Journal of Movement Disorders

Original Articles

Factors Associated With the Response to Exercise in Patients With Parkinson’s Disease: Myung Jun Lee, Jinse Park, Dong-Woo Ryu, Dallah Yoo, Sang-Myung Cheon; J Mov Disord. 2025;18(4):308-316. Published online May 16, 2025; DOI: https://doi.org/10.14802/jmd.25068

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Abstract PDF Supplementary Material: Objective
Exercises have been proposed as adjuvants for the treatment of Parkinson’s disease (PD); however, responses to exercise interventions have shown inconsistent results. We investigated the clinical factors associated with improvements in motor deficits after exercise.
Methods
A total of 85 patients with PD were enrolled from five tertiary hospitals and classified into four exercise groups: home exercise, strength training, Tai Chi, and yoga groups. Clinical measurements of the motor and nonmotor features of patients with PD were performed at baseline and 12 weeks after the exercise intervention. We employed principal component analysis (PCA) to reduce variables into ten factors and then examined associations of baseline characteristics with percentage improvement in the Movement Disorder Society sponsored Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) score via a Bayesian regression model.
Results
In the multivariate Bayesian regression model including ten PCA-derived factors, the percentage improvement in the MDS-UPDRS III score was associated with factors including prominent motor deficits (posterior interval [mean±standard deviation]: 2.5±1.5) and nonmotor symptoms such as depression, anxiety, and subjective memory impairment (3.3±1.7). Another factor related to functional impairments in gait and postural control was associated with less improvement after the exercise intervention (-3.9±1.7). According to the subgroup analyses, motor features were associated with improvements in the home exercise and strength training groups, whereas mood disturbance, fatigue, and subjective cognitive impairment were related to changes in the home exercise and Tai Chi groups.
Conclusion
Our results suggest that the individual phenotypes of patients with PD may be associated with clinical improvement following exercise.

Comparison of the Impact of Various Exercise Modalities on Parkinson’s Disease: Jinse Park, Sang-Myung Cheon, Myung Jun Lee, Dong-Woo Ryu, Dallah Yoo; J Mov Disord. 2025;18(3):222-230. Published online April 15, 2025; DOI: https://doi.org/10.14802/jmd.25038

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Objective
Exercise is a critical nonpharmacological intervention for Parkinson’s disease (PD); however, comparative evidence on the efficacy of different exercise modalities is limited. This study aimed to compare the effects of tai chi, strength training, yoga, and home-based exercises on motor function in patients with PD.
Methods
In this multicenter, open-label, randomized clinical trial, 99 patients with PD were allocated to one of four exercise interventions: tai chi, strength training, yoga, or home-based exercises. Each intervention consisted of 12 weeks of supervised sessions, followed by 12 weeks of independent practice. The primary outcomes included the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III and timed up-and-go (TUG) test parameters. The assessed secondary outcomes included physical activity (measured via short physical performance battery and the 6-minute walking test [6MWT]), balance (measured via the Mini-BEST), and freezing of gait (measured via the New Freezing of Gait Questionnaire).
Results
Home exercise and tai chi demonstrated significant improvements in the MDS-UPDRS Part III scores over 24 weeks. The 6MWT was improved by home exercises and tai chi; additionally, the Mini-BEST test scores were enhanced by strength exercises and yoga. The total duration and forward movement of the TUG test, as well as the turning duration measured via the wearable sensor, were markedly improved in the yoga group.
Conclusion
Our results support the notion that various types of adherence to and outcomes of exercise can be observed in real-world settings, even though the effectiveness of exercise is well established. These findings highlight the importance of tailoring exercise regimens by considering individual patients in PD management.

