Effects of a Multimodal Exercise Program on Clinical, Functional Mobility and Cognitive Parameters of Idiopathic Parkinson's Disease Patients

This chapter has as main objective to present the effects of a multimodal exercise program on major signs/symptoms, functional mobility and cognitive parameters of people with Parkinson’s disease (PD). This program is developed to improve all functional capacity components (strength, balance, aerobic resistance, coordination and flexibility) in order to increase patients’ independence, autonomy and quality of life. As main result, we found maintenance of clinical status and memory after the exercise program with an increase in functional mobility. These results can be attributed to neuro-protection mechanisms enhanced by exercise and to an increase in functional capacity. Parkinson’s Disease (PD) is the second most incident neurodegenerative pathology in subjects over 60 years old (Olanow et al., 2009). PD has been described to affect approximately 0.3% of the population and 1% to 2% of those older than 60 years (de Lau & Breteler, 2006). It is a neurodegenerative pathology characterized by progressive degeneration of the dopamine-producing neurons in the substantia nigra pars compacta. The neuromotor impulses in the subcortical to cortical pathways, responsible for accurate control of muscle activation, are compromised with the decreased amount of dopamine. As a consequence, people with PD show motor (e.g. resting tremor, rigidity, postural instability, mobility and others) and non-motor (e.g. executive functions, depression, memory, humor alterations, dementia and others) (Taylor et al., 1986; Chaudhuri et al., 2006; Martinez-Martin, 2006; Olanow et al., 2009) signs/symptoms. Clinical parameters of PD patients tend to get worse progressively (Karlsen et al., 2000) even though pharmacological interventions associated with non pharmacological therapies have shown some benefits to patients (Sage & Almeida, 2009, 2010). Motor signs/symptoms related to PD can contribute to the decline in balance control and mobility (Christofoletti et al., 2006), which subsequently can lead to a reduction in functional