Table 2.
Description of interventions and results.
| Intervention characteristics | Results | ||||
|---|---|---|---|---|---|
| Author, year | Intervention group activity | Control group activity | Dose | Neuroplasticity outcomes | Behavioral outcomes |
| Angelucci et al., [31] | Motor rehabilitation consisting of 3 sessions per day: (1) exercises to promote flexibility, relaxation, coordination, posture, and walking, (2) treadmill (aerobic) and Wii fit balance board, (3) motor therapy. | NA | 4 wks 15 times/wk 60 min |
BDNF levels at end comparable to baseline (p < 0.14). | Improvements at end: UPDRS II (p < 0.05), UPDRS III (p < 0.005), PDQ-39 (p < 0.01), 6MWT (p < 0.05). |
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| Fontanesi et al., [27] | Multidisciplinary rehab 3 sessions per day: (1) physical therapy including ROM, strength, and balance; (2) aerobic training; and (3) occupational therapy. | NA | 4 wks 15 times/wk 60 min |
Analysis revealed a posttraining upregulation of BDNF-TrkB signaling in the peripheral lymphocytes at the levels of receptors, intracellular mediators, and downstream effectors. | Improvement on all scores: UPDRS total (p < 0.01), UPDRS II (p < 0.01), UPDRS III (p < 0.01), UPDRS IV (p = 0.009), 6MWT (p < 0.01), BBS (p < 0.01), TUG (p = 0.004), PDDS (p < 0.01), and FOG-Q (p < 0.01). |
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| Frazzitta et al., [28] | Multidisciplinary rehab 3 sessions per day: (1) cardiovascular warm-up, relaxation, stretching, etc.; (2) balance and gait training on platform and treadmill (aerobic training); and (3) occupational therapy. | Passive | 4 wks 15 times/wk 60 min |
Posttraining analysis revealed increased levels of BDNF in the training group (ES 1.1, p < 0.001), while they remained unchanged in the control group (p > 0.5). | Participants in the training group improved on UPDRS III compared to controls (p ≤ 0.001). Improvement on all other functional outcome measures in the training group (not tested in controls): UPDRS II (p ≤ 0.001), UPDRS total (p ≤ 0.001), BBS (p = 0.002), and 6MWT (p ≤ 0.001) |
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| Zoladz et al., [33] | Bike (aerobic) at voluntary-rate warm-up and cooldown 10 min each, and 40 min moderate intensity interval exercise in-between. | NA | 8 wks 3 times/wk 60 min |
Posttraining analysis of BDNF levels revealed an increase of 34% (p = 0.03). | Participants decreased their UPDRS-total score significantly after the training period (p = 0.01). |
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| Batson et al., [35] | Improvisational dance emphasizing large ROM, changes in base of support and movement speed variability. | NA | 1 wk 5 times/wk 60 min |
Stronger connections between anterior and posterior aspects of Default Mode Network. The basal ganglia became highly interconnected with the premotor cortex. | No other outcomes to report. |
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| Duchesne et al., [32] | Bike (aerobic), starting at 20 min and 60% intensity (based on each participant fitness level) and intensified each week until reaching 40 min of training at 80% intensity. | NA | 12 wks 3 times/wk 60 min |
Analysis revealed a posttraining increase in brain responses in the temporal lobes, left ventral striatum, left hippocampus, cerebellar lobules 8 and 9 bilaterally, and right crus. These responses reflected motor sequence learning capacity specifically. | Improvement in aerobic fitness (V02 max) (p < 0.003). Improvement in reaction time for sequential condition only (p < 0.006), and also a significant sequence learning effect (p < 0.005). |
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| Maidan et al., [19] | Treadmill training. Speed and duration of the treadmill was progressed throughout the training period according to each participant's ability. | Treadmill training with added virtual reality component. | 6 wks 3 times/wk 45 min |
Posttraining analysis showed significantly different patterns of brain activation between training arms i Brodmann area 10 (p = 0.043) and middle temporal gyrus (p = 0.005). | Improvements at end: UPDRS II (p < 0.05), UPDRS III (p < 0.005), PDQ-39 (p < 0.01), 6MWT (p < 0.05). |
