Publication Date

2015-04-22

Availability

Embargoed

Embargo Period

2017-04-21

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Kinesiology and Sport Sciences (Education)

Date of Defense

2015-04-08

First Committee Member

Joseph F. Signorile

Second Committee Member

Arlette C. Perry

Third Committee Member

Corneliu Luca

Fourth Committee Member

Moataz Eltoukhy

Fifth Committee Member

Christopher Kuenze

Sixth Committee Member

James G. Moore

Abstract

BACKGROUND: Impaired balance and walking function, reduced muscular strength and power, and flexed posture are common in Parkinson’s disease (PD). The benefits of power yoga (YOGA) and power training (PWT) which have been shown to improve physical function in the elderly have yet to be examined in older PD patients. Therefore, the purpose of this research was to compare the effects of YOGA and PWT on neuromuscular performance, balance, gait and perceived quality of life in older PD. METHODS: Forty-one patients (72.2±6.5 y) were randomly allocated to the YOGA, PWT or control (CON) group. YOGA or PWT included 3-month (2 sessions per week) of progressive yoga or high-speed resistance training, respectively. Outcome measures included: the Unified Parkinson's Disease Rating Scale (UPDRS) motor, Berg Balance Scale (BBS), Mini-Best test (MB), timed up-and-go (TUG), functional reach (FR), single leg stance (SLS), postural sway test (PS), 10-m walking test (10-MWT) at normal (Nwalk) and fast walking (Fwalk) speeds, and one repetition maximum (1RM) and peak power on biceps curl, chest press, leg press, hip abduction and seated calf, joint kinematics during gait cycle (hip, knee, ankle, shoulder, elbow), standing posture, and quality of life (PDQ-39). Participants completed 3 testing sessions: pretest, post-test after 3-months of training, and follow-up 3 months after the post-test. All measures, except PS, standing posture, and biomechanical gait analyses, were administered during pretest, post-test and 3-month follow-up. The PS, standing posture, and biomechanical gait analyses were only performed during the pretest and post-test. RESULTS: For the post-test, both training groups produced significant improvement in the UPDRS motor, BBS, MB, TUG, FR less affected side by PD, Nwalk and Fwalk for 10-MWT, and 1RM for all five testing machines and peak power in leg press compared to the pretest. Both training groups showed significantly greater performances in UPDRS motor, BBS, MB, FR less affected side, Nwalk of 10-MWT, 1RM in biceps curl, leg press, hip abduction, calf, and peak power in leg press than the CON. The PWT group showed significant improvement in the FR more affected side, SLS more affected side, peak power in biceps curl, chest press, hip abduction and seated calf, and the medio- lateral average displacement in the PS test eyes closed condition compared to the pretest. This group also showed significant differences in the FR more affected side and peak power of all five machines compared to the CON group. The YOGA group yielded significant improvement in the SLS less affected side, 95% of an ellipse fitted to the overall center of pressure trace and anterior-posterior average displacement and standard deviation for the PS test, and the mobility domain of PDQ-39 compared to the pretest. Additionally YOGA showed better performance in TUG, Fwalk of 10MWT, and the mobility domain of PDQ-39 than CON. Differences were also detected between the YOGA and PWT in the medio-lateral and anterior-posterior average displacement in the PS test in the eyes closed condition. During follow-up testing, both training groups maintained significantly better values in the UPDRS motor, BBS, MB, TUG, Fwalk of 10-MWT, 1RM in leg press and seated calf, and peak power in leg press compared to the pretest. The results for the UPDRS motor, MB, and 1RM and peak power in leg press were also significantly better than the CON. Additionally, the PWT group maintained improvements in the FR more affected side and peak power in hip abduction; while the YOGA group maintained performance in the Nwalk of 10-MWT compared to the pretest. The MB and hip abduction 1RM showed significant declines compared to the post-test for both training groups. No significant changes in any measure were seen for the CON over the study period. CONCLUSION: Both the 3-month PWT and the specially-designed YOGA programs were shown to significantly improve balance and motor functions in older PD patients. However, PWT has a more widespread impact on muscular power than YOGA training, while the YOGA training tends to improve balance function to a greater degree than the power training.

Keywords

Parkinson's Disease; Power Training; Yoga; Physical Function

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