The Effect of Strength and Balance Training on Balance and Cognitive Impairments in Parkinson’s Disease

Evaluation of the effects of Strength and Balance Training on Balance and Cognitive Impairments in PD.  We hypothesize that strength and balance training will result in improved balance and that this improvement will be correlated with an improvement in cognition.  The effects of strength and balance training on balance impairments in PD will be evaluated prior to and following six to eight weeks of training. Strength training will consist of multi-joint functional weight lifting aimed at increasing absolute skeletal muscle strength and functional strength. To assure continual adaptation of the central nervous system (CNS), peripheral nervous system (PNS), and the skeletal muscle system to the strength training program, the intensity of all exercise will be slowly increased throughout the duration of the study. Balance training will consist of performing complex physical tasks, while standing on firm and unstable surfaces. Postural control will be assessed by measuring static posturography prior to and following the training protocol. Specifically, sway area and sway length will be measured by the displacement of the center of pressure (CoP) as determined by a force plate. Additionally, cognition will be assessed utilizing the Montreal Cognitive Assessment (MoCA) prior to and following the training protocol. A correlation between the change in postural control and cognition will be performed to determine the contribution of cognitive improvements to improvements in postural control.