#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The role of physical activity in the management of patients with Parkinson‘s dis­ease


Authors: M. Schön 1,2;  I. Straka 3;  M. Sedliak 4;  J. Ukropec 1;  P. Valkovič 3,5;  B. Ukropcová 1,2,4
Authors‘ workplace: Biomedicínske centrum, Slovenská, akadémia vied, Bratislava, Slovensko 1;  Ústav patologickej fyziológie, LF UK, v Bratislave, Slovensko 2;  II. neurologická klinika LF UK a UNB, Bratislava, Slovensko 3;  Katedra športovej kinantropológie, Fakulta telesnej výchovy a športu UK, v Bratislave, Slovensko 4;  Ústav normálnej a patologickej, fyziológie, Centrum experimentálnej, medicíny, Slovenská akadémia vied, Bratislava, Slovensko 5
Published in: Cesk Slov Neurol N 2019; 82(5): 496-504
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2019496

Overview

Parkinson‘s dis­ease (PD) is the second most prevalent neurodegenerative dis­ease. It is characterized by the progres­sive deterioration of motor as well as non-motor symp­toms, includ­­ing cognitive dysfunction, disorders of mood and sleep and gastrointenstinal symp­toms. Physical activity is a modifiable wel­l-established risk factor for PD and clinical intervention studies with regular exercise undoubtedly point to the beneficial ef­fects of aerobic as well as strength exercise train­­ing in patients with PD. Physical train­­ing improves 1. motor state, balance and functional capacity of skeletal muscles, thus reduc­­ing the risk of fal­ls; 2. physical fitness and general functional capacity of the patient; and 3. energy metabolism, reduc­­ing the risk of type 2 diabetes, which often accelerates progres­sion of PD. Moreover, physical activity and physical train­­ing improve quality of life by ameliorat­­ing both motor and non-motor symp­toms, thus slow­­ing down dis­ease progres­sion. Regular physical activity and exercise, based on individualized prescription and performed under the supervision of an experienced physician or exercise physiologist, are recom­mended as an integral part in the management of a patient with PD.

Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy.

The authors declare they have no potential 
conflicts of interest concerning drugs, products, or services used in the study.

Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.

 

 

M. Schön1,2, I. Straka3, M. Sedliak4, J. Ukropec1, P. Valkovič3,5, 
B. Ukropcová1,2,4

1 
Biomedicínske centrum, Slovenská akadémia vied, Bratislava, Slovensko

2 
Ústav patologickej fyziológie, LF UK v Bratislave, Slovensko

3 
II. neurologická klinika LF UK a UNB, Bratislava, Slovensko

4 
Katedra športovej kinantropológie, Fakulta telesnej výchovy a športu UK v Bratislave, Slovensko

5 
Ústav normálnej a patologickej fyziológie, Centrum experimentálnej medicíny, Slovenská akadémia vied, Bratislava, Slovensko

 

doc. MUDr. Barbara Ukropcová, Ph.D.

Biomedicínske centrum
Ústav experimentálnej 
endokrinológie

Slovenská akadémia vied

Dúbravská cesta 9

845 05 Bratislava

Slovensko

e-mail: barbara.ukropcova@savba.sk

 

Přijato k recenzi: 4. 3. 2019

Přijato do tisku: 2. 9. 2019

Keywords:

Parkinson’s disease – exercise – Physical activity


Sources

1. Cereda E, Barichel­la M, Pedrol­li C et al. Diabetes and risk of Parkinson dis­ease. Mov Disord 2013; 28(2): 2057. doi: 10.1002/ mds.25211.

2. Mantri S, Ful­lard ME, Duda JE et al. Physical activity in early Parkinson dis­ease. J Parkinsons Dis 2018; 8(1): 107– 111. doi: 10.3233/ JPD-171218.

3. van Nimwegen M. Speelman AD, Hofman-van Ros­sum EJ et al. Physical inactivity in Parkinson dis­ease. J Neurol 2011; 258(12): 2214– 2221. doi: 10.1007/ s00415-011-6097-7.

4. Mül­ler J, Myers J. As­sociation between physical fitnes­s, cardiovascular risk factors, and Parkinson dis­ease. Eur J Prevent Cardiol 2018; 25(13): 1409– 1415. doi: 10.1177/ 2047487318771168.