Citations

Citations to this article as recorded by

Telerehabilitation for Parkinson’s disease: a systematic review and meta-analysis based on randomized controlled trials
Renfei Li, Lili Wang, Jian Zhang
Neurological Sciences.2026;[Epub] CrossRef
Comparative Efficacy of 17 Rehabilitation Therapies Combined With Medication for Improving Gait Disorders and Quality of Life in Parkinson's Disease: A Network Meta-Analysis of 137 RCTs
Xinyu Lin, Haojie Li, Xie Wu
Archives of Physical Medicine and Rehabilitation.2026;[Epub] CrossRef
Instrumented Timed Up and Go (iTUG): A Systematic Review of Parameters Across Healthy, Older, and Neurological Populations
Piotr Szaflik, Katarzyna Nowakowska-Lipiec
Journal of Clinical Medicine.2026; 15(9): 3307. CrossRef
Summary of the best evidence for non-pharmaceutical interventions for mild cognitive impairment in Parkinson’s disease
Yud Dan Liu, Hui Fang Li, Ya Xian Zhai, Yun Xia Shen, Jinmei Yang, Li Mei He, Ting Shen
Frontiers in Neurology.2025;[Epub] CrossRef
Symptom Networks and Associations with Quality of Life in Patients with Early to Mid-Stage Parkinson’s Disease: A Network Analysis
Qiu Deng, Yaoling Duan, Zhengting Yang, Puqing Wang, Ziwei Liu, Min Zhou
Degenerative Neurological and Neuromuscular Disease.2025; Volume 15: 101. CrossRef
Factors Associated With the Response to Exercise in Patients With Parkinson’s Disease
Myung Jun Lee, Jinse Park, Dong-Woo Ryu, Dallah Yoo, Sang-Myung Cheon
Journal of Movement Disorders.2025; 18(4): 308. CrossRef

Effectiveness of Live-Streaming Tele-Exercise Intervention in Patients With Parkinson’s Disease: A Pilot Study: Jongmok Ha, Jung Hyun Park, Jun Seok Lee, Hye Young Kim, Ji One Song, Jiwon Yoo, Jong Hyeon Ahn, Jinyoung Youn, Jin Whan Cho; J Mov Disord. 2024;17(2):189-197. Published online February 29, 2024; DOI: https://doi.org/10.14802/jmd.23251

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8 Web of Science
8 Crossref

Abstract PDF Supplementary Material

Objective
Exercise can improve both motor and nonmotor symptoms in people with Parkinson’s disease (PwP), but there is an unmet need for accessible and sustainable exercise options. This study aimed to evaluate the effect, feasibility, and safety of a regularly performed live-streaming tele-exercise intervention for PwP.
Methods
A live-streaming exercise intervention for PwP was implemented twice a week for 12 weeks. We measured the motor and nonmotor symptom scores of the included patients before and after the intervention. Changes in clinical scores from baseline to postintervention were analyzed using paired t-tests. Factors associated with improvements in clinical scores and compliance were analyzed using Pearson’s correlation analysis.
Results
Fifty-six participants were enrolled in the study. There were significant improvements in Hospital Anxiety and Depression Scale (HADS)-anxiety (p = 0.007), HADS-depression (p < 0.001), Unified Parkinson’s Disease Rating Scale (UPDRS) part III (p < 0.001), UPDRS total (p = 0.015), Hoehn and Yahr stage (p = 0.027), and Parkinson’s Disease Fatigue Scale-16 (p = 0.026) scores after the intervention. Improvements in motor symptoms were associated with improvements in mood symptoms and fatigue. Higher motor impairment at baseline was associated with a greater compliance rate and better postintervention composite motor and nonmotor outcomes (ΔUPDRS total score). Overall, the 12-week tele-exercise program was feasible and safe for PwP. No adverse events were reported. The overall adherence rate was 60.0% in our cohort, and 83.4% of the participants were able to participate in more than half of the exercise routines.
Conclusion
The live-streaming tele-exercise intervention is a safe, feasible, and effective nonpharmacological treatment option that can alleviate fatigue and improve mood and motor symptoms in PwP.

