RM, Senior walking

A challenging physical training program has helped reverse the symptom of gait freezing in study participants with Parkinson’s disease, according to investigators from Brazil.

People with freezing of gait cannot move their feet forward despite the intention to walk, a problem that not only interferes with daily functioning but can lead to falls. Researchers at the University of São Paulo recently tested a 12-week exercise protocol that stimulates motor and cognitive skills at the same time.

The 32 study participants, who had stage 3 or 4 Parkinson’s disease, performed adapted resistance training exercises that combined instability, weight lifting, motor coordination and cognitive demands. The exercises were done concurrently to create the complexity necessary to stimulate significant brain changes, explained doctoral candidate Carla da Silva Batista.

“This demands considerable effort from the patient and confidence on the part of the trainer, who will invariably have to give patients some support so they don’t fall,” Batista said.

Significant functional improvements were found following the trial, including a 60% reduction in gait freezing and a 70% reduction in motor symptoms. Measurements of brain activity before and after the training program also showed changes in the brain regions linked to gait freezing, and enhanced brain activity and plasticity in the regions affected by Parkinson’s disease, the researchers reported. 

“The methodology proved reversal of the disorder and enhanced plasticity in the brain regions concerned,” Batista said.

No improvement was observed in control group participants, who took part in conventional rehabilitation physical therapy. “It’s important to stress that the traditional exercises were unable to mitigate the severity of gait freezing or bring about positive alterations to brain regions,” Batista said.

The study was published in the journal Movement Disorders.