5. Can­n­­ing CG, Sher­rington C, Lord SR et al. Exercise for fal­ls prevention in Parkinson dis­ease: a ran­domized control­led trial. Neurology; 84(3): 304– 312. doi: 10.1212/ WNL.0000000000001155.

6. Qi Y, Takahashi N, Hileman SM et al. Adiponectin acts in the brain to decrease body weight. Nat Med 2004; 10(5): 524– 529. doi: 10.1038/ nm1029.

7. Iwabu M, Yamauchi T, Okada-Iwabu M et al. Adiponectin and AdipoR1 regulate PGC-1alpha and mitochondria by Ca(2+) and AMPK/ SIRT1. Nature 2010; 464(7293): 1313– 1319. doi: 10.1038/ nature08991.

8. Earhart GM, Falvo MJ. Parkinson dis­ease and exercise. Compr Physiol 2013; 3(2): 833– 848. doi: 10.1002/ cphy.c100047.

9. Kusminski CM, McTernan PG, Schraw T et al. Adiponectin complexes in human cerebrospinal fluid: distinct complex distribution from serum. Diabetologia 2007; 50(3): 634– 642. doi: 10.1007/ s00125-006-0577-9.

10. Zhang D, Wang X, Lu XY. Adiponectin exerts neurotrophic ef­fects on dendritic arborization, spinogenesis, and neurogenesis of the dentate gyrus of male mice. Endocrinology 2016; 157(7): 2853– 2869. doi: 10.1210/ en.2015-2078.

11. Biskup S, Gerlach M, Kupsch A et al. Genes as­sociated with Parkinson syndrome. J Neurol 2008; 255 (Suppl 5): 8– 17. doi: 10.1007/ s00415-008-5005-2.

12. Xu Q, Park Y, Huang X et al. Physical activities and future risk of Parkinson dis­ease. Neurology 2010; 75(4): 341– 348. doi: 10.1212/ WNL.0b013e3181ea1597.

13. Thacker EL, Chen H, Patel AV et al. Recreational physi­cal activity and risk of Parkinson’s dis­ease. Mov Disord 2008; 23(1): 69– 74. doi: 10.1002/ mds.21772.

14. Chen H, Zhang SM, Schwarzschild MA et al. Physical activity and the risk of Parkinson dis­ease. Neurology 2005; 64(4): 664– 669. doi: 10.1212/ 01.WNL.0000151960.28687.93.

15. Yaf­fe K, Haan M, Blackwell T et al. Metabolic syndrome and cognitive decline in elderly latinos: findings from the Sacramento Area Latino Study of Ag­­ing Study. J Am Geriatr Soc 2007; 55(5): 758– 762. doi: 10.1111/ j.1532-5415.2007.01139.x.

16. Franceschi C. Inflam­mag­­ing as a major characteristic of old people : can it be prevented or cured ? Nutr Rev 2007; 65 (12 Pt 2): S173– S176. doi: 10.1111/ j.1753-4887.2007.tb00358.x.

17. Kim TN, Choi KM. The implications of sarcopenia and sarcopenic obesity on cardiometabolic dis­ease. J Cell Biochem 2015; 116(7): 1171– 1178. doi: 10.1002/ jcb.25077.

18. Kalinkovich A, Livshits G. Sarcopenic obesity or obese sarcopenie: a cross talk between age-as­sociated adipose tis­sue and skeletal muscle inflam­mation as a main mechanism of the pathogenesis. Age­­ing Res Rev 2017; 35: 200– 221. doi: 10.1016/ j.ar­r.2016.09.008.

19. Sofic E, Lange KW, Jel­linger K et al. Reduced and oxi­dized glutathione in the substantia nigra of patients with Parkinson dis­ease. Neurosci Letters 1992; 142(2): 128– 130. doi: 10.1016/ 0304-3940(92)90355-b.

20. Banerjee R, Starkov AA, Beal MF et al. Biochimica et Biophysica Acta Mitochondrial dysfunction in the limelight of Parkinson dis­ease pathogenesis. Biochim Biophys Acta 2009; 1792(7): 651– 663. doi: 10.1016/ j.bbadis.2008.11.007.

21. Bies­sels GJ, Reagan LP. Hippocampal insulin resis­tance and cognitive dysfunction. Nat Rev Neurosci 2015; 16(11): 660– 671. doi: 10.1038/ nrn4019.

