Non-pharmacological rehabilitation of Parkinson’s disease through exercise therapy and music therapy: A narrative review

Parkinson´s disease rehabilitation

Authors

  • Maziar Nikouei Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran https://orcid.org/0000-0001-8491-427X

DOI:

https://doi.org/10.22122/cdj.v12i4.887

Keywords:

Parkinson’s Disease, Rehabilitation, Exercise-Therapy, Music-Therapy, Narrative Review, Non-Pharmacological Therapy

Abstract

BACKGROUND: Parkinson's disease (PD) is a prevalent neurodegenerative condition affecting motor and non-motor functions. This narrative review explores non-pharmacological interventions, focusing on exercise therapy and music therapy.

METHODS: For this research, a thorough exploration of databases, including PubMed and Google Scholar, was undertaken to collect pertinent articles from reputable journals. The focus was on non-pharmacological rehabilitation for PD, targeting studies from the past decade with additional references reviewed. Emphasis was on articles addressing music and physical therapy for PD, resulting in the evaluation of 45 articles. Content analysis was employed, allowing for a detailed examination and synthesis of information from the literature.

RESULTS: The findings underscore the efficacy of exercise therapy, encompassing aerobic, resistance, and balance training, in ameliorating motor symptoms. This includes notable reductions in bradykinesia, rigidity, and postural instability. The positive influences of exercise interventions extend beyond their motor benefits to impacts to cognitive function, mood disorders, and sleep disturbances, presenting a holistic approach to PD management. Music therapy emerges as a promising avenue, especially when integrated with physical activity. Rhythmic auditory stimulation and group singing within the context of music therapy showcase affirmative impacts on motor control, attention, and communication outcomes for individuals with PD.

CONCLUSION: In conclusion, this narrative review sheds light on the considerable potential of non-pharmacological interventions, namely exercise therapy and music therapy, for PD rehabilitation. These insights not only contribute to the existing body of knowledge, but also offer valuable guidance for future research directions and clinical applications in the management of PD.

References

Chou KL, Elm JJ, Wielinski CL, Simon DK, Aminoff MJ, Christine CW, et al. Factors associated with falling in early treated Parkinson's disease: The NET-PD LS1 cohort. Journal of the Neurological Sciences. 2017; 377: 137-43.

Choi H-y, Cho K-H, Jin C, Lee J, Kim T-H, Jung W-S, et al. Exercise therapies for Parkinson’s disease: a systematic review and meta-analysis. Parkinson’s Disease. 2020; 2020.

Lee A, Gilbert RM. Epidemiology of Parkinson's disease. Neurologic clinics. 2016; 34(4): 955-65.

Hosseinzadeh A, Baneshi MR, Sedighi B, Kermanchi J, Haghdoost AA. Estimation of Parkinson's Disease Prevalence and Its Geographical Variation in Iran. Journal of Mazandaran University of Medical Sciences. 2021; 31(200): 113-24.

Dorsey E, Sherer T, Okun MS, Bloem BR. The emerging evidence of the Parkinson's pandemic. Journal of Parkinson's disease. 2018; 8(s1): S3-S8.

Ghosh B, Zhang C, Ziemba KS, Fletcher AM, Yurek DM, Smith GM. Partial reconstruction of the nigrostriatal circuit along a preformed molecular guidance pathway. Molecular Therapy-Methods and Clinical Development. 2019; 14: 217-27.

Oliveira de Carvalho A, Filho ASS, Murillo-Rodriguez E, Rocha NB, Carta MG, Machado S. Physical Exercise For Parkinson's Disease: Clinical And Experimental Evidence. Clin Pract Epidemiol Ment Health. 2018; 14: 89-98.

Braak H, Ghebremedhin E, Rüb U, Bratzke H, Del Tredici K. Stages in the development of Parkinson’s disease-related pathology. Cell and tissue research. 2004; 318: 121-34.

Kalia LV, Lang AE. Parkinson's disease. The Lancet. 2015; 386(9996): 896-912.

Balestrino R, Schapira AHV. Parkinson disease. European journal of neurology. 2020; 27(1): 27-42.

