Impact of Physical Exercise on Reaction Time in Patients With Parkinson's Disease—Data From the Berlin BIG Study

Abstract Objective To determine whether physical activity may affect cognitive performance in patients with Parkinson's disease by measuring reaction times in patients participating in the Berlin BIG study. Design Randomized controlled trial, rater-blinded. Setting Ambulatory care. Participants Patients with mild to moderate Parkinson's disease (N=60) were randomly allocated to 3 treatment arms. Outcome was measured at the termination of training and at follow-up 16 weeks after baseline in 58 patients (completers). Interventions Patients received 16 hours of individual Lee Silverman Voice Treatment-BIG training (BIG; duration of treatment, 4wk), 16 hours of group training with Nordic Walking (WALK; duration of treatment, 8wk), or nonsupervised domestic exercise (HOME; duration of instruction, 1hr). Main Outcome Measures Cued reaction time (cRT) and noncued reaction time (nRT). Results Differences between treatment groups in improvement in reaction times from baseline to intermediate and baseline to follow-up assessments were observed for cRT but not for nRT. Pairwise t test comparisons revealed differences in change in cRT at both measurements between BIG and HOME groups (intermediate: −52ms; 95% confidence interval [CI], −84/−20; P =.002; follow-up: 55ms; CI, −105/−6; P =.030) and between WALK and HOME groups (intermediate: −61ms; CI, −120/−2; P =.042; follow-up: −78ms; CI, −136/−20; P =.010). There was no difference between BIG and WALK groups (intermediate: 9ms; CI, −49/67; P =.742; follow-up: 23ms; CI, −27/72; P =.361). Conclusion Supervised physical exercise with Lee Silverman Voice Treatment-BIG or Nordic Walking is associated with improvement in cognitive aspects of movement preparation.