22. Richter EA, Hargreaves M. Exercise, GLUT4 and skele­tal muscle glucose uptake. Physiol Rev 2013; 93(3): 993– 1017. doi: 10.1152/ physrev.00038.2012.

23. Rowe GC, El-khoury R, Patten IS et al. PGC-1 a is Dispensable for exercise-induced mitochondrial bio­genesis in skeletal muscle. PLOS One 2012; 7(7): e41817. doi: 10.1371/ journal.pone.0041817.

24. Kuroda K, Tatara K, Takatorige T et al. Ef­fect of physi­cal exercise on mortality in patients with Parkinson’s dis­ease. Acta Neurol Scand 1992; 86(1): 55– 59. doi: 10.1111/ j.1600-0404.1992.tb08054.x.

25. Ahlskog JE. Does vigorous exercise have a neuroprotective ef­fect in Parkinson dis­ease? Neurology 2011; 77(3): 288– 294. doi: 10.1212/ WNL.0b013e318225ab66.

26. Lau YS, Patki G, Das’Panja K. Neuroprotective ef­fects and mechanisms of exercise in a chronic mouse model of Parkinson’s dis­ease with moderate neurodegeneration. Eur J Neurosci 2011; 33(7): 1264– 1274. doi: 10.1111/ j.1460-9568.2011.07626.x.

27. Schenkman M, Hall DA, Baron AE et al. Exercise for people in early- or mid-stage Parkinson dis­ease: a 16-month randomized control­led trial. Phys Ther 2012; 92(11): 1395– 1410. doi: 10.2522/ ptj.20110472.

28. Miyai I, Fujimoto Y, Ueda Y et al. Treadmill train­­ing with body weight support: its ef­fect on Parkinson’s dis­ease. Arch Phys Med Rehabil 2000; 81(7): 849– 852. doi: 10.1053/ apmr.2000.4439.

29. Miyai I, Fujimoto Y, Yamamoto H et al. Long-term ef­fect of body weight-supported treadmill train­­ing in Parkinson’s dis­ease: a randomized control­led trial. Arch Phys Med Rehabil 2002; 83(10): 1370– 1373. doi: 10.1053/ apmr.2002.34603.

30. Ramazzina I, Bernazzoli B, Costantino C. Clinical interventions in ag­­ing dovepress systematic review on strength train­­ing in Parkinson’s dis­ease: an unsolved question. Clin Interv Ag­­ing 2017; 12: 619– 628. doi: 10.2147/ CIA.S131903.

31. David FJ, Robichaud JA, Leurgans SE et al. Exercise improves cognition in Parkinson Dis­ease: The PRET-PD randomized clinical trial. Mov Disord 2015; 30(12): 1657– 1663. doi: 10.1002/ mds.26291.

32. Prodoehl J, Raf­ferty M, David FJ et al. Two year exercise program improves physical function in Parkinson dis­ease: the PRET-PD study. Neurorehabil Neural Repair 2015; 29(2): 112– 122. doi: 10.1177/ 1545968314539732.

33. Val­ls-Solé J, Pascual-Leone A, Brasil-Neto JP et al. Abnormal facilitation of the response to transcranial magnetic stimulation in patients with Parkinson’s dis­ease. Neurology 1994; 44(4): 735– 741. doi: 10.1212/ wnl.44.4.735.

34. Carvalho A, Barbirato D, Araujo N et al. Comparison of strength training, aerobic training, and additional physical ther­apy as supplementary treatments for Parkinson’s dis­ease: pilot study. Clin Interv Ag­­ing 2015; 10: 183– 191. doi: 10.2147/ CIA.S68779.

35. Cugusi L, Manca A, Dragone D et al. Nordic Walk­­ing for the management of people with Parkinson dis­ease: a systematic review. PM R 2017; 9(11): 1157– 1166. doi: 10.1016/ j.pmrj.2017.06.021.

36. van Eijkeren FJ, Reijmers RS, Kleinveld MJ et al. Nordic walk­­ing improves mobility in Parkinson’s dis­ease. Mov Disord 2008; 23(15): 2239– 2243. doi: 10.1002/ mds.22293.

37. Combs SA, Diehl MD, Chrzastowski C et al. Com­munity-based group exercise for persons with Parkinson dis­ease: a randomized control­led trial. NeuroRehabilitation 2013; 32(1): 117– 124. doi: 10.3233/ NRE-130828.

