Exercise Program for Parkinson's Disease

Overseen By Jacquie Ellison

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Health and Science University

Must be taking: Levodopa

Disqualifiers: Major musculoskeletal, Neurological disorders, others

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

Compensation: Varies

Number of Visits: 20

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new exercise program called TURN-IT, designed to help individuals with Parkinson's Disease improve their turning ability while moving. The program targets specific exercises to address stiffness, slow movements, and balance issues that affect turning. Participants will either join the exercise sessions or continue their usual routine for comparison. Ideal candidates are those with Parkinson's who have experienced falls in the past year and can attend sessions at the OHSU campus. The trial aims to determine if the TURN-IT program is effective enough for a larger study. As an unphased trial, it offers participants the opportunity to contribute to innovative research that could enhance the quality of life for those with Parkinson's.

Will I have to stop taking my current medications?

The trial requires that you do not change your anti-parkinson medications during the study.

What prior data suggests that this exercise program is safe for participants with Parkinson's Disease?

Research has shown that exercise programs like the TURN-IT program are generally safe for people with Parkinson's Disease (PD). The TURN-IT program aims to improve turning ability, a common challenge for those with PD. Similar exercise programs have demonstrated positive results in enhancing balance and movement without causing serious side effects.

Participants in these programs typically exercise with a trainer, ensuring safety. While no specific issues have been reported with TURN-IT, exercise programs like this are considered safe for most individuals. It's important to note that any exercise might cause minor discomfort, especially for newcomers. However, the benefits of improved movement often outweigh these risks.

For concerns, consulting a healthcare provider can help determine if this program is suitable. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the exercise programs for Parkinson's Disease because they offer a fresh approach to managing symptoms. Unlike standard treatments that primarily involve medications like Levodopa to manage motor symptoms, the Turning Boot Camp and TURN-IT programs focus on physical activity to potentially improve movement and coordination. These exercise programs are unique because they involve personalized, one-on-one sessions with a consistent trainer, overseen by a physical therapist, which can provide tailored support and motivation. This approach not only aims to enhance physical health but also promotes overall well-being and quality of life for individuals with Parkinson's Disease.

What evidence suggests that the TURN-IT exercise program is effective for improving turning in Parkinson's Disease?

Research has shown that exercise programs can help people with Parkinson's Disease improve their movement. Early results suggest that the TURN-IT exercise program, which participants in this trial may receive, might ease the difficulty of turning, a common challenge. In similar programs, participants improved their walking and balance, which are crucial for daily activities. Studies have found that guided exercise routines can greatly enhance movement abilities. These improvements suggest that TURN-IT might help reduce falls and boost overall quality of life for participants. ^{1 2 4 6 7}

Who Is on the Research Team?

Fay Horak, PhD, PT

Principal Investigator

Oregon Health and Science University

Are You a Good Fit for This Trial?

This trial is for people aged 55-85 with Parkinson's Disease who have fallen in the past year. They must respond to levodopa treatment, be at certain stages of the disease, and can't have other major health issues or recent medication changes. Participants need to commit to attending exercise sessions without altering their medications or exercise habits.

Inclusion Criteria

I have Parkinson's diagnosed by a specialist, with symptoms like slow movement, tremor, stiffness, or balance issues not caused by other conditions.

My Parkinson's disease is at a moderate to advanced stage.

I am between 55 and 85 years old.

Exclusion Criteria

I have recently changed my medication.

I do not have major musculoskeletal, neurological disorders, or epilepsy, except for Parkinson's Disease.

I may have difficulty understanding or following instructions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants in the TURN-IT group attend supervised, 1-hour classes, 3 times per week for 6 weeks, focusing on exercises to improve turning ability

6 weeks

18 visits (in-person)

Control

Participants in the control group are tested at baseline and 6 weeks later, continuing their normal daily life

6 weeks

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with a focus on prospective fall rate over 12 months

52 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Turning Boot Camp exercise program
• TURN-IT exercise program

Trial Overview The TURN-IT program focuses on improving turning movements in those with Parkinson's by addressing common physical limitations caused by the disease. The study will compare a group doing this special exercise three times a week for six weeks against a control group that does not receive any intervention.

How Is the Trial Designed?

Group I: TURN-IT group Experimental Treatment 1 Intervention

Participants in the treatment group will attend supervised, 1-hour classes, 3 times per week for 6 weeks, one-on-one with the same exercise trainer, overseen by a physical therapist investigator.

Group II: No Intervention Control Group Active Control 1 Intervention

Participants in this group will be tested at baseline and 6 weeks later. They will go about their normal daily life during the 6 week period.

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials

1,024

Recruited

7,420,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

A case series involving six patients with Parkinson's disease showed that a boxing training program led to significant improvements in balance, mobility, and quality of life after 12 weeks, with continued benefits observed at 24 and 36 weeks.

