A vigorous resistance training program not only makes patients with Parkinson’s disease (PD) stronger but also reduces signs of their disease over the long term, a new study has found.

The study showed that such a weight-training regimen reduces scores on the motor section of the Unified Parkinson’s Disease Rating Scale (UPDRS-III) by 7.3 points.

This represents “meaningful and clinically important” changes in the lives of patients with PD, said lead investigator Daniel Corcos, PhD, professor, Department of Kinesiology and Nutrition, University of Illinois at Chicago.

The study was presented here during the American Academy of Neurology 64th Annual Meeting.

Increasing Resistance
For the study, participants were paired according to sex and off-medication scores on the UPDRS-III. Scores on the UPDRS-III motor subscales (bradykinesia, tremor, rigidity, and postural instability/gait disorder) range from 0 to 108.

Within pairs, patients were randomly assigned to progressive resistance exercises (PRE), a series of weight-bearing exercises designed to build strength by gradually increasing the amount of resistance, or to Fitness Counts (FC), a program that includes flexibility, balance, and strengthening exercises. Patients exercised for 1 hour twice a week for 24 months.

Investigators, who were blinded to group assignment, administered the UPDRS-III while patients were not receiving medication at baseline and 6, 12, 18, and 24 months.

The study enrolled 48 participants, 58% of whom were male. Their mean age was 59 years, and the mean duration of disease was 7 years. These patients completed a 6-month exercise program, with 38 going on to complete the full 24 months.

From baseline to 6 months, the mean UPDRS-III score decreased for both FC (-5.38) and PRE (-6.42) (P < .0001). These changes did not differ by group (P = .5467).

Persistent Benefits
However, by 12 months, there was a significant difference in favor of the PRE group. At that stage, the UPDRS-III score was reduced for PRE compared with FC participants (P = .023). The benefit persisted at 18 months (P = .017) and 24 months (P < .001).

At 24 months, the UPDRS-III score for the FC group had returned to baseline whereas the PRE group maintained a 7.3-point improvement.

The PRE group may have sustained an advantage because progressive resistance exercises challenge the neuromuscular system while other types of exercise don’t.

How does this improvement translate into real-life benefits? The literature shows that a difference in 5 points on the UPDRS-III scale is enough to make a clinical difference. “We’ve exceeded that by a couple of points”, said Dr. Corcos. “It’s not just that we have a statistically significant difference between these 2 groups; it’s that the difference we’ve observed is clinically important.”

Patients with PD keen on starting a vigorous resistance program should first get clearance from their doctor and then find a trainer who is familiar with weight training, said Dr. Corcos. He recommends a “whole body” program that targets leg muscles, back muscles, the abdomen, and upper arms.

“If you have PD and you’re a little bit posturally unstable, then you should probably do that exercise sitting down, with your back supported, so there’s no possibility that you can fall.”