Exercise and Parkinson's: Comparing Interventions and Exploring Neural Mechanisms
Exercise and Parkinson's: Comparing Interventions and Exploring Neural Mechanisms
Parkinson disease (PD) is characterized by substantial disability and reduced quality of
 life, both of which can be attributed in large part to difficulties with walking. Evidence
 suggests that exercise may be an important addition to traditional treatments, particularly
 with respect to addressing walking problems. In particular, dance and treadmill training have
 been individually shown to improve walking performance and quality of life. At present it is
 not clear whether dance or treadmill training have similar effects or if one is superior to
 the other. Furthermore, our understanding of the means by which these exercise interventions
 convey benefits is extremely limited. This study aims to address these knowledge gaps by
 directly comparing dance, treadmill training and stretching (control group). The primary area
 of interest is the effects on gait, with secondary measures of disease severity, balance, and
 quality of life. The investigators will determine not only the effects of the interventions
 on walking performance, but will also investigate the effects of the interventions on
 connections between different parts of the brain and on brain function during imagined
 walking tasks using functional magnetic resonance imaging (fMRI). Participants will be
 randomly assigned to dance, treadmill training, or a stretching/flexibility control group.
 Participants will be assessed over a period of 6 months at 3 different time points. The
 investigators hypothesize that both dance and treadmill training will lead to improvements in
 forward walking, but that dance will result in greater improvements in backward walking
 compared to treadmill training. Furthermore, the investigators hypothesize that the tango and
 treadmill interventions will have different effects of brain function and brain connections.
 The investigators expect dance to enhance the activity and connections of particular brain
 regions and treadmill training to enhance activity and connections of different brain
 regions. The investigators do not expect changes in brain activity or connections in the
 control group.
Inclusion Criteria:

 1. diagnosis of Parkinson disease

 2. at least grade 3/5 strength and normal joint ranges of motion in both legs,

 3. vision corrected to 20/40 or better,

 4. able to walk independently for 10 feet with or without an assistive device, 5) normal
 gross somatosensory function in the feet (2-point discrimination, vibration, joint
 kinesthesia, and light touch),

 6) no history of vestibular disease, 7) no evidence of dementia

 Exclusion Criteria:

 1. medical condition for which exercise is contraindicated,

 2. evidence of abnormality other than PD-related changes on brain imaging,

 3. history or evidence of neurological deficit other than PD that could interfere, such
 as previous stroke or muscle disease,

 4. history or evidence of orthopedic or muscular problem,

 5. failed to pass magnetic resonance imaging screening procedure