Parkinson's Disease

  • Parkinson's Recovery of Brain with Exercise (PROBE)

    The purpose of this translational study is to advance findings from our preliminary data with human subjects to elucidate underlying mechanisms of exercise which may mediate brain repair (neuroplasticity) in patients with PD. Specifically we will test the hypothesis that high intensity exercise in persons with early Parkinson’s disease leads to neuroplasticity, or a normalization of cortical excitability (CE) as measured by Transcranial Magnetic Stimulation.
    Twenty-four participants with early stage PD will be recruited and randomly assigned to one of two intense exercise groups (n=16) or a control group (n=8). Both exercise groups will train with a doctor of physical therapy one hour 3 times per week for 6 weeks at USC. One exercise group (n=8) will receive intensive training utilizing a body weight-supported treadmill, and the other exercise group (n=8) will receive intense overground training using the Walk Big therapy approach developed by Dr. Becky Farley, PhD, PT.

    Evaluations will be assessed at baseline and immediately post exercise intervention. The primary outcome variables will be: 1) Cortical excitability measured by TMS, and 2) gait and dynamic functional postural control (measured with biomechanical motion analysis). Participants walk across a 5 meter walkway while responding to cues to turn, stop, and to walk as fast as possible. Motor performance will be characterized by quantifying 1) gait spatiotemporal parameters (i.e. step width, step length, and the variation of swing and step time), and 2) dynamic postural control. Moreover, the relationship between changes in brain and motor behavior will be analyzed.

    Traditionally, physical therapy is prescribed for individuals with late PD. By demonstrating both brain and functional improvements in early PD, one can argue the need for early exercise intervention that is intense, continuous, may alter disease progression, and delay the need for drug therapies. By understanding the underlying brain mechanisms associated with exercise, novel pharmacological and non-pharmacological therapeutic modalities may be designed to delay or reverse disease progression in idiopathic Parkinson’s disease. In addition and for the future, exercise may be determined to enhance the effects of other interventions such as striatal tissue transplants.

    For more information, contact:
    Beth Fisher, PhD
    Associate Professor of Clinical Physical Therapy
    (323) 442-2796
    bfisher@usc.edu