title: Resistance Training with Instability for Patients with Parkinson's Disease.
abstract: This randomized controlled trial compared the effects of resistance training (RT) and RT with instability (RTI) on the timed up and go test (TUG), on-medication Unified Parkinson's Disease Rating Scale part III motor subscale score (UPDRS-III), Montreal Cognitive Assessment (MoCA) score, Parkinson's Disease Questionnaire (PDQ-39) score, and muscle strength in the leg press exercise (one-repetition maximum) of patients with Parkinson's disease (PD).
  
  
  
  Thirty-nine patients with moderate to severe PD were randomly assigned to a nonexercising control group (C), RT group, and RTI group. The RT and RTI groups performed progressive RT twice a week for 12 wk. However, only the RTI group used high motor complexity exercises (i.e., progressive RT with unstable devices), for example, half squat exercise on the BOSU® device. The primary outcome was mobility (TUG). The secondary outcomes were on-medication motor signs (UPDRS-III), cognitive impairment (MoCA), quality of life (PDQ-39), and muscle strength (one-repetition maximum).
  
  
  
  There were no differences between RTI and RT groups for any of the outcomes at posttraining (P > 0.05). However, there were differences between RTI and C groups in the TUG, MoCA, and muscle strength values at posttraining (P < 0.05). Only the RTI group improved the TUG (-1.9 s), UPDRS-III score (-4.5 score), MoCA score (6.0 score), and PDQ-39 score (-5.2 score) from pre- to posttraining (P < 0.001). Muscle strength improved for both training groups (P < 0.001). No adverse events were reported during the trial.
  
  
  
  Both training protocols improved muscle strength, but only RTI improved the mobility, motor signs, cognitive impairment, and quality of life, likely because of the usage of high motor complexity exercises. Thus, RTI may be recommended as an innovative adjunct therapeutic intervention for patients with PD.
authors.affiliation: 1Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, BRAZIL; 2Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL; 3Department of Neurological Sciences, Rush University Medical Center, Chicago, IL; 4Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, BRAZIL; 5Posture and Gait Studies Lab, São Paulo State University at Rio Claro, Rio Claro, BRAZIL; 6Faculty of Medical Science, University of São Paulo, São Paulo, BRAZIL; 7Department of Psychobiology, Center for Psychobiology and Exercise Studies, University Federal de São Paulo, São Paulo, BRAZIL.
authors.forename: Carla
authors.initials: C
authors.lastname: Silva-Batista
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Corcos
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
authors.forename: Hélcio
authors.initials: H
authors.lastname: Kanegusuku
authors.forename: Lilian Teresa Bucken
authors.initials: LT
authors.lastname: Gobbi
authors.forename: Maria Elisa Pimentel
authors.initials: ME
authors.lastname: Piemonte
authors.forename: Eugenia Casella Tavares
authors.initials: EC
authors.lastname: Mattos
authors.forename: Marco Tuúlio
authors.initials: MT
authors.lastname: DE Mello
authors.forename: Cláudia L M
authors.initials: CL
authors.lastname: Forjaz
authors.forename: Valmor
authors.initials: V
authors.lastname: Tricoli
authors.forename: Carlos
authors.initials: C
authors.lastname: Ugrinowitsch
mesh_terms: D000368:Aged; D003071:Cognition; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength; D010300:Parkinson Disease / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training