High-Intensity Interval Training for Parkinson's Disease

(PD HIIT Trial)

Overseen By Ron Walser, PT, DPT

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Pacific Northwest University of Health Sciences

Disqualifiers: Stroke, Dementia, Multiple sclerosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 8 weeks

64 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it mentions that a major change in medication during the study period is not allowed. It's best to discuss your current medications with the study team.

What data supports the effectiveness of the treatment High-Intensity Interval Training for Parkinson's Disease?

Research suggests that high-intensity interval training (HIIT) is a promising treatment for Parkinson's disease, as it may help improve motor symptoms and promote neuroplasticity (the brain's ability to reorganize itself). Studies have shown that similar high-intensity exercises can enhance muscle strength, balance, and quality of life in people with Parkinson's. ^{1 2 3 4 5}

Is high-intensity interval training safe for people with Parkinson's disease?

Research shows that high-intensity interval training (HIIT) is generally safe for people with Parkinson's disease and does not worsen symptoms. It can also have positive effects on balance, muscle strength, and overall quality of life. ^{2 3 5 6 7}

How is high-intensity interval training different from other treatments for Parkinson's disease?

High-intensity interval training (HIIT) is unique for Parkinson's disease as it not only helps improve motor symptoms but also promotes neuroplasticity (the brain's ability to adapt) and reduces inflammation, which are not typically addressed by standard drug treatments. Unlike continuous exercise, HIIT involves short bursts of intense activity, which may lead to quicker improvements in both motor and cognitive functions. ^{1 2 3 7 8}

What is the purpose of this trial?

The goal of the study is to compare different types of high intensity circuit exercises over an 8-class training series in people with Parkinson disease. The main question it aims to answer is: -Does including arm and hand exercises with leg exercises improve reaction time, balance, functional measures, gait speed and quality of life? This group will be compared to a group that only does leg exercises. Participants will be asked to participate in 8 high intensity circuit exercise classes.

Research Team

Tiffany B Salido, DPT, PhD

Principal Investigator

Pacific Northwest University of Health Sciences

Eligibility Criteria

This trial is for individuals with Parkinson's Disease who are interested in participating in an exercise program. The study will include people willing to complete 8 high-intensity circuit training classes focusing on different body parts.

Inclusion Criteria

I can walk on my own, with or without help from a device.

I have been cleared by a doctor to do moderate or hard exercise.

I have been diagnosed with Parkinson's disease.

Exclusion Criteria

I haven't changed my medications significantly during the study period.

I have unstable bones or severe osteoporosis.

I have a muscle or ligament tear.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Baseline assessment includes demographics, disease and fall history, and outcome measure collection

1 week

1 visit (in-person)

Treatment

Participants engage in 8 high intensity circuit exercise classes focusing on lower and/or upper extremity training

8 weeks

8 visits (in-person)

Post-intervention Assessment

Post-intervention balance and stepping outcomes are reassessed

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

8-10 weeks

Treatment Details

Interventions

• High-intensity Interval Circuit Training

Trial Overview The study tests whether a combination of arm and hand exercises with leg exercises can improve reaction time, balance, functional measures, gait speed, and quality of life compared to just leg exercises.

Participant Groups

Group I: Lower extremity and upper extremity exercise Experimental Treatment 1 Intervention

Exercises in the circuit (8 total) will focus on the lower extremity (4) and upper extremity (4)

Group II: Lower extremity exercise Active Control 1 Intervention

Exercises in the circuit (8 total) will focus on the lower extremity (4) alone.

Who Is Running the Clinical Trial?

Pacific Northwest University of Health Sciences

Lead Sponsor

Trials

11

Recruited

2,200+

Findings from Research

A study involving four participants with Parkinson's disease compared the effects of 4 weeks of high-intensity interval training (HIIT) to continuous aerobic exercise, aiming to assess improvements in both motor and non-motor symptoms.

The research also aimed to explore the relationship between exercise types and changes in blood biomarkers related to neuroplasticity and neurodegeneration, which could provide insights into potential disease-modifying effects of HIIT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Cycle Ergometer Training in Parkinson's Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject Research Design. van Wegen, EEH., Hirsch, MA., van de Berg, WDJ., et al.[2020]

Resistance training (RT) and endurance training (ET) are safe and feasible exercise modalities for people with Parkinson's disease, showing significant benefits in muscle strength, functional capacity, and quality of life based on a review of 33 new randomized controlled trials.

RT demonstrated a strong positive impact on muscle strength (SMD = 0.83) and functional capacity, while ET improved cardiorespiratory fitness (SMD = 0.27) and also showed potential benefits for functional outcomes, indicating that both types of exercise can be effective adjunct therapies for managing Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. Gamborg, M., Hvid, LG., Dalgas, U., et al.[2022]

High-intensity interval training (HIIT) has been shown to significantly improve disease severity and quality of life in individuals with Parkinson's disease, based on a systematic review of 15 randomized clinical trials involving 654 participants.

