TUESDAY, April 12 (HealthDay News) -- The difficulties with
walking, movement and coordination that Parkinson's patients
struggle with might be partially offset by a new drug combination
and a different approach to exercise, researchers suggest.
Parkinson's patients may achieve the greatest improvements in
gait and mobility from lengthy, low-intensity training such as
brisk walking, scientists said. This runs counter to prior advice
that vigorous exercise helps Parkinson's patients the most.
Additionally, a drug known as safinamide shows promise in
reducing involuntary movements in some mid- or late-disease
patients when paired with an established medication called
levodopa. Safinamide has not yet been approved by the U.S. Food and
About 500,000 Americans have been diagnosed with Parkinson's
disease, according to the U.S. National Institutes of Health. The
findings are to be presented Tuesday at the American Academy of
Neurology annual meeting in Honolulu.
In the exercise research, scientists from the University of
Maryland randomly assigned 67 Parkinson's patients who had trouble
walking to three types of exercise: high-intensity treadmill (with
greater speed and shorter duration); low-intensity treadmill (lower
speed, longer duration); or stretching and resistance training,
which included leg presses, extensions and curls.
Participants who did the low-intensity treadmill training
performed better than the other two groups on distance and speed
tests, and experienced the most consistent improvements in gait and
mobility, study author Dr. Lisa Shulman said. But only stretching
and resistance training improved scores on a standardized
Parkinson's rating scale, probably because that type of exercise
improved flexibility, researchers said.
Researchers said that an exercise routine that includes
low-intensity walking, as well as stretching and resistance
training, might help Parkinson's patients the most.
"There has been quite a bit of media attention regarding high-intensity exercise as key, but our research showed low-intensity exceeded its efficacy," said Shulman, a professor of neurology at University of Maryland School of Medicine. "What was very significant was it was not necessary to increase intensity of walking . . . [and] we can say that virtually everyone at all stages of the disease can achieve some benefit."
The safinamide study was the first randomized, long-term
clinical trial to show the drug reduced dyskinesia, or involuntary
movements, when taken with levodopa. Levodopa increases levels of
dopamine in the brain to help ease the stiffness, tremors and poor
muscle control of Parkinson's, which is incurable.
Over a two-year period, researchers split 669 patients with mid-
to late-stage Parkinson's who were already taking levodopa into
groups that were given either 50 milligrams (mg) or 100 mg per day
of safinamide, or a placebo.
Overall, the study found no significant improvements in their
dyskinesia or other movement problems among patients taking the
drug vs. the placebo.
But among a subset of participants suffering from severe
dyskinesia, those taking 100 mg of safinamide per day experienced
an average 24 percent reduction in movement problems, according to
the study, which was funded by Newron Pharmaceuticals in Italy.
"It is a nice amount of improvement -- not dramatically life-changing, but real and interesting," said Dr. Michael Kaplitt, leading Michael Stern Parkinson's Research Foundation researcher and vice chairman for research in the department of neurological surgery at Weill Cornell Medical College in New York City.
"I think it's promising, to the extent that Parkinson's patients always need new therapies to come out," Kaplitt added. "It definitely warrants further study."
Kaplitt noted that the exercise study made walking long
distances "almost like self-physical therapy" for Parkinson's
patients because the regimen essentially helps train their brains
to walk in a more stable manner.
He and Shulman agreed that Parkinson's patients should take
these findings to heart and integrate long, brisk walks into their
"Patients understandably want to know how they can slow the progression of the disease and unfortunately we don't have any medication proven to [do that]," said Shulman, also a fellow at the American Academy of Neurology. "But people who remain more active . . . can improve in terms of gait and mobility, and they're highly likely to delay their progression over time."
Because these studies were presented at a medical meeting, the
data and conclusions should be viewed as preliminary until
published in a peer-reviewed journal.
The National Parkinson Foundation has more on the
symptoms of Parkinson's.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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