Parkinson's disease s a progressive neurologic disorder that ultimately results in loss of functional capability and complete dependence. Until recently most discussions of intervention for Parkinson's disease have centered on pharmacologic management of the major neurologic deficits of the Parkinson's patient. Exercise has been used as a minor adjunct to te therapy and to teach patients compensatory techniques for their deficits. Recently, Drs. Schenkman and Butler have suggested that the patient's difficulties with functional performance result in part from the musculoskeletal impairments that accompany PD as sequelae to the neurologic impairments. These authors have suggested that exercise should be an integral part of the management of the Parkinson's patient. The purposes of this investigation are: (1) To compare the effects of two different exercise approaches for Parkinson's patients in producing improvements of impairments and function limitation (2) To compare group as apposed to individualized intervention strategies for those patients. One of the exercise approaches that will be used in this study (called the Axial Mobility Exercise Program) focuses on restoration of mobility of the axial structures (neck, back and pelvic complex) in the context of functional tasks. The second exercise approach (called the Traditional PD Exercise Program) utilizes standard exercises for the Parkinson's patient that have been prepared by the United Parkinson's Foundation. These exercises are general stretching exercises with emphasis on the extremities and are less specifically directed toward axial mobility. Phase I of the study will establish the effects of the specific individualized Axial Mobility Exercise Program as compared to the Traditional PD Exercise Program. Assuming that the Axial Mobility Exercise Program is more effective that the Traditional PD Exercise Program, Phase II of the study will determine whether patients who are treated in group settings with the Axial Mobility Exercise Program can receive the same benefit as patients do who are treated on an individual basis. Data from both phases will be analyzed using an Analysis of Variance.
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