While HIIT demonstrated benefits in motor function and functional mobility compared to control groups, the evidence comparing HIIT to moderate intensity exercise remains limited and shows variability among studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and effect of high-intensity training on the progression of motor symptoms in adult individuals with Parkinson's disease: A systematic review and meta-analysis. Sena, IG., Costa, AVD., Santos, IKD., et al.[2023]

High-intensity interval training (HIIT) is feasible and safe for people with mild-to-moderate Parkinson's disease, with 90-100% program completion reported in studies lasting up to 12 weeks.

HIIT significantly improves cardiorespiratory fitness (VO2peak/max) and may enhance brain-derived neurotrophic factor (BDNF) levels and motor symptoms, although it did not show superior effects compared to moderate-intensity continuous exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The feasibility, safety, physiological and clinical effects of high-intensity interval training for people with Parkinson's: a systematic review and meta-analysis. Harpham, C., Gunn, H., Marsden, J., et al.[2023]

The high-intensity multimodal exercise boot camp (HIBC) was found to be feasible and safe for individuals with Parkinson's disease, with no significant differences in adverse events compared to a usual care, low-intensity exercise program.

Participants in the HIBC showed significant improvements in 7 out of 31 measured outcomes related to balance, motor activity, and quality of life, compared to only 3 improvements in the usual care group, suggesting that high-intensity exercise may offer greater benefits for people with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A High-Intensity Exercise Boot Camp for Persons With Parkinson Disease: A Phase II, Pragmatic, Randomized Clinical Trial of Feasibility, Safety, Signal of Efficacy, and Disease Mechanisms. Landers, MR., Navalta, JW., Murtishaw, AS., et al.[2022]

The FIGHT-PD study demonstrated that a 15-week boxing training program for 10 participants with early-stage Parkinson's disease was highly feasible, with a 97.7% adherence rate and no withdrawals, indicating strong participant engagement and safety.

Nine out of ten participants showed improvement in their motor scores on the Unified Parkinson Disease Rating Scale (UPDRS-III), suggesting that boxing training may be an effective intervention for enhancing motor function in individuals with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

FIGHT-PD: A feasibility study of periodized boxing training for Parkinson disease. Blacker, DJ., Fazio, R., Tucak, C., et al.[2023]

A 12-week high-intensity interval training (HIIT) program significantly reduced inflammation markers, such as TNF-α, and improved antioxidant capacity in the serum of 28 Parkinson's disease patients, suggesting potential benefits for managing the disease.

The study also found a decrease in neutrophil levels and ratios, alongside an increase in the antioxidant enzyme superoxide dismutase, indicating that HIIT may help slow the progression of Parkinson's disease by enhancing the body's inflammatory response and antioxidant defenses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity interval training modulates inflammatory response in Parkinson's disease. Malczynska-Sims, P., Chalimoniuk, M., Wronski, Z., et al.[2022]

In a study involving 14 individuals with Parkinson's disease, high-intensity interval training (HIIT) significantly improved cognitive functions such as attention and immediate auditory memory compared to a control session, while moderate-intensity continuous training (MICT) also enhanced immediate auditory memory.

The results indicate that the intensity of aerobic exercise plays a crucial role in its effectiveness on cognitive performance, with HIIT providing greater cognitive benefits than MICT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Differential Acute Effect of High-Intensity Interval or Continuous Moderate Exercise on Cognition in Individuals With Parkinson's Disease. Fiorelli, CM., Ciolac, EG., Simieli, L., et al.[2020]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Cycle Ergometer Training in Parkinson's Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject Research Design. [2020]

2. Denmark pubmed.ncbi.nlm.nih.gov

Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Feasibility and effect of high-intensity training on the progression of motor symptoms in adult individuals with Parkinson's disease: A systematic review and meta-analysis. [2023]

4. Germany pubmed.ncbi.nlm.nih.gov

The feasibility, safety, physiological and clinical effects of high-intensity interval training for people with Parkinson's: a systematic review and meta-analysis. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

A High-Intensity Exercise Boot Camp for Persons With Parkinson Disease: A Phase II, Pragmatic, Randomized Clinical Trial of Feasibility, Safety, Signal of Efficacy, and Disease Mechanisms. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

FIGHT-PD: A feasibility study of periodized boxing training for Parkinson disease. [2023]

7. Germany pubmed.ncbi.nlm.nih.gov

High-intensity interval training modulates inflammatory response in Parkinson's disease. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Differential Acute Effect of High-Intensity Interval or Continuous Moderate Exercise on Cognition in Individuals With Parkinson's Disease. [2020]