceived ability (MDS-UPDRS III and II) scores and Non-motor Rating Scale (MDS-NMS) scores were assessed before (Pre), after training (Post_6m) and 6-month follow-up (FU_6m).

Results: 128 PD volunteers (aged 62.4, PD duration 5.4 years and modified Hohen and Yahr stage 2.5) were randomized into the study. 117 participants (EXP=61; CON=56) completed the program with 96% in 6-month attendance rate. No adverse effects or falls was reported during training and self-practice. Significant group*time interactions were found in all outcome measures using 2-way repeated ANOVA in EXP group. At Post_6m, there were significant decreases from baseline of MDS-UPDRS III and II scores (-4.0 and -2.2 points) and MDS-NMS score (-4.8 point) in EXP group (p<0.05). At FU_6m, there were significant decreases of MDS-UPDRS III and II (-5.1 and -1.6 points) and MDS-NMS score (-1.7 point) in the same group (p<0.05).

Conclusion: The 6-month mobile technology-based brisk walking program alleviates parkinsonian symptoms and improved self-perceived ability up to 6-month follow-up in people with mild to moderate PD.

References: 1. Mak MK, Wong-Yu IS. Effects of combined balance and brisk walking on alleviating non-motor symptoms in Parkinson disease. The 12th Pan-Pacific Conference on Rehabilitation 2021 abstract.
2. Mak MK, Wong-Yu IS. Six-month community-based brisk walking and balance exercise alleviates motor symptoms and promotes functions in people with Parkinson’s disease: a randomized controlled trial. Journal of Parkinson’s Disease. 2021;11(3):1431-41.
3. Schootemeijer S, van der Kolk NM, Bloem BR, de Vries NM. Current perspectives on aerobic exercise in people with Parkinson’s disease. Neurotherapeutics. 2020;17:1418-33.
4. Mak MK, Ren L, Kong L, Wong-Yu IS. Validity of a physical activity tracker for heart rate measurement during aerobic exercise in people with Parkinson’s disease. Parkinsonism & Related Disorders. 2020;79:e42-3.
5. Benka Wallén M, Franzén E, Nero H, Hagströmer M. Levels and patterns of physical activity and sedentary behavior in elderly people with mild to moderate Parkinson disease. Physical therapy. 2015;95(8):1135-41.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-a-mobile-technology-based-brisk-walking-program-on-parkinsonian-symptoms-in-parkinsons-disease-a-randomized-controlled-trial/