High intensity interval training for Parkinson's disease: A scoping review of systemic effects and physiological adaptations

Abstract

BackgroundHigh intensity interval training (HIIT) involves vigorous intensity exercise bouts interspersed with low intensity bouts. Despite growing interest, the optimal dosage and clinical adaptability of HIIT in Parkinson's disease (PD) remain unclear. This scoping review synthesized the literature on systemic adaptations underlying HIIT in PD and developed a clinical framework while considering chronotropic incompetence, orthostatic hypotension, and disease progression.MethodsThree databases were searched for studies that incorporated HIIT interventions in PD. The Template for Intervention Description and Replication checklist was used to characterize the quality of intervention reporting.ResultsA total of 285 studies were screened, of which 10 studies were included. HIIT was administered 2-3 times/week for 30-60 min/session over 8-12 weeks. Seven studies used moderate-volume HIIT and three studies used high-volume HIIT protocols. The quality of intervention reporting was fair to good. HIIT improved cardiorespiratory fitness, motor severity, and functional mobility in PD, however, improvements were comparable to moderate intensity continuous training (MICT). HIIT may facilitate neuroplasticity by increasing brain-derived neurotrophic factor levels and dopamine transporter uptake. We recommend that HIIT programs for individuals with autonomic dysfunction use individualized heart rate targets, and perceived exertion for determining exercise intensity, and incorporate longer duration programs (>12 weeks).ConclusionHIIT is a well-tolerated intervention that may improve cardiorespiratory fitness, disease severity, and certain neurobiological markers in mild-moderate PD, with benefits similar to MICT. Larger trials comparing different HIIT volumes are needed to identify optimal exercise volume to inform individualized exercise prescription. High intensity interval training and Parkinson's disease This review studied the effects of high intensity interval training (HIIT) for people with Parkinson's disease (PD). HIIT is an exercise program that involves alternate short bursts of intense exercise followed by rest periods. Although HIIT is being explored for people with PD, its effects and clinical adaptability is not well understood. The researchers performed a literature review to obtain a detailed understanding of the effects of HIIT in PD. The researchers were also interested in finding out how HIIT can be adjusted for certain characteristics unique to PD such as autonomic nervous system problems and progressing disease.The reviewers found 285 studies when they ran the search and found 10 that met eligibility criteria. HIIT programs in these studies were performed twice or thrice per week, for 30–60 minutes over 8–12 weeks. Their findings showed that HIIT can improve fitness (i.e. ability to exercise for longer durations without getting tired), movement difficulties such as slowness, shakiness or stiffness and the ability to move around. It may improve brain health by increasing levels of a protein related to learning and growth, and a chemical that manages dopamine levels. However, HIIT did not seem to be more beneficial compared to moderate-intensity exercise. Overall, HIIT appears safe and effective for increasing fitness and movement difficulty for people in the early to middle stages of PD. More research via larger trials is needed to compare different types of HIIT protocols to understand how to integrate it into treatment protocols for PD.

Neurotransmitters

• Dopamine
• Endorphins
• Norepinephrine (Noradrenaline)

Related

• High-intensity interval training (HIIT)