38. Duncan RP, Earhart GM. Randomized control­led trial of com­munity-based danc­­ing to modify dis­ease progres­sion in Parkinson dis­ease. Neurorehabil Neural Repair 2012; 26(2): 132– 143. doi: 10.1177/ 1545968311421614.

39. McKee KE, Hackney ME. The ef­fects of adapted tango on spatial cognition and dis­ease severity in Parkinson’s dis­ease. J Mot Behav 2013; 45(6): 519– 529. doi: 10.1080/ 00222895.2013.834288.

40. Hackney ME, Earhart GM. Ef­fects of dance on movement control in Parkinson’s dis­ease: a comparison of Argentine tango and American bal­lroom. J Rehabil Med 2009; 41(6): 475– 481. doi: 10.2340/ 16501977-0362.

41. Yang Y, Li X, Gong L et al. Tai Chi for improvement of motor function, balance and gait in Parkinson dis­ease: a systematic review and meta-analyses. PLOS One 2014; 9(7): e102942. doi: 10.1371/ journal.pone.0102942.

42. Yang YR, Lee YY, Cheng SJ et al. Downhill walk­­ing train­­ing in individuals with Parkinson’s dis­ease. Am J Phys Med Rehabil 2010; 89(9): 706– 714. doi: 10.1097/ PHM.0b013e3181e721c5.

43. Broeders M, Velseboer DC, de Bie R et al. Cognitive change in newly-dia­gnosed patients with Parkinson’s dis­ease: a 5-year fol­low-up study. J Int Neuropsychol Soc 2013; 19(6): 695– 708. doi: 10.1017/ S1355617713000295.

44. Hely MA, Reid WG, Adena MA et al. The Sydney multicenter study of Parkinson’s dis­ease: the inevitability of dementia at 20 years. Mov Disord 2008; 23(6): 837– 844. doi: 10.1002/ mds.21956.

45. Oguh O, Eisenstein A, Kwasny M et al. Back to the basics: regular exercise matters in Parkinson’s dis­ease: results from the National Parkinson Foundation QII registry study. Park Relat Disord 2014; 20(11): 1221– 1225. doi: 10.1016/ j.parkreldis.2014.09.008.

46. Tanaka K, Quadros AC Jr, Santos RF et al. Benefits of physical exercise on executive functions in older people with Parkinson’s dis­ease. Brain Cogn 2009; 69(2): 435– 441. doi: 10.1016/ j.bandc.2008.09.008.

47. Cruise KE, Bucks RS, Loftus AM et al. Exercise and Parkinson’s: benefits for cognition and quality of life. Acta Neurol Scand 2011; 123(1): 13– 19. doi: 10.1111/ j.1600-0404.2010.01338.x.

48. da Silva FC, Iop RD, de Oliveira LC et al. Ef­fects of physical exercise programs on cognitive function in Parkinson’s dis­ease patients: a systematic review of ran­domized control­led trials of the last 10 years. PLoS One 2018; 13(2): e0193113. doi: 10.1371/ journal.pone.0193113.

49. Nyberg J, Aberg MA, Schiöler L et al. Cardiovascular and cognitive fitness at age 18 and risk of early-onset dementia. Brain 2014; 137 (Pt 5): 1514– 1523. doi: 10.1093/ brain/ awu041.

50. Kandiah N, Zainal NH, Narasimhalu K et al. Hippocampal volume and white matter dis­ease in the prediction of dementia in Parkinson’s dis­ease. Parkinsonism Relat Disord 2014; 20(11): 1203– 1208. doi: 10.1016/ j.parkreldis.2014.08.024.

51. Erickson KI, Prakash RS, Voss MW et al. Aerobic fitness is as­sociated with hippocampal volume in elderly humans. Hippocampus 2009; 19(10): 1030– 1039. doi: 10.1002/ hipo.20547, 10.1002/ hipo.20547.

52. Rodrigues de Paula F, Teixeira-Salmela LF, Coelho de Morais Faria CD et al. Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson’s dis­ease. Mov Disord 2006; 21(8): 1073– 1077. doi: 10.1002/ mds.20763.

53. Elbers R, van Wegen EE, Rochester L et al. Is impact of fatigue an independent factor as­sociated with physical activity in patients with idiopathic Parkinson’s dis­ease? Mov Disord 2009; 24(10): 1512– 1518. doi: 10.1002/ mds.22664.

