Exercise as it relates to Disease/Balance and High-intensity resistance training on persons with Parkinson's Disease

Parkinson’s disease is a neurodegenerative disorder affecting the physical, psychological, social, and the functional status of individuals. This impairment is affecting around 3.3% of the elderly population and increasing with ageing. The research is about the certain Parkinson’s disease called idiopathic Parkinson’s disease (IPD), this disease feature impairment of the resting muscle tone and voluntary movement. Why this disease effects the muscle is because of the loss of striatal dopamine in the nigrostriatal dopamine pathway. Exercise programs may be an effective way to delay or reverse the functional declines that Parkinson’s has on the individual. The benefits of physical activity in Parkinson’s disease is producing a substantial amount of evidence supporting exercise as being beneficial with the regards of the physical functions that people with PD have, this research finding has helped out that if balance training and high-intensity training on a person with IPD can help reduce the effect that PD has on the person.



History of Research
This research is from America, university medial center, Baltimore, Maryland. Florida state university, Tallahassee, Florida. The authors Mark A. Hirsch, PhD, Tonya Toole, PhD, Charles G. Maitland, MD, Robert A. Rider, PhD. Published by American congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation 2003.

Kind of Research
Exercise is a planned, structured physical activity which aims to improve one or more aspects of physical fitness. Not only exercise increases bodily function but evidence shows that the benefits of exercise can reduce mood disturbances such as depression among both young and older adults. Improvements in cognitive functioning as a result of exercise have also been widely demonstrated, with selective benefits for executive functioning. The idea of the research was to assess immediate and near-term effects of 2 exercise training programs for persons with IDP. Strategies for enhancing balance among adults with PD are needed, because in the absence of regular physical activity having both balance and muscle building exercises deteriorate in persons with PD. The reason behind this, is that people who have PD are frail and are more likely to be imbalanced and fall.

Research involvement
Fifteen people were chosen to be involved with this research. Two groups, a combined group (balance and resistance training) and balance group (balance training only). They under went a 10 week of 3 times a week on nonconsecutive days. The groups were assessed before, immediately after training, as well 4 weeks later/after the 10 weeks was up.
 * The high-intensity resistance group consist of knee extensors and flexors, ankle plantar flexion training and
 * for the balance training group, they under went a altered visual and somatosensory sensory conditions.

Results
Both of the types (balance and both balance and high-intensity) improved in the sensory orientation test performance. This effect was much larger in the combined group, both groups showed a slight increase, in they could balance longer before falling, and this effect persisted for at least 4 weeks. Muscle strength increase marginally in the balance group and substantially in the combined group, and this effect persisted for at least 4 weeks.
 * High-intensity resistance training increased lower-extremity muscle strength by 52% with combined training and 9% with balance-only training.
 * Training had 3 effects on balance:
 * 1. Training increased the latency of fall by 15%,
 * 2. Training reduced the percentage of trials resulting in falls by 20% from pretreatment to post-treatment, and
 * 3. Participation in the combined group improved the ability to maintain equilibrium, during destabilizing conditions.

Researchers interpret
There were four findings;
 * 1. the balance training group improved performance on the summary of balance measures and the help of not falling over quite quickly, this effect was enhanced by concurrent resistance training.
 * 2. Training increased latency to falling and reduced the percentage of trails resulting in falls, and this effect went on for the four weeks after training examine.
 * 3. The muscle strength of the individuals increase and this changed the ability of the individual could do before the experiment underwent, this change that happened went on till the four weeks after training examine.
 * 4. Extended the findings and helped improve the results by showing that balance and resistance- training benefits persist till the 4 weeks after examine even if the participants do not maintain their level of training.

Conclusion
By maintaining some optimal level of body strength in the old age of people with PD, it can prove to help or prevent falls from happening. The hypothesis of having the ability to interact in a strength and balance training, under the supervision can be enjoyable and safe to improve the skills and balance functions that people should have in preventing the risk of falling. Everyone in the old age that have been asked who have or are in a fear of falling, say that they would like to prevent themselves from falling and injuring themselves.

Implication
The four weeks after the training the participant were tested to see if the effects of the training programs have changed, the participant were in a detraining load for the four weeks to see if any changes happened over that period. It didn’t but an implication was that the researchers didn’t follow up after that to see if any of the participant kept training or if they didn’t keep training to see if the detraining affected them substantially.