Oversimplification?
Commenting on the research, Alice Nieuwboer, PhD, professor in the department of rehabilitation sciences and head of the neurorehabilitation research group at the University of Leuven, Belgium, disagreed that exercise type is of secondary importance in Parkinson’s disease.
“In my view, it’s of primary interest, especially at the mid- to later stages,” said Dr. Nieuwboer, who was not involved with the research.
She noted it is difficult to carry out meta-analyses of resistance training versus other interventions because studies comparing different exercise types “are rather scarce.”
“Another issue is that the dose may differ, so you’re comparing apples with pears,” said Dr. Nieuwboer.
She did agree that all patients should exercise, because it is “better than no exercise,” and they should be “free to choose a mode that interests them.”
However, she stressed that exercise requires significant effort on the part of patients with Parkinson’s disease, requires “sustained motivation,” and has to become habit-forming. This makes “exercise targeting” very important, with the target changing over the disease course, Dr. Nieuwboer said.
For example, for a patient at an early stage of the disease who can still move quite well, both resistance training and endurance training can improve fitness and health; but at a mid-stage, it is perhaps better for patients to work on balance and walking quality “to preempt the risk of falls and developing freezing,” she noted.
Later on, as movement becomes very difficult, “the exercise menu is even more restricted,” said Dr. Nieuwboer.
The bottom line is that a message saying “any movement counts” is an oversimplification, she added.
The study was funded by a grant from the German Federal Ministry of Education and Research. The investigators and Dr. Nieuwboer have reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.