title: Intensive rehabilitation treatment in early Parkinson's disease: a randomized pilot study with a 2-year follow-up.
abstract: BACKGROUND
  Although physical exercise improves motor aspects of Parkinson's disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression.
  
  
  METHODS
  Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson's Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later.
  
  
  RESULTS
  Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were better than at T0 (all Ps < .03). No changes were noted in the Control Group. l-dopa equivalent dosages increased significantly only in the Control Group (P = .0015), with a decrease in the percentages of patients in monotherapy (T1 40%; T2, T3, and T4 20%). In the MIRT Group, the percentages of such patients remained higher (T1 and T2 100%; T3 89%; T4 75%).
  
  
  CONCLUSIONS
  These results suggest that MIRT might slow down the progression of motor decay, it might delay the need for increasing drug treatment, and thus, it might have a neuroprotective effect.
authors.affiliation: "Moriggia-Pelascini" Hospital, Gravedona ed Uniti, Italy Fondazione Europea Ricerca Biomedica FERB, "S. Isidoro" Hospital, Trescore Balneario, Italy frazzittag62@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
authors.affiliation: Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Maestri
authors.affiliation: Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Bertotti
authors.affiliation: Macchi Foundation, Varese and Department of Rehabilitation, "Le Terrazze" Hospital, Cunardo, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Riboldazzi
authors.affiliation: Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy.
authors.forename: Natalia
authors.initials: N
authors.lastname: Boveri
authors.affiliation: Gallarate Hospital, Gallarate, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Perini
authors.affiliation: Tradate Hospital, Tradate, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Uccellini
authors.affiliation: Valle Camonica Hospital, Esine, Italy.
authors.forename: Marinella
authors.initials: M
authors.lastname: Turla
authors.affiliation: University of the Eastern Piedmont, Novara, Italy.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Comi
authors.affiliation: Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.affiliation: City University of New York Medical School, New York, NY, USA.
authors.forename: M Felice
authors.initials: MF
authors.lastname: Ghilardi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000627:therapeutic use; D018450:Disease Progression; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking
chemical_list: D000978:Antiparkinson Agents; D007189:Indans; C031967:rasagiline
keywords: Parkinson’s disease; neuroplasticity; rehabilitation