Evidence map›Paper›PMID 32557868›Full record

Trial reportMovement disorders : official journal of the Movement Disorder Society2020

A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait.

Carla Silva-Batista, Andrea Cristina de Lima-Pardini, Mariana Penteado Nucci, Daniel Boari Coelho, Alana Batista, Maria Elisa Pimentel Piemonte, Egberto Reis Barbosa, Luis Augusto Teixeira, Daniel M Corcos, Edson Amaro and 2 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Movement disorders : official journal of the Movement Disorder Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 11 pooled it
4.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 11 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  10. Functional MRI in Parkinson's disease with freezing of gait: a systematic review of the literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
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  16. Towards the Prevention of Freezing of Gait in Parkinson's Disease.The European journal of neuroscience · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 3 countries.

Carla Silva-BatistaLaboratory of Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.ORCID 0000-0003-0244-6535
Andrea Cristina de Lima-PardiniCentre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.
Mariana Penteado NucciDepartment of Radiology, University of São Paulo, São Paulo, SP, Brazil.
Daniel Boari CoelhoBiomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil.
Alana BatistaDepartment of Radiology, University of São Paulo, São Paulo, SP, Brazil.
Maria Elisa Pimentel PiemonteFaculty of Medical Science, University of São Paulo, São Paulo, SP, Brazil.
Egberto Reis BarbosaMovement Disorders Clinic, Department of Neurology, School of Medicine of the University of São Paulo, São Paulo, SP, Brazil.
Luis Augusto TeixeiraHuman Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.
Daniel M CorcosDepartment of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA.
Edson AmaroDepartment of Radiology, University of São Paulo, São Paulo, SP, Brazil.
Fay B HorakDepartment of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
Carlos UgrinowitschLaboratory of Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.
Universidade de São Paulo · BRNorthwestern University · USOregon Health & Science University · USQueen's University · CA

Funding

PERIPHERAL AND CENTRAL POSTURAL DISORDERS IN THE ELDERLYR01AG006457 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI HORAK, FAY BAHLING · 1986 to 2018
$5.2M
Frontal Cortex and Gait Freezing in Parkinson's Disease: Rehabilitation ImpactI01RX001075 · VA · PORTLAND VA MEDICAL CENTER · PI HORAK, FAY BAHLING · 2015 to 2017
–
NIA NIH HHS R01 AG006457RRD VA I01 RX001075
6 · The paper itself

Abstract

backgroundExercises with motor complexity induce neuroplasticity in individuals with Parkinson's disease (PD), but its effects on freezing of gait are unknown. The objective of this study was to verify if adapted resistance training with instability - exercises with motor complexity will be more effective than traditional motor rehabilitation - exercises without motor complexity in improving freezing-of-gait severity, outcomes linked to freezing of gait, and brain function.

methodsFreezers were randomized either to the adapted resistance training with instability group (n = 17) or to the active control group (traditional motor rehabilitation, n = 15). Both training groups performed exercises 3 times a week for 12 weeks. The primary outcome was the New Freezing of Gait Questionnaire. Secondary outcomes were freezing of gait ratio (turning task), cognitive inhibition (Stroop-III test), motor signs (Unified Parkinson's Disease Rating Scale part-III [UPDRS-III]), quality of life (PD Questionnaire 39), anticipatory postural adjustment (leg-lifting task) and brain activation during a functional magnetic resonance imaging protocol of simulated anticipatory postural adjustment task. Outcomes were evaluated before and after interventions.

resultsOnly adapted resistance training with instability improved all the outcomes (P < 0.05). Adapted resistance training with instability was more effective than traditional motor rehabilitation (in improving freezing-of-gait ratio, motor signs, quality of life, anticipatory postural adjustment amplitude, and brain activation; P < 0.05). Our results are clinically relevant because improvement in the New Freezing of Gait Questionnaire (-4.4 points) and UPDRS-III (-7.4 points) scores exceeded the minimally detectable change (traditional motor rehabilitation group data) and the moderate clinically important difference suggested for PD, respectively. The changes in mesencephalic locomotor region activation and in anticipatory postural adjustment amplitude explained the changes in New Freezing of Gait Questionnaire scores and in freezing-of-gait ratio following adapted resistance training with instability, respectively.

conclusionsAdapted resistance training with instability is able to cause significant clinical improvement and brain plasticity in freezers. © 2020 International Parkinson and Movement Disorder Society.

Indexed as

Gait Disorders, NeurologicParkinson DiseaseExercise TherapyGaitHumansPostural BalanceQuality of Lifeanticipatory postural adjustmentsBOLDcognitive inhibitionfreezersmotor complexity exercises

Identifiers

PMID32557868
PMCPMC7722148
OpenAlexW3036641012

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.