The program was found to be safe and feasible, with patients experiencing greater improvements earlier if they had mild Parkinson's disease, while those with moderate to severe disease required longer training to achieve similar benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Boxing training for patients with Parkinson disease: a case series. Combs, SA., Diehl, MD., Staples, WH., et al.[2022]

A case report involving four participants with Parkinson's disease showed that multiple 3.5-day intensive exercise programs, called Movement Camp, were feasible and could help maintain or improve physical function over three years.

Participants engaged in high-intensity exercises targeting various skills, and most showed maintained or improved performance in balance, endurance, gait speed, and overall function after the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and longitudinal effects of repeated participation in an annual, brief and intense exercise program in individuals with Parkinson's disease: A case report. Readinger, J., Eastlack, M., Von Nieda, K., et al.[2022]

A 4-week task-specific movement (TSM) exercise program significantly improved turning ability and clinical outcomes in 22 adults with early-to-mid-stage Parkinson's disease, as measured by various assessments including the Unified Parkinson's Disease Rating Scale (UPDRS).

Participants in the exercise group showed better turning kinematics and reduced fall risk compared to the control group, suggesting that targeted exercise can enhance mobility and safety in individuals with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of task-specific movement program on en bloc turning in Parkinson's disease: A randomized controlled trial. Khobkhun, F., Hollands, M., Tretriluxana, J., et al.[2022]

Both the Agility Boot Camp and treadmill training programs improved mobility in people with Parkinson's disease, with significant changes in measures like stride velocity and peak arm speed after 4 weeks of exercise.

The Agility Boot Camp specifically showed a greater improvement in postural sway compared to treadmill training, indicating that certain exercise types may offer unique benefits for mobility in Parkinson's patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring outcome measures for exercise intervention in people with Parkinson's disease. King, LA., Salarian, A., Mancini, M., et al.[2022]

Boxing exercises for people with Parkinson's disease (PD) showed potential benefits, including improved balance, mobility, and quality of life, based on two studies with 37 participants over 12 weeks, although the evidence is limited due to the small sample size.

Despite the growing popularity of boxing as an intervention for PD, the overall quality of supporting evidence is low, with many websites lacking verifiable data and safety guidelines, highlighting the need for more rigorous research and professional training for effective implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Boxing for Parkinson's Disease: Has Implementation Accelerated Beyond Current Evidence? Morris, ME., Ellis, TD., Jazayeri, D., et al.[2020]

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]

A four-day personalized educational and exercise boot camp for individuals with Parkinson's disease was found to be very satisfying, with all 8 participants expressing a desire to attend future events.

At a one-month follow-up, participants reported that the program was very useful and noted positive changes in their exercise habits, particularly enjoying cognitive stepping and dance-based movements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Novel Boot Camp Program to Help Guide Personalized Exercise in People with Parkinson Disease. Domingos, J., Dean, J., Cruickshank, TM., et al.[2021]

A 10-week home-based exercise program focusing on turning significantly improved turning performance and clinical outcomes in 20 individuals with Parkinson's disease, particularly in measures related to mobility and fall risk.

Participants in the exercise group showed notable enhancements in various metrics, including motor and rigidity scores on the Unified Parkinson's Disease Rating Scale, indicating that targeted exercises can effectively address challenges faced by individuals with Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can a targeted home-based exercise programme improve turning characteristics in individuals with Parkinson's disease? Khobkhun, F., Srivanitchapoom, P., Richards, J.[2022]

Citations

1. bmcneurol.biomedcentral.com bmcneurol.biomedcentral.com/articles/10.1186/s12883-022-02934-5

TURN-IT: a novel turning intervention program to improve ... We will use daily-life monitoring of mobility as outcome measures for rehabilitation to improve turning. This is a randomized controlled trial ...

2. researchgate.net researchgate.net/publication/365804225_TURN-IT_a_novel_turning_intervention_program_to_improve_quality_of_turning_in_daily_life_in_people_with_Parkinson's_disease

a novel turning intervention program to improve quality of ... The TURN-IT group will be seen for 6 weeks (18 visits) for an individualized, progressive program that is based on the specific constraints of turning in PD.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11561861/

Effects of a Cognitively Challenging Agility Boot Camp ... The ABC-C program was effective in improving gait performance in both PD−FoG and PD+FoG, even after controlling for disease duration.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3657411/

Exploring Outcome Measures for Exercise Intervention in ... In our study, the 3 outcome measures that showed the most promising ability to detect a change between the ABC and the TT program were (1) range ...

5. nature.com nature.com/articles/s41598-025-07009-2

Supervised aerobic-strength exercise reduces postural ... Post-intervention, motor MDS-UPDRS scores improved significantly in both ON (p = 0.013) and OFF (p < 0.001) states. BBS scores increased (p = ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7217755/

Cognitively Challenging Agility Boot Camp Program for ... The ABC-C for people with PD and FoG is a feasible exercise program that has potential to improve FoG, balance, dual-task cost, executive function and brain ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05680597

Balance Tele-Rehab in Parkinson's Disease ... The intervention is tele-rehabilitation conducted by a physical therapist virtually for 60 minutes approximately three times a week for four weeks (12 sessions) ...