Intensity gets results

One of the key characteristics of CrossFit workouts is High Intensity Interval Training (HIIT). Research continues to support the effectiveness of HIIT for overall health, fitness,  disease prevention, and body composition changes. This recent physical therapy article highlights the benefits of HIIT for individuals with Parkinson’s Disease: 

Higher-Intensity Parkinson’s Rehab

New research examines the protective effects of vigorous interval training.

Advance Magazine  Vol. 27 • Issue 9 • Page 10

According to the Parkinson’s Disease Foundation, 7-10 million people are currently living with Parkinson’s disease (PD) worldwide, making it the second-most common neurodegenerative disorder following Alzheimer’s disease.1

Symptoms of Parkinson’s disease include bradykinesia, rigidity, stiffness, postural instability, depression, emotional dysfunction, weakness, dyskinesia and reduced cognitive function.

Emerging Role of Exercise


According to current research, high-intensity aerobic exercise is thought to demonstrate a neurotrophic/neuroprotective mechanism — this includes the formation of new synapses, axonal and dendritic growth and neuroprotection. This is also associated with improved cognition, learning and memory.7 For patients with PD, high-intensity aerobic exercise improves dopamine agonist efficacy and motor performance acutely with reduced bradykinesia.8high intensity parkinson's rehab

Higher Intensities

As with aerobic exercise, high-intensity interval training (HIIT) has been shown to improve cognitive function.9 HIIT is a combination of low- to moderate-effort aerobic training cycled with short bursts of high-intensity bouts.

In a study comparing interval treadmill training, endurance training and conventional therapy in persons with early PD, interval treadmill training resulted in significantly improved results compared to endurance and conventional therapy regarding gait speed, stride length and decreased double-limb stance time.10

At JFK Johnson Rehabilitation Institute in New Jersey, aerobic exercise and high-intensity interval training are often incorporated into our treatment of people with PD. Practitioners’ clinical experience and literature reviews have shown that aerobic exercise is effective in improving ability to dual-task and that patients demonstrate overall increased quality of life and executive function.

For example, patients reported increased independence in taking care of young grandchildren, returning to work managing full caseloads, as well as improved mood and sleep and significant decline in falls. They also demonstrated improved Functional Gait Assessment (FGA), Montreal Cognitive Assessment (MoCA) and Unified Parkinson’s Disease Rating Scale (UPDRS) scores.7,11

Interestingly, balance was also improved in patients performing only aerobic exercise with HIIT. Improved FGA scores are likely the result of improved ability to dual-task, as many items require the patient to count steps prior to head turning or listening to the physical therapist’s cues for directional changes. These changes are not likely related to improvements in postural stability or motor performance, as no balance intervention was provided, but rather to improved executive function.

HIIT is an easy but effective way to improve executive function and overall learning for patients with PD during physical therapy treatments. Progressive aerobics and HIIT result in neural priming in the brain for learning and skill acquisition, promote brain and muscle interactions and activate attentional and working memory systems.5Aerobic exercise and HIIT increase brain alertness and help prepare patients to learn and acquire new skills, as well as to accept higher challenges in therapy sessions to reach functional goals.


After HIIT, therapists can engage patients with therapy designed to enhance neuroplasticity principles and optimize brain health, learning, function and slow-motor deterioration. These therapies can include directional changes with ambulation, balance and functional tasks that incorporate a cognitive component.

At JFK Johnson Rehabilitation Institute, therapy for patients with PD includes the Lee Silverman Voice Treatment (LSVT) BIG program and Parkinson’s Wellness Recovery (PWR!) moves. Both LSVT and PWR! moves incorporate large, whole-body multi-directional movements with emphasis on power and effort in order to make movements more efficient.5

The Final Word

Aerobic exercise and HIIT improves executive function, cognition, mobility and overall quality of life in patients with PD. Beginning sessions with aerobic and HIIT will help improve cerebral perfusion and enhance motor learning and skill acquisition.

We believe that including this type of exercise is vital in the treatment of patients with PD in order to improve both cognitive and physical deficits to ensure safe and efficient mobility.

Read full article HERE

Dana Abel is senior physical therapist in the outpatient physical therapy department at JFK Johnson Rehabilitation Institute, Edison, N.J. She is certified in LSVT BIG and trained in PWR! Kristina Lagzdins is staff physical therapist and LSVT BIG-certified clinician in the Brain Trauma Unit and the Extended Recovery Brain Injury Unit at JFK Johnson Rehabilitation Institute.

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