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| Shah et al., [30] | Bike (aerobic) at forced-rate exercise. | Bike (aerobic) at voluntary-rate exercise. | 8 wks 3 times/wk 60 min |
Posttraining analysis revealed that participants exercising at forced-rate showed that the active motor cortex had a stronger connection to the ipsilateral thalamus compared to those participants who pedaled at voluntary-rate. | No other outcomes to report. |
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| Carvalho et al., [29] | Treadmill training (aerobic) or strength training. | Calisthenics | 12 wks 2 times/wk 40 min |
EEG analysis showed a higher mean frequency in treadmill and strength training groups compared to calisthenics (p = 0.00). No significance regarding brain areas (p = 0.97), moment (pre-post) (p = 0.89) or any interactions (moment×group (p = 0.09), moment×area (p = 0.93), group×area (p = 0.99), moment×group×area (p = 0.93)). | (Effect size strength training/treadmill/calisthenics) (p value): UPDRS I (-0.93, 0.00, −0.21) (p = 0.405) UPDRS II (−0.46, −1.12, 0.13) (p = 0.313) UPDRS III (−1.25, −1.34, −0.07) (p = 0.287) UPDRS IV (−0.46, 1.23, 0.51) (p = 0.322) 8-FT (−1.18, −1.08, −1.35) (p = 0.859) BST (−0.38, −0.79, −0.41) (p = 0.338) CSRT (−0.28, −0.06, 0.08) (p = 0.735) ACT (0.74, 1.16, 0.07) (p = 0.271) CST (1.81, 0.86, 0.57) (p = 0.328) 2-MST (0.72, 0.69, −0.73) (p = 0.012) 10mWT (−0.78, −1.20, −0.34) (p = 0.346) BBS (0.44, 0.38, 0.00) (p = 0.721) |
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| Fisher et al., 2008 | High-intensity body weight-supported treadmill training (aerobic). | Low intensity physical therapy (active and passive ROM training, balance, gait, resistance and functional training) or passive control group. | 8wks 3 times/wk 60 min |
All subjects in the treadmill group showed an increased CSP-duration in both hemispheres after training. No changes were found in the physical therapy group. | Not reported for the TMS subsample. |
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| Fisher et al., 2013 | Treadmill (aerobic), each session aimed at reaching and maintaining a metabolic equivalent of task level greater than 75% of age-adjusted heart rate. | Passive | 8 wks 3 times/wk 60 min |
PET imaging post-training demonstrated a marked increase in Fallypride BP in the dorsal putamen in both individuals. No changes were seen in control subjects. | Exercise subjects demonstrated improved turning performance, while control subjects did not. No participant improved in either UPDRS total or UPDRS III. |
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| del Olmo et al., [36] | Gait and fingertapping training with and without rhythmic auditory cues. | NA | 4 wks 5 times/wk 60 min |
PET imaging post-training revealed a metabolic increment in the right cerebellum (p < 0.001) and in the right parietal and temporal lobes (p < 0.001). | Coefficient of variation decrement for both fingertapping (p < 0.05) and gait (p < 0.01). No significant change on all other parameters. |
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| Sehm et al., 2013 | Balance training using a movable platform. | NA | 6 wks 1 time/wk 45 min |
Imaging analysis revealed a post-training increase in grey matter volume in the right hemisphere of the cerebellum (lobule V–VI) (p < 0.05). | Participants showed a significant increase in DBT (time in target). Results on BBS are not reported. |
Abbreviations: Exp—Experimental group, Con—Control group, BDNF—Brain-derived Neutrophic Factor, UPDRS—Unified Parkinson's Disease Rating Scale, PDQ-39—Parkinson's Disease Questionnaire-39, 6MWT—6-minute walk test, BBS—Berg Balance Scale, TUG—Timed Up and Go, AT—Aerobic training, ST—Strength training, LI—Low intensity, ZI—Zero intensity, NR—Not reported, EEG—Electroencephalogram, CSP—Cortical Silent Period, 8-FT—8 Foot Up and Go test, BST—Back Scratch Test, CSRT—Chair Sit and Reach Test, ACT—Arm Curl Test, CST—Chair Stand Test, 2-MST—2 Minute Step Test, 10mWT—10 meter Walk Test, TMS—Transcranial Magnetic Stimulation, PET—Positron Emission Tomography, BP—Binding Potential.