PHYS THER
Vol. 89, No. 4, April 2009, pp. 384-393
DOI: 10.2522/ptj.20080214
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Perspectives

Delaying Mobility Disability in People With Parkinson Disease Using a Sensorimotor Agility Exercise Program

Laurie A King and Fay B Horak

LA King, PT, PhD, is Post-doctoral Fellow, Oregon Health and Sciences University, Portland, Oregon.
FB Horak, PT, PhD, is Research Professor of Neurology and Adjunct Professor of Physiology and Biomedical Engineering, Department of Neurology, Oregon Health and Sciences University, West Campus, Building 1, 505 NW 185th Ave, Beaverton, OR 97006-3499 (USA).

Address all correspondence to Dr Horak at: horakf{at}ohsu.edu

This article introduces a new framework for therapists to develop an exercise program to delay mobility disability in people with Parkinson disease (PD). Mobility, or the ability to efficiently navigate and function in a variety of environments, requires balance, agility, and flexibility, all of which are affected by PD. This article summarizes recent research identifying how constraints on mobility specific to PD, such as rigidity, bradykinesia, freezing, poor sensory integration, inflexible program selection, and impaired cognitive processing, limit mobility in people with PD. Based on these constraints, a conceptual framework for exercises to maintain and improve mobility is presented. An example of a constraint-focused agility exercise program, incorporating movement principles from tai chi, kayaking, boxing, lunges, agility training, and Pilates exercises, is presented. This new constraint-focused agility exercise program is based on a strong scientific framework and includes progressive levels of sensorimotor, resistance, and coordination challenges that can be customized for each patient while maintaining fidelity. Principles for improving mobility presented here can be incorporated into an ongoing or long-term exercise program for people with PD.


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