A randomised controlled cross-over trial of aerobic training versus Qigong in advanced Parkinson's disease.
OBJECTIVE
To investigate the effects of an aerobic training in subjects with Parkinson's disease (PD) as compared to a medical Chinese exercise (Qigong).


METHODS



METHODS
randomized controlled trial with a cross over design.


METHODS
PD out-patients referred to a Neurorehabilitation facility for the management of motor disability.


METHODS
26 PD patients in Hoehn and Yahr stage II to III under stable medication were randomly allocated to either Group AT1+QG2 (receiving 20 aerobic training sessions followed by 20 ''Qigong'' group sessions with 2 month interval between the interventions), or Group QG1+AT2 (performing the same treatments with an inverted sequence).


METHODS
clinical effects of treatment were sought through the Unified Parkinson's Disease Rating Scale (UPDRS), Brown's Disability Scale (B'DS), six-Minute Walking Test (6MWT), Borg scale for breathlessness, Beck Depression Inventory (BDI) and Parkinson's Disease Questionnaire-39 items (PDQ-39). A spirometry test and maximum cardiopulmonary exercise test (CPET) were also performed to determine the pulmonary function, the metabolic and cardio-respiratory requests at rest and under exercise. All measures were taken immediately before and at the completion of each treatment phase.


RESULTS
The statistical analysis focusing on the evolution of motor disability and quality of life revealed a significant interaction effect between group and time for the 6MWT (time x group effect: F: 5.4 P=0.002) and the Borg scale (time x group effect: F: 4.2 P=0.009). Post hoc analysis showed a significant increase in 6MWT and a larger decrease in Borg score after aerobic training within each subgroup, whereas no significant changes were observed during Qigong. No significant changes over time were detected through the analysis of UPDRS, B'DS, BDI and PDQ-39 scores. The analysis of cardiorespiratory parameters showed significant interaction effects between group and time for the Double Productpeak (time x group effect: F: 7.7 P=0.0003), the VO(2peak) (time x group effect: F: 4.8 P=0.007), and the VO(2)/kg ratio (time x group effect: F: 4.3 P=0.009), owing to their decrease after aerobic training to an extent that was never observed after Qigong treatment.


CONCLUSIONS
Aerobic training exerts a significant impact on the ability of moderately disabled PD patients to cope with exercise, although it does not improve their self-sufficiency and quality of life.
Burini
D
D
Neurorehabilitation Clinic, Department of Neurosciences, Politecnica University of Marche, Azienda Ospedali Riuniti, Ancona, Italy.
Farabollini
B
B
Iacucci
S
S
Rimatori
C
C
Riccardi
G
G
Capecci
M
M
Provinciali
L
L
Ceravolo
M G
MG
D000203:Activities of Daily Living; D000368:Aged; D001945:Breathing Exercises; D018592:Cross-Over Studies; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D018709:Statistics, Nonparametric; D016896:Treatment Outcome