54. Riedel O, Klotsche J, Spottke A et al. Frequency of dementia, depres­sion, and other neuropsychiatric symp­toms in 1,449 outpatients with Parkinson’s dis­ease. J Neurol 2010; 257(7): 1073– 1082. doi: 10.1007/ s00415-010-5465-z.

55. Kvam S, Kleppe CL, Nordhus IH et al. Exercise as a treatment for depres­sion: a meta-analysis. J Af­fect Disord 2016; 202: 67– 86. doi: 10.1016/ j.jad.2016.03.063.

56. Gujral S, Aizenstein H, Reynolds CF et al. Exercise ef­fects on depres­sion: pos­sible neural mechanisms. Gen Hosp Psychiatry 2017; 49: 2– 10. doi: 10.1016/ j.genhosppsych.2017.04.012.

57. Yuan TF, Paes F, Arias-Car­rión O et al. Neural Mecha­nisms of exercise: anti-depres­sion, neurogenesis, and serotonin signaling. CNS Neurol Disord Drug Targets 2015; 14(10): 1307– 1311. doi: 10.2174/ 1871527315666151111124402.

58. Wu P, Lee M, Huang T. Ef­fectiveness of physical activi­ty on patients with depres­sion and Parkinson’ s dis­ease : a systematic review. PLoS One 2017; 12(7): e0181515. doi: 10.1371/ journal.pone.0181515.

59. Krumpolec P, Val­lova S, Slobodova L et al. Aerobic-strength exercise improves metabolism and clinical state in Parkinson’s dis­ease patients. Front Neurol 2017; 8: 698. doi: 10.3389/ fneur.2017.00698.

60. Dereli EE, Yaliman A. Comparison of the ef­fects of a physiotherapist- supervised exercise program­me and a self-supervised exercise program­me on quality of life in patients with Parkinson’ s dis­ease. Clin Rehabil 2010; 24(4): 352– 362. doi: 10.1177/ 0269215509358933.

61. El­lis T, Latham NK, Deangelis TR et al. Feasibility of a virtual exercise coach to promote walk­­ing in com­munity-dwel­l­­ing persons with Parkinson Dis­ease. Am J Phys Med Rehabil 2014; 92(6): 472– 485. doi: 10.1097/ PHM.0b013e31828cd466.

62. Ahlskog JE. Aerobic exercise: evidence for a direct brain ef­fect to slow Parkinson dis­ease progres­sion. Mayo Clin Proc 2018; 93(3): 360– 372. doi: 10.1016/ j.mayocp.2017.12.015.

63. Alonso-Frech F, Sanahuja JJ, Rodriguez AM. Exercise and physical ther­apy in early management of Parkinson dis­ease. Neurologist 2011; 17 (6 Suppl 1): S47– S53. doi: 10.1097/ NRL.0b013e31823968ec.

64. da Silva PG, Domingues DD, de Carvalho LA et al. Neurotrophic factors in Parkinson’s dis­ease are regulated by exercise: evidence-based practice. J Neurol Sci 2016; 363: 5– 15. doi: 10.1016/ j.jns.2016.02.017.

65. Gerecke KM, Jiao Y, Pani A et al. Exercise protects against MPTP-induced neurotoxicity in mice. Brain Res 2010; 1341: 72– 83. doi: 10.1016/ j.brainres.2010.01.053.

66. Til­lerson JL, Cohen AD, Caudle WM et al. Forced nonuse in unilateral parkinsonian rats exacerbates injury. J Neurosci 2002; 22(15): 6790– 6799. doi: 20026651.

67. Kordower JH, Bjorklund A. Trophic factor gene ther­a­­-py for Parkinson’s dis­ease. Mov Disord 2013; 28(1): 96– 109. doi: 10.1002/ mds.25344.

68. Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the ef­fects of exercise on brain-derived neurotrophic factor. J Psychiatr Res 2015; 60: 56– 64. doi: 10.1016/ j.jpsychires.2014.10.003.

69. Frazzitta G, Balbi P, Maestri R et al. The beneficial role of intensive exercise on Parkinson dis­ease progres­sion. Am J Phys Med Rehabil 2013; 92(6): 523– 532. doi: 10.1097/ PHM.0b013e31828cd254.

70. Marusiak J, Zeligowska E, Mencel J et al. Interval training-induced al­leviation of rigidity and hypertonia in patients with Parkinson’s dis­ease is accompanied by increased basal serum brain-derived neurotrophic factor: a repeated-measures, case series pilot study. J Rehabil Med 2015; 47(4): 372– 375. doi: 10.2340/ 16501977-1931.