Aarsland D, Zaccai J, Brayne C. A systematic review of prevalence studies of dementia in Parkinson's disease. Movement disorders: official journal of the Movement Disorder Society. 2005; 20(10): 1255-63.

Schrag A, Horsfall L, Walters K, Noyce A, Petersen I. Prediagnostic presentations of Parkinson's disease in primary care: a case-control study. The Lancet Neurology. 2015; 14(1): 57-64.

Curtze C, Nutt JG, Carlson‐Kuhta P, Mancini M, Horak FB. Levodopa I sa D ouble‐E dged S word for Balance and G ait in P eople W ith P arkinson's Disease. Movement disorders. 2015; 30(10): 1361-70.

Cruise K, Bucks R, Loftus A, Newton R, Pegoraro R, Thomas M. Exercise and Parkinson’s: benefits for cognition and quality of life. Acta Neurologica Scandinavica. 2011; 123(1): 13-9.

Titova N, Chaudhuri KR. Nonmotor Parkinson's and future directions. International Review of Neurobiology. 2017; 134: 1493-505.

Mak MK, Wong-Yu IS, Shen X, Chung CL. Long-term effects of exercise and physical therapy in people with Parkinson's disease. Nature Reviews Neurology. 2017; 13(11): 689-703.

Westheimer O, McRae C, Henchcliffe C, Fesharaki A, Glazman S, Ene H, et al. Dance for PD: a preliminary investigation of effects on motor function and quality of life among persons with Parkinson’s disease (PD). Journal of Neural Transmission. 2015; 122: 1263-70.

Pacchetti C, Mancini F, Aglieri R, Fundarò C, Martignoni E, Nappi G. Active music therapy in Parkinson’s disease: an integrative method for motor and emotional rehabilitation. Psychosomatic Medicine. 2000; 62(3): 386-93.

Carroll LM, Volpe D, Morris ME, Saunders J, Clifford AM. Aquatic exercise therapy for people with Parkinson's disease: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2017; 98(4): 631-8.

van der Kolk NM, de Vries NM, Kessels RP, Joosten H, Zwinderman AH, Post B, et al. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson's disease: a double-blind, randomised controlled trial. The Lancet Neurology. 2019; 18(11): 998-1008.

Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, et al. Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: a phase 2 randomized clinical trial. JAMA Neurology. 2018; 75(2): 219-26.

Marusiak J, Fisher BE, Jaskólska A, Słotwiński K, Budrewicz S, Koszewicz M, et al. Eight weeks of aerobic interval training improves psychomotor function in patients with Parkinson’s disease-randomized controlled trial. International Journal of Environmental Research and Public Health. 2019; 16(5): 880.

Ridgel AL, Ault DL. High-cadence cycling promotes sustained improvement in bradykinesia, rigidity, and mobility in individuals with mild-moderate Parkinson’s disease. Parkinson’s Disease. 2019; 2019.

Cammisuli DM, Bonuccelli U, Daniele S, Martini C, Fusi J, Franzoni F. Aerobic exercise and healthy nutrition as neuroprotective agents for brain health in patients with Parkinson’s disease: A critical review of the literature. Antioxidants. 2020; 9(5): 380.

Cheng F-Y, Yang Y-R, Wu Y-R, Cheng S-J, Wang R-Y. Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: a randomized controlled trial. Parkinsonism and Related Disorders. 2017; 43: 20-6.

Vieira de Moraes Filho A, Chaves SN, Martins WR, Tolentino GP, de Cássia Pereira Pinto Homem R, Landim de Farias G, et al. Progressive resistance training improves bradykinesia, motor symptoms, and functional performance in patients with Parkinson's disease. Clinical Interventions in Aging. 2020: 87-95.

Corcos DM, Robichaud JA, David FJ, Leurgans SE, Vaillancourt DE, Poon C, et al. A two‐year randomized controlled trial of progressive resistance exercise for Parkinson's disease. Movement Disorders. 2013; 28(9): 1230-40.

Troche M, Okun M, Rosenbek J, Musson N, Fernandez H, Rodriguez R, et al. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology. 2010; 75(21): 1912-9.

