Objective: In this randomized controlled trial, we will determine the effects of a highly challenging balance training (the HiBalance program) on balance, gait, cognition and relate it to functional MRI (fMRI) as well as wet biomarkers in participants with mild-moderate Parkinson’s disease (PD).

Background: PD affects many physiological systems essential for balance control. We have developed the HiBalance program, emphasizing critical aspects of balance control through highly challenging and progressive exercises incorporating dual/multi-tasking and shown it to be effective in improving balance, gait and physical activity level (1). New findings also suggest that intensive, challenging and cognitively demanding physical exercise can induce neuroplasticity in PD (2). We have therefor further developed the study design aiming to link the behavioral changes to neuroplastic changes in the brain. This design has been shown feasible in a pilot RCT.

Methods: One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3,  60 years of age,  21 on Montreal Cognitive Assessment, will be recruited in successive waves and randomized to either the HiBalance program or to a an active control group (HiCommunication: speech and communication training). Both interventions will be performed twice a week with 1 h sessions in small groups (6-8 PDs) for 10 weeks. In addition, they will be performing a home exercise program once a week. An assessor blinded design will be used. At the pre- and post-interventions, participants will be assessed on gait, balance, disease symptoms (MDS-UPDRS), cognition, physical activity, neural growth factor (BDNF in serum) and functional MRI (3T Philips) and during performance of motor-cognitive tasks and resting state as well as structural MRI. The trial is registered at ClincalTrials.gov: NCT03213873 data collection started in Jan 2018.

Results: We will present the study protocol in detail as well as preliminary results at the meeting.

Conclusions: Since there is currently no cure for PD, findings of neuroplastic changes and possibly an inhibition of the degenerative process in response to exercise would revolutionize the way we treat PD, and it would give new hope to patients of a longer life with better health, higher independence and improved quality of life.

References: 1. Conradsson D, Lofgren N, Nero H, Hagstromer M, Stahle A, Lokk J, et al. The Effects of Highly Challenging Balance Training in Elderly With Parkinson’s Disease: A Randomized Controlled Trial. Neurorehabil Neural Repair. 2015;29(9):827-36. 2. Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. Lancet neurology. 2013;12(7):716-26.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/linking-neuroplastic-effects-to-behavioral-changes-after-balance-training-in-parkinsons-disease-a-study-protocol-of-a-randomized-controlled-trial/