Effects of an exercise program on upper limb functionality in people with Parkinson's disease

Abstract

Introduction: People with Parkinson's disease (PD) show impairments in motor coordination, involving even the upper limbs which limit the execution of activities of daily living. Studies investigating exercise interventions targeting the upper limbs in this population are scarce. Objective: This study investigated the feasibility and safety of a Pilates-based exercise program aimed to improve upper limb muscle strength, manual dexterity, bradykinesia, and functionality for people with PD. Methods: Twelve participants with PD (4 women, median [P25-P75] age 66 [65-70] years) were enrolled in this clinical trial study quasi-experimental underwent a 6-week (30 min/day, 3 days/week) exercise program targeting the upper limbs using Pilates’s equipment (Reformer, Cadillac, Chair, Barrel). The feasibility was evaluated by the number of sessions attended, the capacity of each participant to accomplish the exercises, as well as its progressions on difficulty. Safety was checked by computing the quantity and type of adverse events. Clinical and functional trends before and after the intervention were also computed regarding handgrip strength (HGS) with
an analogue dynamometer; fine motor coordination (Nine Pins Test; 9HPT); bradicinesia (Unified Scale of PD Evaluation; UPDRS), and upper limb functionality (Test D'évaluation des Membres Supérieurs des Personnes Âgées, TEMPA). Results: Adherence to the rehabilitation program was 100% among those who completed the trial, all participants performed the exercises without difficulty, the only adverse event observed was mild muscle pain. Pre-post differences were observed only for functionality (TEMPA item #8, left UL; rank biserial-correlation = 0.795 [0.417; 0.938], p = 0.017) and bradykinesia (UPDRS item #31; rank biserialcorrelation
= 1.000 [1.000; 1.000], p = 0.006). Conclusion: A Pilates-based exercise program targeting upper limb muscle strength, manual dexterity, bradykinesia, and functionality for people with PD is feasible and safe. The observed changes in UL functionality and bradykinesia encourage further investigations with randomized clinical trials.