Impact of Exercise in Parkinson's Disease

Persons with Parkinson's disease (PD) often experience non-motor symptoms such as cognitive
dysfunction and sleep problems. These symptoms can be more disabling than the motor symptoms
of PD. Medications are often not effective for treating these non-motor symptoms or can have
unwanted side effects. Non- medication treatments such as exercise are known to improve the
motor symptoms of PD, but the effect of exercise on cognition and sleep has not been fully
explored. This study investigates the impact of 16 weeks of supervised exercise, 3 times per
week, compared to no-exercise over the same duration, on cognition and sleep dysfunction.
Participants will be evaluated with cognitive tests and sleep studies before and after
16-weeks to determine the impact of this exercise intervention. The goal of this research is
to identify an intervention that will improve cognition and sleep in persons with PD.

Inclusion Criteria:

- a clinical diagnosis of idiopathic PD, based on the presence of bradykinesia as well
as rest tremor and/or rigidity;

- Hoehn and Yahr stage 2-3;

- age ≥ 45;

- on stable medications for at least 4 weeks prior to study entry;

- Participants must have Montreal Cognitive Assessment (MoCA) score ≥ 18;

- No contraindications to an exercise program, based on the Physical Activity Readiness
Questionnaire (PAR-Q), resting physical examination, and 12-lead electrocardiogram.

Exclusion Criteria:

- features suggestive of atypical Parkinsonism (cerebellar signs, supranuclear gaze
palsy, prominent autonomic failure, or prominent upper motor neuron signs);

- secondary Parkinsonism (multiple strokes with stepwise progression of Parkinsonism,
neuroleptic treatment at time of diagnosis, or multiple head injuries);

- inability to walk without a cane or walker;

- regular participation in an exercise program in the past 6 months;

- presence of deep brain stimulator; and

- untreated sleep apnea.