Complexity of an animal's environment has been shown to affect structural and functional changes in the brain. Evidence from animal models of Parkinson's disease (PD) suggests that exercising in an enriched environment may protect against the onset of Parkinsonian symptoms in rats that are exposed to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The variety of activities and visual interfaces that can be created using commercially available gaming devices provide cognitively stimulating as well as physically challenging environments for exercise. This case series will: 1) elaborate on the rationale behind selection of specific games to target common deficits seen in PD; and 2) present preliminary results on clinical outcomes from three pilot participants who each completed six sessions of exercise. All three participants had mild to moderate PD. They were functionally independent individuals leading an active lifestyle. Participants were tested on the outcome measures before and after the six exercise sessions. On average, participants showed a 33.8% (22.8) improvement in functional reach test, 12.7% (35.0) improvement in single limb stance (SLS) time-right leg, 55.2% (33.9) improvement in SLS time-left leg, 11.9% (7.3) improvement in 6-min walk test, 2% (6.8) improvement in self-selected gait speed (GS), and 8.0% (5.8) improvement in fastest possible GS. Further investigation is warranted to study if these effects can be replicated over a longer exercise intervention and in a larger group, and if these effects are maintained at follow-up testing after the enriched exercise intervention is discontinued.
Keywords: Exergaming; Parkinson disease; exercise environment.