71. Chauhan NB, Siegel GJ, Lee JM. Depletion of glial cell line-derived neurotrophic factor in substantia nigra neurons of Parkinson’s dis­ease brain. J Chem Neuroanat 2001; 21(4): 277– 288. doi: 10.1016/ S0891-0618(01)00115-6.

72. Colcombe SJ, Kramer AF, Erickson KI et al. Cardiovascular fitnes­s, cortical plasticity, and aging. Proc Natl Acad Sci 2004; 101(9): 3316– 3321. doi: 10.1073/ pnas.0400266101.

73. Cotman CW, Berchtold NC, Christie LA. Exercise builds brain health: key roles of growth factor cascades and inflam­mation. Trends Neurosci 2007; 30(9): 464– 472. doi: 10.1016/ j.tins.2007.06.011.

74. Marques-Aleixo I, Oliveira PJ, Moreira PI et al. Physi­cal exercise as a pos­sible strategy for brain protection: evidence from mitochondrial-mediated mechanisms. Prog Neurobio­l 2012; 99(2): 149– 162. doi: 10.1016/ j.pneurobio­.2012.08.002.

75. Difrancisco-Donoghue J, Lamberg EM, Rabin E et al. Ef­fects of exercise and B vitamins on homocysteine and glutathione in Parkinson dis­ease : a randomized trial. Neurodegenerative Dis 2012; 10(1– 4): 127– 134. doi: 10.1159/ 000333790.

76. Chen­naoui M, Drogou C, Geof­froy H et al. Ef­fects of exercise on brain and peripheral inflam­matory bio­markers induced by total sleep deprivation in rats. J Inflamm 2015; 12: 56. doi: 10.1186/ s12950-015-0102-3.

77. Reuter I, Harder S, Engelhardt M et al. The ef­fect of exercise on pharmacokinetics and pharmacodynamics of levodopa. Mov Disord 2000; 15(5): 862– 868. doi: 10.1002/ 1531.

78. van Kes­sel SP, Frye AK, El-Gendy AO et al. Gut bacterial tyrosine decarboxylases restrict levels of levodopa in the treatment of Parkinson dis­ease. Nat Com­mun; 10(1): 310. doi: 10.1038/ s41467-019-08294-y.

79. Frazzitta G, Bertotti G, Morel­li M et al. Rehabilitation improves dyskinesias in Parkinsonian patients : a pilot study compar­­ing two dif­ferent rehabilitative treatments. Neurorehabilitation 2012; 30(4): 295– 301. doi: 10.3233/ NRE-2012-0758.

80. Pedersen BK, Saltin B. Exercise as medicine –  evidence for prescrib­­ing exercise as ther­apy in 26 dif­ferent chronic dis­eases. Scand J Med Sci Sport 2015; 25 (Suppl 3): 1– 72. doi: 10.1111/ sms.12581.

81. Fisher BE, Wu AD, Salem GJ et al. The ef­fect of exercise train­­ing in improv­­ing motor performance and corticomotor excitability in people with early Parkinson’s dis­ease. Arch Phys Med Rehabil 2008; 89(7): 1221– 1229. doi: 10.1016/ j.apmr.2008.01.013.

82. Keus S, Mun­neke M, Graziano M et al. European Physiother­apy Guideline for Parkinson’ s Dis­ease. Mov Disord 2013; 28 (Suppl 1): 1077

83. Matsumoto Y, Yanase D, Noguchi-Shinohara Met al. Blood-brain bar­rier permeability cor­relates with medial temporal lobe atrophy but not with amyloid-beta protein transport across the blood-brain bar­rier in Alzheimer’s dis­ease. Dement Geriatr Cogn Disord 2007; 23(4): 241– 245. doi: 10.1159/ 000100019.

84. Gal­lo PM, Mendola NM. Exercise prescription recom­­-mendations for Parkinson’ s dis­ease. Strength Cond J 2018; 40(5): 126– 133. doi: 10.1519/ SSC.0000000000000415.

85. American col­lege of Sports Medicine. ACSM‘s guidelines for exercise test­­ing and prescription. 9th ed. Philadelphia: Lippincott Wil­liams & Wilkins 2014.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 5

2019 Issue 5

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#