This study will compare the effects of two Chinese and one Western exercise modalities on
the signs and symptoms of Parkinson's disease.
The long-term goal of this project is to study the effects of different exercise modalities
on Parkinson's disease (PD). PD is a disorder whose primary disability stems from motor
dysfunction including balance. Recent studies have shown that the risk of falling in the
elderly can be reduced through the practice of the Chinese complementary and alternative
medicine (CAM) such as T'ai Chi Chuan (TCC). This finding may be highly significant to PD.
Although a recent report from Emory suggests PD patients can do well with aerobic (walk-run)
exercise training (AET), it is still unclear whether the potential anti-Parkinsonian effect
of such modalities is secondary to improved physical fitness (CRF), motor control or both.
CAM interventions such as TCC may offer a unique opportunity to examine these fundamental
In PD we hypothesize that exercise training will reduce primary and secondary disability and
that some of these changes represent adaptive reprogramming of central motor pathways. We
will conduct a controlled double-blind, 16-week dose-response study of exercise based on
caloric expenditure and thus on the cardiorespiratory fitness effects of exercise (CRF).
The treatments will be Qi Gong (minimal caloric expenditure), TCC (low expenditure), and
walk-cycle AET (moderate expenditure).
We will examine exercise-induced change in motor control using quantitative measures of
motor disability, including dynamic gait stability measures. We will also examine exercise
effects on central and peripheral indices of Parkinsonian motor disability.
A caloric "dose-response" effect of exercise would suggest CRF is a major determinant of the
anti-Parkinsonian effects of exercise. If the Chinese modalities are as effective or
superior to AET however, this would suggest that other mechanisms such as change in central
motor programming may be playing a role (e.g. relaxation effects, reinforcement of central
motor programs?). A better understanding of exercise-induced neural plasticity and motor
control would offer a significant, and heretofore unexploited rehabilitative potential in
- Ambulatory patients with Parkinson's Disease, defined as a clinical state in which at
least two of these four cardinal features are present- 1) slowness of movement, 2)
tremor at rest, 3) muscular rigidity, 4) gait disturbance or posture imbalance.
- Ambulatory patients with Parkinson's Disease not exercising regularly more than 2x
per week. Willing to be randomly assigned to 1 of the 3 exercise modalities: Tai
Chi, Qi Gong and Aerobic exercise.
NOTE THAT PARTICIPATION IN THE STUDY REQUIRES BI-WEEKLY PARTICIPATION IN A 16-WEEK
SUPERVISED EXERCISE PROGRAM PLUS RELATED EVALUATIONS AT EMORY. ACCORDINGLY, RECRUITMENT IS
LIMITED TO LOCAL PATIENTS.