Motor Responses To Patient-Specific Adaptive Dynamic Cycling In Individuals With Deep Brain Stimulation

Parkinson’s disease (PD) is a neurological disorder associated with a degeneration of dopaminergic neurons within the substantia nigra of the brain. PD is characterized by the presence of symptoms including bradykinesia, tremor, postural instability, dyskinesia, cognitive impairment, and speech disorders. High-cadence dynamic cycling has been shown to be an effective therapy for improving motor symptoms in individuals with PD. The number of individuals with PD who have undergone deep brain stimulation (DBS) surgery has grown substantially in effort to treat the symptoms associated with the disease. Presently, there is very little known regarding potential benefits of exercise therapies in individuals with PD and DBS. PURPOSE: To compare PD motor symptom responses following 12 sessions of patient-specific adaptive dynamic cycling (PSADC) in individuals with and without DBS. METHODS: 13 individuals (DBS: n = 6; non-DBS: n = 7) with PD (Hoehn and Yahr Stage 1-5) were recruited to perform 12 sessions of PSADC. Sessions consisted of a 5-minute warm up at 60 revolutions per minute (rpm), 30-minute exercise session (80 rpm), and 5-minute cool down (60 rpm). Resistance was optimized weekly based on the individual’s entropy of cadence. The outcome measures assessed were Unified Parkinson’s Disease Rating Scale-III (UPDRS-III) score and Timed Up and Go (TUG). UPDRS-III and TUG were assessed in all participants pre- and post- intervention. Two-way analysis of variance (ANOVA) was performed to compare differences in outcomes between groups. RESULTS: There was a significant main effect of time for UPDRS-III (DBS: Pre: 32.7, Post: 27.5; non-DBS: Pre: 32.9, Post: 27.4; F = 24.245, p < .001). However, improvements were not significantly different between DBS and non-DBS (F = .015, p = .905) following the intervention. No significant main effect of time for TUG was found from pre- to post-intervention (F = 1.580, p = .237). CONCLUSION: Motor responses were similar amongst individuals with and without DBS. These results suggest that PSADC may be beneficial for improving motor symptoms in individuals with DBS. These findings will also be valuable in furthering the development of machine learning algorithms to appropriately predict exercise prescriptions for individuals with PD and DBS. Davis Phinney Foundation