Intensive rehabilitation treatment in early Parkinson's disease: a randomized pilot study with a 2-year follow-up

Neurorehabil Neural Repair. 2015 Feb;29(2):123-31. doi: 10.1177/1545968314542981. Epub 2014 Jul 18.


Background: Although physical exercise improves motor aspects of Parkinson's disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression.

Methods: Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson's Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later.

Results: Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were better than at T0 (all Ps < .03). No changes were noted in the Control Group. l-dopa equivalent dosages increased significantly only in the Control Group (P = .0015), with a decrease in the percentages of patients in monotherapy (T1 40%; T2, T3, and T4 20%). In the MIRT Group, the percentages of such patients remained higher (T1 and T2 100%; T3 89%; T4 75%).

Conclusions: These results suggest that MIRT might slow down the progression of motor decay, it might delay the need for increasing drug treatment, and thus, it might have a neuroprotective effect.

Keywords: Parkinson’s disease; neuroplasticity; rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analysis of Variance
  • Antiparkinson Agents / therapeutic use
  • Disease Progression
  • Exercise Therapy* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Indans / therapeutic use
  • Male
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Parkinson Disease / rehabilitation*
  • Pilot Projects
  • Severity of Illness Index
  • Treatment Outcome
  • Walking


  • Antiparkinson Agents
  • Indans
  • rasagiline