Parkinsonʼs Disease and Forced Exercise In a Community Setting: A Feasibility Study A. Gagne BA, SPT, S. Makins BS, SPT, J. Walrath BS, SPT
v Aim 1: To assess the feasibility of an 6-‐ week tandem bike forced exercise protocol conducted in community sefng for individuals with PD. v Aim 2: To assess balance and health outcomes of a 6-‐week tandem bike forced exercise protocol conducted in community sefng for individuals with PD.
AYendance SaVsfacVon
Exercise Tolerance
Mini-‐BESTest Brief-‐BESTest
ParVcipant GRC* “Captain” GRC*
*Global Rate of Change
Interven.on: v Bi-‐Weekly 1 hr tandem bike forced exercise v Intensity: 80-‐90 RPM at target HR v Community member on front seat (Captain) v Person with PD on rear seat (Stoker)
4
21.00
19.00
5
26.00
24.00
4
25.00
18.00
13.00
13.00
9.00
22.00
22.00
v Data supported the feasibility of a tandem bike program in a community sefng. v Data did not support the effecVveness of forced exercise for improving balance. v Brief-‐BESTest items seem to be more sensiVve to the observed changes.
LimitaHons
18.00
QualitaHve
22.00
QuanHtaHve
26.00
Measures: Feasibility
26.00
stage PD (3 male, 2 female, 72 ± 6 years)
Aim 2: Balance Outcomes Brief-‐BESTest 25.00 20.00 15.00 10.00 5.00 0.00 1 2 3 ParHcipants pre post Mini-‐BESTest 30.00 25.00 20.00 15.00 10.00 5.00 0.00 1 2 3 ParHcipants pre post 16.00
Se*ng: Medically Oriented Gym (MOG) • Specialized fitness center • Wellness focused • Members with complex health condiVons • Inter-‐professional team Par.cipants: 5 individuals with early to mid-‐
24.00
Pre-‐test 6-‐week IntervenHon Post-‐test Sept. 9 – 12, 2013 Sept. 16 – Oct. 24, 2013 Oct. 28 – Nov. 1, 2012
18.00
Discussion
Aim 1: Feasibility v SaVsfacVon: All parVcipants viewed program as valuable. v AYendance: 85% v Avg. ex. tolerance per session: 39.65 min
20.00
Aims
Design: Quasi-‐experimental pre-‐ and post-‐test
26.00
v In recent studies, an 8-‐week tandem bike forced exercise program was effecVve in reducing overall parkinsonian symptoms. v The feasibility of a tandem bike forced exercise program in a community sefng has not been studied previously. v AddiVonally, there has not been a published study evaluaVng balance and health outcomes aner parVcipaVon in a forced exercise program.
Results
Score
v Parkinson’s disease (PD) is a neurodegeneraVve disorder that increases an individuals fall risk.
Methods
Score
Background
5
v 4/5 parVcipants perceived no significant change in balance (mean GRC = 1.42) or ADLs (mean GRC = 0.32). Secondary Health Outcomes v No decrease in health (5/5) v Improved health (4/5) v Program was valuable (5/5)
v Difficulty recruiVng Captains v Electronic data collecVon and storage errors v High staffing requirements v Scheduling biking sessions
RecommendaHons and Future Research v RecommendaVons for future implementaVon in a community sefng: • Appropriate staff training in data collecVon and management • Partnership with local biking clubs for recruitment of experienced riders as captains • Appoint exclusive staff coordinator v Future Research: • Forced exercise on a tandem bike involving individuals with PD as both the captain and the stoker
We would like to thank Jim Cavanaugh, PT, PhD, NCS, Jaclyn Morrill-‐Chadbourne, MS, ACSM, ABD, Michelle Oswald, BS, L-‐ATC, and Megan Gilbert, MS