Research Article Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson’s Disease Khashayar Dashtipour, 1 Eric Johnson, 2 Camellia Kani, 1 Kayvan Kani, 1 Ehsan Hadi, 1 Mark Ghamsary, 3 Shant Pezeshkian, 1 and Jack J. Chen 1,4 1 Department of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA 2 Department of Physical herapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA 92354, USA 3 Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA 4 Department of Pharmacy Practice, College of Pharmacy, Marshal B. Ketchum University, Fullerton, CA 92831, USA Correspondence should be addressed to Khashayar Dashtipour; kdashtipour@llu.edu Received 1 November 2014; Accepted 14 January 2015 Academic Editor: Jan O. Aasly Copyright © 2015 Khashayar Dashtipour et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Novel rehabilitation strategies have demonstrated potential beneits for motor and non-motor symptoms of Parkinson’s disease (PD). Objective. To compare the efects of Lee Silverman Voice herapy BIG (LSVT BIG therapy) versus a general exercise program (combined treadmill plus seated trunk and limb exercises) on motor and non-motor symptoms of PD. Methods. Eleven patients with early-mid stage PD participated in the prospective, double-blinded, randomized clinical trial. Both groups received 16 one-hour supervised training sessions over 4 weeks. Outcome measures included the Uniied Parkinson’s Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Modiied Fatigue Impact Scale (MFIS). Five patients performed general exercise and six patients performed LSVT BIG therapy. Post-intervention evaluations were conducted at weeks 4, 12 and 24. Results. he combined cohort made improvements at all follow-up evaluations with statistical signiicance for UPDRS total and motor, BDI, and MFIS ( < 0.05). Conclusion. his study demonstrated positive efects of general exercise and LSVT BIG therapy on motor and non-motor symptoms of patients with PD. Our results suggest that general exercise may be as efective as LSVT BIG therapy on symptoms of PD for patients not able to readily access outpatient LSVT BIG therapy. 1. Introduction Parkinson’s disease (PD) is a neurodegenerative disorder con- sisting of a constellation of motor and nonmotor symptoms. For many years, even before the availability of medical ther- apies for PD, clinicians have been trying physical activities to improve symptoms of PD. In recent years, basic science evidence based on animal models suggests that the efects of the exercise are beyond solely symptomatic therapies [1–4]. In 1999, van Praag et al. showed the increase of neurogenesis following exercise in the adult brain rats [5]. Since then, other scientists have replicated this inding and clinicians have tried to assess and quantify the efect of exercise on a variety of neurological disorders [6, 7]. Multiple clinical studies demonstrated the beneit of exercise on motor symptoms of PD by applying diferent exercise models such as treadmill training [8–10], resistance training [11–13], biking [14], Tai Chi [15, 16], tango [17, 18], and boxing [19]. One of the exercise models that has been shown to be efective and is currently being used widely is Lee Silverman Voice herapy BIG (LSVT BIG therapy) [20–22]. LSVT BIG therapy is designed to overcome amplitude deicits associated with PD. his therapy improves proprioception through increasing amplitude together with sustained attention and cognitive involvement by mentally focusing on individual movements. Emerging evidence examining the beneits of LSVT BIG therapy for patients with PD has demonstrated improvements in gait speed and the speed of reaching across the upper and lower limbs as well as improvements of the UPDRS motor score [21, 22]. LSVT BIG therapy incorporates large trunk and extrem- ity functional motions and should only be administered Hindawi Publishing Corporation Parkinson’s Disease Volume 2015, Article ID 586378, 5 pages http://dx.doi.org/10.1155/2015/586378