Citations

Citations to this article as recorded by

Effects of Telehealth Interventions for People With Parkinson Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Minyue Sun, Fuyou Tang, Luo min, Shiyu Wen, Shuang Wang, Huiping Jiang
JMIR mHealth and uHealth.2026; 14: e70994. CrossRef
Cycling exercise for autonomic symptoms in early Parkinson's disease
Jin-Sun Jun, Nyeonju Kang, Kiwon Park, Beomseok Jeon, Kyeongho Byun, Ryul Kim
Autonomic Neuroscience.2026; 264: 103397. CrossRef
Characterizing virtual community exercise programs for people with mobility limitations: a scoping review
Renato Barbosa dos Santos, Jing Lin, Anchal Badwal, Hardeep Singh, Susan B. Jaglal, Chavon Niles, Nancy M. Salbach
Journal of Exercise Science & Fitness.2026; 24(3): 200477. CrossRef
Relationship between stigma and negative emotions among patients with Parkinson’s disease: The mediating role of health literacy and family function
Aoxue Zhu, Huiling Xie, Juan Wei, Mei Wang, Tianrong Huang, Huina Mao
Geriatric Nursing.2025; 63: 567. CrossRef
Feasibility and preliminary efficacy of an online home-based functional exercise program for Parkinson's disease: a pilot study
Hyungwoo Lee, Hunyoung Ha, Heehyun Shin, Byungjun Park, Nyeonju Kang, Kiwon Park, Ryul Kim, Kyeongho Byun
Frontiers in Neurology.2025;[Epub] CrossRef
Effectiveness of telerehabilitation in reducing motor disability and enhancing quality of life in parkinson’s disease: a systematic review and meta-analysis
Anas Zakarya Nourelden, Mohamed Mamdouh, Ibrahim Kamal, Osama Khalid Abdelgawad Ahmed, Adel Reda Abd Elwahab, Mohammed Elkholy, Abdelrahman G. Tawfik, Mohamed Hesham Gamal, Ahmed Hashem Fathallah
Acta Neurologica Belgica.2025;[Epub] CrossRef
Effects of Whole-Body, Local, and Modality-Specific Vibration Therapy on Gait in Parkinson’s Disease: A Systematic Review and Meta-Analysis
Ji-Woo Seok, Se-Ra Park
Biomedicines.2025; 13(10): 2505. CrossRef
Factors Associated With the Response to Exercise in Patients With Parkinson’s Disease
Myung Jun Lee, Jinse Park, Dong-Woo Ryu, Dallah Yoo, Sang-Myung Cheon
Journal of Movement Disorders.2025; 18(4): 308. CrossRef

Brief communication

Effectiveness of Exercise on the Sequence Effect in Parkinson’s Disease: Suk Yun Kang, Young Ho Sohn; J Mov Disord. 2020;13(3):213-217. Published online August 31, 2020; DOI: https://doi.org/10.14802/jmd.20045

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166 Download
3 Web of Science
3 Crossref

Abstract PDF Supplementary Material

Objective
To determine the benefits of motor training on the sequence effect (SE), an essential component of bradykinesia in Parkinson’s disease (PD).
Methods
Seven patients with de novo PD participated in this study. The patients performed regular pentagon drawing tests and exercises during four visits. The first two visits occurred before the start of medication, and the last two visits occurred at least six months after the start of medication. We assessed the severity of bradykinesia and SE at each visit and compared the results before and after exercise in both the de novo and treatment conditions.
Results
In the de novo condition, the severity of bradykinesia significantly improved after motor training (p = 0.018), but it did not resolve and only showed a trend of improvement after treatment (p = 0.068). The severity of the SE decreased significantly in the drug-naïve condition (p = 0.028) but not after medication (p = 0.273).
Conclusion
Our study suggests that regular motor training may be beneficial for the SE in PD.

Citations

Citations to this article as recorded by

Long-term motor learning in focal hand dystonia
Ejaz A. Shamim, Min Seung Kim, Suk Yun Kang, Prachaya Srivanitchapoom, Seung-Hyun Jin, Elise Houdayer, Pierre Diomi, Nivethida Thirugnanasambandam, Sahana N. Kukke, Masao Matsuhashi, Jean-Charles Lamy, Tianxia Wu, Sabine Meunier, Mark Hallett
Clinical Neurophysiology.2024; 168: 63. CrossRef
Exploring the Complex Phenotypes of Impaired Finger Dexterity in Mild-to-moderate Stage Parkinson’s Disease: A Time-Series Analysis
Pattamon Panyakaew, Kotchakorn Duangjino, Apiwoot Kerddonfag, Teerit Ploensin, Krerk Piromsopa, Chanon Kongkamol, Roongroj Bhidayasiri
Journal of Parkinson’s Disease.2023; 13(6): 975. CrossRef
The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
Alessia Putortì, Michele Corrado, Micol Avenali, Daniele Martinelli, Marta Allena, Silvano Cristina, Valentina Grillo, Luca Martinis, Stefano Tamburin, Mariano Serrao, Antonio Pisani, Cristina Tassorelli, Roberto De Icco
Frontiers in Neurology.2021;[Epub] CrossRef

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