Canning CG, Sherrington C, Lord SR, Close JC, Heritier S, Heller GZ, et al. Exercise for falls prevention in Parkinson disease: a randomized controlled trial. Neurology. 2015; 84(3): 304-12.

Allen NE, Sherrington C, Paul SS, Canning CG. Balance and falls in Parkinson's disease: a meta‐analysis of the effect of exercise and motor training. Movement Disorders. 2011; 26(9): 1605-15.

Shen X, Wong-Yu IS, Mak MK. Effects of exercise on falls, balance, and gait ability in Parkinson’s disease: a meta-analysis. Neurorehabilitation and Neural Repair. 2016; 30(6): 512-27.

Da Silva FC, Iop RdR, de Oliveira LC, Boll AM, de Alvarenga JGS, Gutierres Filho PJB, 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.

Kwok JY, Kwan JC, Auyeung M, Mok VC, Lau CK, Choi K, et al. Effects of mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson disease: a randomized clinical trial. JAMA Neurology. 2019; 76(7): 755-63.

Son HG, Choi E-O. The effects of mindfulness meditation-based complex exercise program on motor and nonmotor symptoms and quality of life in patients with Parkinson's disease. Asian Nursing Research. 2018; 12(2): 145-53.

Reynolds GO, Otto MW, Ellis TD, Cronin‐Golomb A. The T herapeutic P otential of E xercise to improve M ood, C ognition, and S l eep in P arkinson's Disease. Movement Disorders. 2016; 31(1): 23-38.

Amara AW, Memon AA. Effects of exercise on non-motor symptoms in Parkinson’s disease. Clinical Therapeutics. 2018; 40(1): 8-15.

Memon AA, Coleman JJ, Amara AW. Effects of exercise on sleep in neurodegenerative disease. Neurobiology of Disease. 2020; 140: 104859.

Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. Journal of Behavioral Medicine. 2015; 38: 427-49.

Liu XL, Chen S, Wang Y. Effects of health Qigong exercises on relieving symptoms of Parkinson’s disease. Evidence-Based Complementary and Alternative Medicine. 2016; 2016.

Pohl P, Wressle E, Lundin F, Enthoven P, Dizdar N. Group-based music intervention in Parkinson’s disease–findings from a mixed-methods study. Clinical Rehabilitation. 2020; 34(4): 533-44.

da Silva LK, Brito TSS, de Souza LAPS, Luvizutto GJ. Music-based physical therapy in Parkinson's disease: An approach based on international Classification of Functioning, Disability, and Health. Journal of Bodywork and Movement Therapies. 2021; 26: 524-9.

Park J-K, Kim SJ. Dual-task-based drum playing with rhythmic cueing on motor and attention control in patients with Parkinson’s disease: A preliminary randomized study. International Journal of Environmental Research and Public Health. 2021; 18(19): 10095.

Thaut MH, Rice RR, Braun Janzen T, Hurt-Thaut CP, McIntosh GC. Rhythmic auditory stimulation for reduction of falls in Parkinson’s disease: a randomized controlled study. Clinical rehabilitation. 2019; 33(1): 34-43.

Burt J, Ravid E, Bradford S, Fisher NJ, Zeng Y, Chomiak T, et al. The effects of music-contingent gait training on cognition and mood in Parkinson's disease: a feasibility study. Neurorehabilitation and Neural Repair. 2020; 34(1): 82-92.

Karpodini CC, Tsatalas T, Giannakopoulos I, Romare M, Giakas G, Tsaklis PV, et al. The Effects of a Single Session of a Rhythmic Movement Program

on Selected Biopsychological Parameters in PD Patients: A Methodological Approach. Medicina. 2023; 59(8): 1408.

Tamplin J, Morris ME, Marigliani C, Baker FA, Noffs G, Vogel AP. Parkinson: Outcomes of a 12-month controlled trial of therapeutic singing groups in Parkinson's disease. Journal of Parkinson's Disease. 2020; 10(3): 1217-30.

Calabrò RS, Naro A, Filoni S, Pullia M, Billeri L, Tomasello P, et al. Walking to your right music: a randomized controlled trial on the novel use of treadmill plus music in Parkinson’s disease. Journal of Neuroengineering And Rehabilitation. 2019; 16(1): 1-14.

