Exercise, Physical Function, and Parkinson’s Disease
Currently we are comparing the benefits of three different exercise interventions for people who have Parkinson’s disease. The interventions include the following: 1) usual care, in which the participant performs exercises recommended by the National Parkinson’s Foundation; 2) aerobic conditioning in which the participant exercises on a treadmill, bicycle, or elliptical trainer; flexibility and function in which the participant first is learns specific exercises (one-on-one with the physical therapist) to improve axial flexibility and then participates in a group exercise with exercises designed to incorporate flexibility in the context of balance and function.
Participants exercise in a supervised setting for four months and then exercise on their own (with once monthly sessions) for an additional year (16 months total). Our primary outcomes are at 10 months and our goal is to determine which of these three exercise approaches best improves balance, economy of movement and overall functional ability. In addition, our secondary goals are to examine specificity of treatment at 4 months and to determine which exercise the participants can continue with on their own for best outcomes at 16 months.
Economy of Movement in People who have Parkinson’s Disease
People with Parkinson’s disease (PD) have increased energy expenditure during walking (i.e., poor walking economy) compared to similarly aged healthy adults. The implication of poor walking economy for individuals with PD is that the relative intensity of walking is high. This high intensity of walking could contribute to excessive fatigue, a major problem that develops early in the disease process.
The goal of this research is to determine the extent to which factors specific to PD explain variability in walking economy above and beyond typical aging.
Critical Illness Weakness
Moss M, (PI), Nordon-Craft A, Schenkman M, Quan D
This investigation is designed to diagnose and characterize individuals who are critically ill and require mechanical ventilation for at least seven days. An important part of the investigation is designed to characterize impairments and functional limitations of these individuals and to determine the benefits of physical therapy intervention.
Participants are randomly assigned to a physical intervention program, specifically tailored to individuals in the ICU, or to usual care. They are treated for a month, beginning in the ICU and continuing on the medical ward and / or home, depending on their length of hospital stay. The goal is to determine whether the physical intervention improves outcomes, both immediately and after six months.