The Effects of Treadmill Versus Agility Training in Parkinson's Disease

Aim:

To determine the Responsiveness of the iMOBILITY in response to intensive physical therapy
exercise programs. (Is it sensitive to change?) Although exercise is thought to be the most
effective intervention for balance and gait in PD (compared to dopaminergic medication or
DBS surgery), the best exercise program for mobility in PD is unknown. The iMOBILITY will be
used to quantify balance and gait performance before and after two PT-supervised, intensive,
exercise programs, expected to improve balance and gait. The first program is a published
Treadmill training program and the second is the investigators new Agility training program
with sensorimotor progressions, targeted at specific impairments that underlie the
abnormalities of balance and gait in PD (developed for the Kinetics Foundation). This pilot
clinical trial will randomize 40 PD subjects into the two exercise programs at OHSU in
preparation for a larger clinical trial to determine the most effective exercise for
mobility disability in PD. The effects of exercise will be compared with no treatment
during a 5-week delay prior to start of exercise.

This trial will also determine the relative responsiveness (compared to traditional clinical
scales) of the iMOBILITY for testing the hypothesis that intensive exercise can improve
mobility in PD. We will use existing instruments (Berg Balance Scale, BEST of dynamic
balance, UPDRS, PDQ-39, 5 times sit-to-stand time and the Functional Performance Battery) to
show there is a difference between the exercise groups. Superior responsiveness of the
iMOBILITY system will be determined by larger differences with exercise intervention with
the iMOBILITY system than with traditional clinical measures of mobility in PD.