Objective: To assess the feasibility of an aerobic exercise regimen in those with advanced PD and DBS.

Background: Aerobic exercise is known to have beneficial effects on motor symptoms in PD but most studies have focused on analyzing its role in disease prevention or its effects on those with early disease. Subjects with advanced PD are often excluded, especially those who have undergone DBS.

Method: Subjects who had undergone DBS for management of PD and were not regular exercisers were recruited to participate in a 12-week graduated aerobic exercise program. Baseline physical activity was collected for up to 4 weeks before starting aerobic exercise. Subjects exercise intensity was increased every two weeks to a goal of moderate (70% max heart rate) intensity based on the intensity of baseline activity that they were able to maintain for 30 minutes. Each 2-week visit was supervised by a physical therapist and subjects’ compliance between visits was measured in addition to the number of subjects who completed the study.

Results: Eight of eleven enrolled subjects completed the approximately 3-month exercise study (1 study participant withdrew due to worsening nonmotor symptoms, particularly anxiety and depression; 2 subjects were excluded during screening). The median age was 67 years, with a mean disease duration since diagnosis of 8.75 years (range 3-14 years). Mean duration since DBS surgery was 3.63 years (range 1-9 years). All participants racially self-identified as White/Caucasian, with 33.3% identifying as Hispanic or Latino. One (11.1%) of 9 participants was female.  Based on reported compliance, 55.6% (21.2, 86.3) of subjects completed 80% or more of the exercise sessions (i.e. at least 30 minutes of aerobic exercise at least 3 times per week.) There were no severe adverse events or safety issues.

Conclusion: In a pilot study to assess feasibility of starting an aerobic exercise program in those with PD and DBS, 89% of participants included after screening completed the study though only 55.6% of subjects completed at least 80% of 30min sessions at least 3 times a week for 12 weeks. Future studies possibly exploring programs transitioning from fully supervised to unsupervised sessions need to be studied to determine if better compliance can be achieved in this cohort.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/aerobic-exercise-in-non-exercisers-with-advanced-parkinsons-disease-pd-and-deep-brain-stimulation-dbs-a-pilot-study/