Telephone-linked Home-based Exercise Training in PD

Background/Rationale:

Nonmotor symptoms in Parkinson's disease (PD) are thought to be present from the early stages
of disease and are often more disabling and resistant to treatment than motor symptoms. One
of the most important and serious of these symptoms is depression. However, there is no
consensus on best pharmacological treatment for depression in PD as efficacy is lacking and
there is much concern about polypharmacy and safety of various antidepressant medications.
Therefore, it is essential that the investigators characterize the effects of
nonpharmacological interventions on depression in PD. A number of studies have shown
significant benefits of exercise in reducing depressive symptoms. Emerging studies indicate
similar benefits of exercise in the form of resistance training in limiting depression in
older adults as well as in those with PD.

Objective:

The investigators hypothesize that a home-based exercise intervention will reduce depression
in Veterans with depression in PD.

Methods:

The proposed study is a randomized, controlled trial of a structured exercise intervention,
evaluating effects on depression. Community-dwelling Veterans with depression in PD will be
randomized to the exercise intervention or a health education control intervention.
Participants will be male and female Veterans with a physician diagnosis of idiopathic,
typical PD, with at least 2 of 3 cardinal signs of PD, response to dopaminergic medication,
and depression. The interventions will last 6 months.

Inclusion Criteria:

- Physician diagnosis of idiopathic, typical Parkinson's disease (PD)

- At least 2 of 3 cardial signs of PD

- Response to dopaminergic medication

- Depression

Exclusion Criteria:

- Angina pectoris

- History of myocardial infarction within 6 months

- History of ventricular dysrhythmia requiring current therapy