Ellis TD, Colón-Semenza C, DeAngelis TR, Thomas CA, Hilaire MS, Earhart GM, Dibble LE. Evidence for Early and Regular Physical Therapy and Exercise in Parkinson's Disease. Semin Neurol. 2021;41(2):189-205..

Emig M, George T, Zhang JK, Soudagar-Turkey M. The role of exercise in Parkinson’s disease. Journal of Geriatric Psychiatry and Neurology. 2021; 34(4): 321-30.

Lau YS, Patki G, Das‐Panja K, Le WD, Ahmad SO. Neuroprotective effects and mechanisms of exercise in a chronic mouse model of Parkinson’s disease with moderate neurodegeneration. European Journal of Neuroscience. 2011; 33(7): 1264-74.

Scalzo P, Kümmer A, Bretas TL, Cardoso F, Teixeira AL. Serum levels of brain-derived neurotrophic factors correlate with motor impairment in Parkinson's disease. Journal of Neurology. 2010; 257: 540-5.

LaHue SC, Comella CL, Tanner CM. The best medicine? The influence of physical activity and inactivity on Parkinson's disease. Movement Disorders. 2016; 31(10): 1444-54.

Patki G, Lau Y-S. Impact of exercise on mitochondrial transcription factor expression and damage in the striatum of a chronic mouse model of Parkinson's disease. Neuroscience letters. 2011; 505(3): 268-72.

Bhat AH, Dar KB, Anees S, Zargar MA, Masood A, Sofi MA, et al. Oxidative stress, mitochondrial dysfunction, and neurodegenerative diseases; a mechanistic insight. Biomedicine and Pharmacotherapy. 2015; 74: 101-10.

Svensson M, Lexell J, Deierborg T. Effects of physical exercise on neuroinflammation, neuroplasticity, neurodegeneration, and behavior: what we can learn from animal models in clinical settings. Neurorehabilitation and Neural Repair. 2015; 29(6): 577-89.

Huang J, Wang X, Zhu Y, Li Z, Zhu YT, Wu JC, et al. Exercise activates lysosomal function in the brain through AMPK‐SIRT1‐TFEB pathway. CNS neuroscience & therapeutics. 2019; 25(6): 796-807.

Chung CLH, Thilarajah S, Tan D. Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis. Clinical Rehabilitation. 2016; 30(1): 11-23.

Duncker DJ, Bache RJ. Regulation of coronary blood flow during exercise. Physiological Reviews. 2008; 88(3): 1009-86.

Sacheli MA, Murray DK, Vafai N, Cherkasova MV, Dinelle K, Shahinfard E, et al. Habitual exercisers versus sedentary subjects with Parkinson's Disease: Multimodal PET and fMRI study. Movement Disorders. 2018; 33(12): 1945-50.

Arufe-Giráldez V. Music Therapy and Parkinson’s Disease: A Systematic Review from 2015–2020. International Journal of Environmental Research and Public Health. 2021; 18: 21.

Salimpoor VN, Benovoy M, Larcher K, Dagher A, Zatorre RJ. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neuroscience. 2011; 14(2): 257-62.

Salimpoor VN, Zald DH, Zatorre RJ, Dagher A, McIntosh AR. Predictions and the brain: How musical sounds become rewarding. Trends in Cognitive Sciences. 2015; 19(2): 86-91.

Schaefer RS. Auditory rhythmic cueing in movement rehabilitation: findings and possible mechanisms. Philosophical Transactions of the Royal Society B: Biological Sciences. 2014; 369(1658): 20130402.

Petter EA, Lusk NA, Hesslow G, Meck WH. Interactive roles of the cerebellum and striatum in sub-second and supra-second timing: Support for initiation, continuation, adjustment, and termination (ICAT) model of temporal processing. Neuroscience and Biobehavioral Reviews. 2016; 71: 739-55.

Downloads

Published

2024-11-18

How to Cite

1.
Nikouei M. Non-pharmacological rehabilitation of Parkinson’s disease through exercise therapy and music therapy: A narrative review: Parkinson´s disease rehabilitation. Chron Dis J. 2024;12(4):249–260.

Issue

Section

Review Article(s)