April 14, 2011

New study has surprising findings on which types of exercise work best

Here's a test question for you.  Suppose you took 67 Parkinson's patients who had trouble walking and randomly assigned them to these three different exercise groups:
  1. High-intensity treadmill walking (walking at faster speeds but for a shorter duration of 30 minutes)
  2. Low-intensity treadmill walking (walking at slower speeds but for  a longer period of 50 minutes)
  3. Stretching and resistance training which included leg presses, extensions and curls.
Which group do you think would show the greatest progress?

I'd have guessed (reluctantly) that the high-intensity treadmillers would score highest.  But a study done by scientists at the University of Maryland found that those 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. Only stretching and resistance training improved scores on a standardized Parkinson's rating scale, probably because that type of exercise improved flexibility, researchers said.

All participants exercised three times a week for three months, supervised by exercise physiologists at the Baltimore VA Medical Center.

“Contrary to evidence suggesting that high-intensity exercise is the most effective, our results suggest that a combination of low-intensity training and stretching-resistance training may achieve the greatest improvements for people with Parkinson’s disease,” Lisa M. Shulman, MD, of the University of Maryland, said in a news release. “These results have important implications for how we manage Parkinson’s disease, since low-intensity exercise can be done by most people with Parkinson’s, and our patients frequently ask what type of exercise they should be doing.”

Researchers concluded 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 study author Dr. Lisa 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."

Reaction to Study's Report

Bastiaan Bloem, a researcher at the Michael J. Fox Foundation, noted that Shulman's findings underscore the importance of exercise in PD. Regular exercise slows down cognitive decline, helps to prevent bone loss and is good for pulmonary and cardiovascular health.

But he also said that much work remains to be done to pinpoint the most beneficial form of exercise for those living with the disease. He noted that the Shulman study  involved a relatively small number of people and  that the work needs replication before we can draw practical conclusions for patients' day-to-day regimens.  The study's findings, he said, were unexpected at a variance with some earlier studies that found the greatest benefit from strenuous activity.

Bottom Line for Me

The Shulman study at least provides some reassurance and consolation for people like me who like walking, but not jogging or running on a treadmill. Everyone agrees that exercise is crucial.  Laboratory findings as to which forms of exercise show the best results are interesting, but what, for me, is  more important is finding  the exercises that I'm most  likely to incorporate into my daily routine. Even if this study had ranked vigorous workouts on a treadmill as being the most beneficial, you wouldn't find me doing it. Of course, I also have to be willing to "push the envelope" beyond my comfort zone. That's why it's helped me a lot to work with the exercise therapists in the BIG program of exercises specifically designed for people with Parkinson's.


Jakob said...

Who knew? I've been working WAY too hard on my treadmill! Thanks, John. --Jakob

Lita W said...

Saw Jeannine Stein's report on this subject in Tuesday's LA Times. Good news for us all!

John Schappi said...

Jakob and Lita -- I think we are not alone in rejoicing that this study's findings on the benefits of different forms of exercise had vigorous running on a treadmill in last place.

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