TITLE: “The Science and Practice of Amplitude-based Therapies in
Parkinson disease.” – Training BIG and LOUD
This presentation will (a) summarize the evidence for disease-modifying
effects of exercise in animal models of Parkinson Disease (PD) (e.g.,
slowing disease progression), (b) highlight fundamental principles of
exercise that promote neuroplasticity, and (c) discuss the translation
of these principles to an exercise intervention for people with early
Parkinson disease to promote brain plasticity and slow motor
deterioration. The PD-specific exercise intervention (Training BIG and
LOUD) directly addresses the primary deficit of inadequate muscle
activation hypothesized to underlie slow/small movement in people with
Parkinson disease. To increase drive to the neuromuscular system, a
single motor control parameter – amplitude – is targeted simultaneously
across different motor systems (speech, reaching, gait). The exercise
intervention is based upon a standardized, proven protocol, already
shown for the speech motor system (LSVT/LOUD) to impact brain
reorganization in human PD (O15 PET). The application of speech
treatment principles (LSVT/LOUD) to the limb motor system (Training
BIG) is novel and has recently documented improvements in amplitude
that have also generalized to improved speed, balance, and quality of
life. We are now proposing to use this research- and hypothesis-driven
whole-body approach (Training BIG and LOUD) as a physiological tool for
modifying disease progression in early PD - when there is the greatest
potential for restoring function on the impaired side, and slowing
onset of disability on the non-impaired side. Pilot data will be
presented suggesting that training whole-body (speech and limb)
amplitude may generalize to an untrained fine motor skill (handwriting)
and improve dual task performance in early PD.