Parkinsonism and Related Disorders 15S3 (2009) S49–S52 Contents lists available at ScienceDirect Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis Exercise programs improve mobility and balance in people with Parkinson’s disease Lilian T.B. Gobbi a, *, Maria D.T. Oliveira-Ferreira a , M. Joana D. Caetano a, b , Ellen Lirani-Silva a , Fabio A. Barbieri a , Florindo Stella c, d , Sebasti˜ ao Gobbi c a Posture and Gait Studies Lab, UNESP – S˜ ao Paulo State University at Rio Claro, S˜ ao Paulo, Brazil b Department of Physical Education, FAESO – Faculty of Est´ acio de S´ a at Ourinhos, S˜ ao Paulo, Brazil c Physical Activity and Aging Lab, UNESP – S˜ ao Paulo State University at Rio Claro, S˜ ao Paulo, Brazil d Faculty of Medical Sciences, UNICAMP – Campinas State University at Campinas, S˜ ao Paulo, Brazil article info Keywords: Exercise Mobility Balance Parkinson’s disease summary Compromised balance and loss of mobility are among the major consequences of Parkinson’s disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD. Thirty-four participants, with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr (H&Y) scale, were assigned to two groups. Group 1 (n = 21; 67±9 years old) was engaged in an intensive exercise program (aerobic capacity, flexibility, strength, motor coordination and balance) for 6 months: 72 sessions, 3 times a week, 60 minutes per session; while Group 2 (n = 13; 69±8 years old) participated in an adaptive program (flexibility, strength, motor coordination and balance) for 6 months: 24 sessions, once a week, 60 minutes per session. Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test. Before and after the interventions, groups were similar in clinical conditions (H&Y, UPDRS, and Mini-Mental). A MANOVA 2 (programs) by 2 (moments) revealed that both groups were affected by the exercise intervention. Univariate analyses showed that participants improved their mobility and balance from pre- to post-test. There were no differences between groups in either mobility or balance results. Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD. © 2009 Elsevier Ltd. All rights reserved. 1. Introduction Functional independence is related to the capacity to perform activities of daily living (ADL) independently. Balance and mobility are crucial to their performance. Motor disturbances related to Parkinson’s disease (PD) can contribute to the decline of balance and mobility [1], which subsequently can lead to a reduction in functional independence. As a consequence, individuals with PD experience an increase both with difficulties in performing daily activities and in the risk of falls [2]. Non-pharmacologic therapies related to PD, such as physical exercises and nutrition, are not known to attenuate the disease’s severity or reduce its progression, but they can contribute to improvements in the patient’s quality of life [3,4]. Systematic participation in physical activity programs can help individuals *Corresponding author. Lilian Teresa Bucken Gobbi. Universidade Estadual Paulista – UNESP – IB – Rio Claro, Departamento de Educa ¸ c˜ ao F´ ısica, Laborat ´ orio de Estudos da Postura e da Locomo ¸ c˜ ao, Avenida 24-A, 1515 – Bela Vista – CEP: 13.506-900 – Rio Claro, S˜ ao Paulo, Brasil. Tel./fax: +55 19 3534 6436. E-mail address: lilian.gobbi@pq.cnpq.br (L.T.B. Gobbi). maintain not only their motor repertories, but also their ability to perform daily living activities. Crizzle and Newhouse [5] reviewed the literature and concluded that, through exercise, patients with PD improve their physical performance and the execution of activities of daily living. In addition, they suggested that future studies should include the development of standardized exercise programs specific to problems associated with PD, as well as standardized testing methods for measuring improvements in PD patients. Physical activity programs for PD patients that focus on improvements in functional capacity and mobility vary according to the type of proposed activity, whether it will be practiced by individuals or in a group, the program’s duration, the duration and frequency of weekly sessions, and type of evaluation. Such programs include intensive sports training [6], treadmill training with body weight support [7], resistance training [8,9], aerobic exercise [10], alternative forms of exercise [11], home- based exercise intervention [12], and the practice of movement strategies [4]. Within this context, the purpose of this study was to verify the effectiveness of two intervention programs on functional balance and mobility in people with idiopathic PD. Two physical 1353-8020/$ – see front matter © 2009 Elsevier Ltd. All rights reserved.