Progress and Prospects in Parkinson's Research/Therapy/Exercise/Neuroprotective effects
Fisher et al 
Laboratory evidence that physical exercise can have a neuroprotective effect was reported by Dr Beth Fisher and others from the University of Southern California. They studied the effect of exercise in mice. A motorized treadmill was used to give the exercise. One group of mice was given a nerve toxin MPTP (which causes damage to dopaminergic neurones and gives the mouse a Parkinsonian-like condition) and was exercised intensively for 30 days. A second group was given MPTP but no exercise. A third group was given the exercise and saline injections, but not the MPTP. A fourth group was given saline and no exercise. After 30 days each group was assessed for speed and endurance. The MPTP and exercise group almost caught up with the saline and exercise group, suggesting that exercise had indeed been neuroprotective.
Tomlinson et al  measured the effects of physiotherapy upon PD by carrying out an extensive review of literary sources.
They identified 33 trials with 1518 participants. Compared with no-intervention, physiotherapy significantly improved the gait outcomes of velocity, confidence interval, two- or six-minute walk test, and step length, functional mobility and balance outcomes of Timed Up & Go test, Functional Reach Test, and Berg Balance Sccale; and clinician-rated disability using the Unified Parkinson's Disease Rating Scale (UPDRS), activities of daily living, and motor. There was no difference between arms in falls or patient-rated quality of life.
Most of the observed differences between the treatments were small. However, for some outcomes (e.g. velocity, Berg Balance Scale and UPDRS), the differences observed were at, or approaching, what are considered minimally clinical important changes. The review illustrates that a wide range of approaches are employed by physiotherapists to treat PD. However, there was no evidence of differences in treatment effect between the different types of physiotherapy interventions being used, though this was based on indirect comparisons. There is a need to develop a consensus menu of 'best-practice' physiotherapy, and to perform large well-designed randomised controlled trials to demonstrate the longer-term efficacy and cost-effectiveness of 'best practice' physiotherapy in PD.
- Fisher BE, Petzinger GM, Nixon K, Hogg E, Bremmer S, Meshul CK, Jakowec MW Exercise-induced behavioral recovery and neuroplasticity in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse basal ganglia. J Neurosci Res. 2004 Aug 1;77(3):378-90 http://www.ncbi.nlm.nih.gov/pubmed/15248294
- Tomlinson, C. L.; Patel, S.; Meek, C.; Clarke, C. E.; Stowe, R.; Shah, L.; Sackley, C. M,; Deane, K. H.; Herd, C. P.; Wheatley, K. and Ives, N. (2012) Abstract< Cochrane Database Syst. Rev. 2012 Jul 11;7:CD002817 Physiotherapy versus placebo or no intervention in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/22786482