Physical rehabilitation complements the treatment of Parkinson's disease (PD). The applied physical exercises are effective in PD by promoting activity-dependent neuroplasticity. The main aim of this study was to assess the effect of a 16-week moderate-intensity functional physical rehabilitation program (FPR) on the concentration of mature brain-derived neurotrophic factor (BDNF) and its precursor (proBDNF) in blood serum and the severity of symptoms and quality of life in people with PD. People with PD (Hoehn and Yahr stage 3) were randomly assigned to the experimental (FPR) and control (CG) groups. FPR participated in movement training to improve functional mobility, motor coordination, and balance. Pre- and post-intervention assessments included serum levels of proBDNF, mature BDNF, MDS-UPDRS sub-scales, and the PDQ-39 quality of life measured. In the FPR group, a statistically significant increase in serum proBDNF levels by 39.42% (p = 0.006) was observed, as well as an improvement in motor and non-motor aspects of daily functioning, motor complications, and overall quality of life. No statistically significant changes in BDNF levels were observed. The results indicate that moderately intensive FPR enhances neurotrophic mechanisms, primarily through regulating proBDNF and improving motor functions and quality of life in patients with PD. The results underline the potential of targeted rehabilitation programs to increase neuroplasticity and improve clinical outcomes in PD.

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