Exercise Protocol Reduces Freezing of Gait Symptom of Parkinson’s Disease

Freezing of gait, one of the most disabling symptoms of Parkinson’s disease, manifests as sudden, short episodes of an inability to move the feet forward despite the intention to walk.// Brazilian researchers use complex training program to activate different motor and cognitive skills simultaneously and restore brain regions associated with freezing of gait in advanced-stage patients.

Researchers at the University of São Paulo (USP) in Brazil have shown that the disorder can be mitigated by means of a complex physical exercise protocol designed to stimulate different motor and cognitive skills simultaneously. An article on the study is published in the journal Movement Disorders.

Resistance training with instability modified brain regions associated with the physiological alterations typical of gait freezing, advances neuron activation and enhances brain plasticity in the affected regions.

“In addition to positive reports from the patients who took the training, clinical trials also evidenced significant improvements, especially a 60% reduction in gait freezing and a 70% reduction in motor symptoms of the disease. Another important outcome concerned the restoration of brain regions directly linked to the problem. Brain plasticity in these areas is a predictor of gait freezing mitigation”, Carla da Silva Batista, a researcher in USP’s School of Physical Education and Sports and first author of the article, told Agência FAPESP.

Reactivation of brain regions was substantiated by functional magnetic resonance imaging (fMRI). The protocol is the first to reduce symptoms of gait freezing, clinically assessed in an objective manner, and to record the associated pathophysiologic alterations in the brain.

Batista reveals that activation of the cerebellar area, associated with gait automaticity, and the mesencephalic locomotor region, associated with gait initiation and postural control, explains the reversal of gait freezing after adapted resistance training.

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Researchers designed the training program to address the difficulties typically experienced by patients with the disorder, and hence to include sensorimotor, weightlifting, motor coordination and cognitive demand exercises simultaneously.

Cognitive impairment is also a predictor of gait freezing, so cognitive tasks and dual-task exercises that require simultaneous attention to two activities or mental flexibility is essential to switch from one task to another.

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“Weights are part of most exercises in our program, which isn’t easy. It demands quite a lot of the patient. Many volunteers in our study said they enjoyed the challenge and felt stronger as time passed, which motivated them to continue”, said Batista.



Source-Medindia