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Chinese
Exercise Modalities in Parkinson's Disease
Principal
Investigator
Jorge L. Juncos, M.D.
- Dr. Juncos is responsible for the overall direction of the project,
patient recruitment, initial screening, optimization of drug therapy,
and for the direct supervision of the clinical coordinator, the motor
control technician, the research nurse and the CAM fellow. He supervises
all data acquisition and assists with the obtainment of medical histories
and administration of the physical, neurological and Parkinson disability
exams. Dr. Wolf, in conjunction with Dr.
Ray Watts, is the attending physician during the sub-maximal GTX,
which is conducted at the Center for Human Movement Studies at Georgia
Tech.
Dr. Juncos
is a neurologist and movement disorder specialist with extensive clinical
and research experience in PD. He is the Director of the Neurology Hospital
Service at the Wesley Woods
Center and is the Co-Director of the Emory Movement Disorders Program.
Dr. Juncos routinely uses the clinical assessment instruments of this
study in clinical research and in a practice that includes over 800 movement-disorder
patients, about 60% of which have PD. For the last several years, he has
worked closely with Dr. Tingsen Txu (Tai Chi Chuan Grand Master) to adapt
for parkinsonian patients the Tai Chi Chuan (TCC) forms originally developed
for the frail and elderly. He is in the process of doing the same for
Qi Gong. Dr. Juncos is also experienced at investigating the effects of
conventional exercise in PD.
Co-Principal
Investigator
Dr. Steven L. Wolf, Ph.D.,
FAPTA - Dr. Wolf is responsible for the study oversight, particularly
the Georgia Tech Human Movement
Studies component. He assists with the patient recruitment and, along
with Dr. Bob Gregor and
Dr. Dwight Waddell, has primary responsibility for all of the EMG studies
and gait analysis studies conducted by the Movement Analysis Core. He
is also partly responsible for data analysis and reporting.
Background
PD is a disorder whose primary disability stems from motor dysfunction
including balance. Recent studies have shown that the risk of falling
in the elderly can be reduced through the practice of Chinese CAMs such
as TCC. Although a recent Emory report suggests that PD patients can do
well with aerobic exercise training (AET) (e.g., walk/run), it is still
unclear whether the potential anti-parkinsonian effect of such modalities
is secondary to improved physical fitness, motor control, or both. CAM
interventions such as TCC offer a unique opportunity to examine fundamental
questions such as this one.
Study
The long-term goal of this project is to study the effects of different
exercise modalities on PD.
We are conducting a controlled, double-blind, 16-week dose-response study
of exercise based on caloric expenditure and thus on the cardiorespiratory
fitness effects of exercise. The treatments are Qi Gong (minimal caloric
expenditure), TCC (low expenditure), and a walk-cycle AET (moderate expenditure).
We are examining exercise-induced change in motor control using quantitative
measures of motor disability, including dynamic gait and stability measures.
We are also examining exercise effects on central and peripheral indices
of parkinsonian motor disability.
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