Effects of Physical Activity on Pakinson's Disease Patients

Introduction

Parkinson Disease (PD) is disabling movement disorder caused by the degeneration of dopamine (DA) producing neurons of the substantia nigra pars compacta (SNpc). It is characterized by a wide range of motor and non-motor symptoms (NMS). At the date, there is no proven treatments that can stop or even slow the disease progression and the therapeutic approaches available are only used to target symptom management and enhance the patient’s quality of life (QOL) (Amara et al., 2019). Additionally, medications are usually inadequate and can have side effects. Hence, the role of nonpharmacologic therapies in the treatment of PD is of great interest and can be useful to delay and slow the DA neuron degeneration. It is estimated that over the coming decades the number of PD patients will increase drastically. Thus, it is crucial to implement interventions that could minimize the morbidity and enhance the patients’ QOL. Recently, physical activity (PA) has gained increasing attention in the research literature as it plays a paramount role in the prevention and treatment of several conditions. PA is broadly defined as any bodily movement induced by skeletal muscles that result in energy expenditure, which can be measured in kilocalories (Bhalsing, Abbas and Tan, 2018) ; (P. Wu, Lee and Huang, 2017). In PD, increasing evidence outpoint the important role of PA in the management and even the prevention of the disease. Exercise training is beneficial to patients with PD, especially those in the early stages of the disease (Crizzle and Newhouse, 2006). Indeed, PA or exercise has been proved as effective complement to the pharmacological approaches available for the control of both motor and nonmotor symptoms in PD (Coe et al., 2018), and may affect disease onset, severity, and progression in PD (Mantri et al., 2018) (Bhalsing, Abbas and Tan, 2018) (Lauz, 2016). Moreover, PA seems to improve mobility, gait, balance and muscle strength of people living with PD (Lauz, 2016). Additionally, it has been suggested that higher levels of PA are associated with reduced risk of developing PD (Amara et al., 2019). For these reasons, PA assessment is one component of the quality guidelines of the American Academy of Neurology for patients with PD (Factor et al., 2016). Therefore, it is important to understand when PA clearly promotes health, when those advantages are less certain, and when further research is required. This chapter will give an overview of the effects of PA on patients with PD.