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The effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly patients with Parkinson disease: a pilot randomized controlled single-blinded trial
Ferraz DD, Trippo KV, Duarte GP, Neto MG, Bernardes Santos KO, Filho JO
Archives of Physical Medicine and Rehabilitation 2018 May;99(5):826-833
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD). DESIGN: A pilot randomized, controlled, single-blinded trial. SETTING: A state reference health care center for elderly, a public reference outpatient clinic for the elderly. PARTICIPANTS: Elderly individuals (>= 60 years of age; n = 62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank. INTERVENTION: The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n = 22); group 2 (G2) performed bicycle exercise (n = 20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n = 20). MAIN OUTCOME MEASURES: The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale. RESULTS: All groups showed significant improvements in 6MWT (G1 p = 0.008; G2 p = 0.001; G3 p = 0.005), SRT (G1 p < 0.001; G2 p = 0.001; G3 p = 0.003), and WHODAS 2.0 (G1 p = 0.018; G2 p = 0.019; G3 p = 0.041). Only G3 improved gait speed in 10MWT (p = 0.11). G1 (p = 0.014) and G3 (p = 0.004) improved quality of life. No difference was found between groups. CONCLUSIONS: Eight weeks of exergaming can improve the walking capacity of elderly patients with PD. Exergame training had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants.

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