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Effects of high-intensity interval training and moderate-intensity continuous training on non-motor symptoms in patients with Parkinson’s disease: a randomised pilot trial
  1. Ryul Kim1,
  2. Seohee Choi2,
  3. Nyeonju Kang3,
  4. Kiwon Park4,
  5. Heehyun Shin3,
  6. Hanall Lee3,
  7. Hyungwoo Lee3,
  8. Jin-Sun Jun5,
  9. Beomseok Jeon6,
  10. Kyeongho Byun3
  1. 1Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  2. 2Department of Neurology, Inha University Hospital, Incheon, Korea (the Republic of)
  3. 3Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
  4. 4Department of Biomedical and Robotics Engineering, Incheon National University, Incheon, Korea (the Republic of)
  5. 5Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)
  6. 6Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  1. Correspondence to Dr Ryul Kim, Department of Neurology, Seoul National University - Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Dongjak-gu, Seoul, Korea (the Republic of); arkrk86{at}; Professor Kyeongho Byun, Division of Sport Science, Incheon National University, Yeonsu-gu, Incheon, Korea (the Republic of); kbyun21{at}

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The benefits of engaging in regular exercise for individuals with Parkinson’s disease (PD) have been widely recognised.1 With respect to non-motor symptoms, previous studies have demonstrated the efficacy of physical exercises on cognitive function and depressive and sleep-related symptoms.2–4 However, it is largely unknown whether exercise improves other non-motor symptoms and how such effects differ with exercise intensity and mode.

Growing evidence in populations with cardiometabolic disease supports the superiority of high-intensity interval training (HIIT) over moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness.5 Recent studies have shown that HIIT is feasible and safe for patients with PD,6 but its effects on clinical outcomes, particularly non-motor symptoms, remain unclear. Thus, this trial aimed to explore the potential effects of HIIT and MICT programmes on a range of non-motor symptoms in patients with PD.


Details regarding the protocol and methodology of this study are described in online supplemental appendices S1–S3. In this 24-week, randomised, controlled, investigator-blinded pilot trial, participants with PD (Hoehn and Yahr stages 1–2; aged 50–80 years) were allocated to HIIT (3 days/week, 60% maximum aerobic power for 30–50 s with 1 min rest intervals), MICT (3 days/week, 50% peak oxygen consumption [V̇O2 peak]) or control (usual care) groups.

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The feasibility outcomes included attrition and adherence rates. The primary clinical outcome was a 24-week change in the Non-Motor Symptoms Scale (NMSS) score. The secondary clinical outcomes were 24-week changes in the scores of Montreal Cognitive Assessment, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Apathy Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Rapid Eye Movement Sleep Behaviour Disorder Screening Questionnaire, Scales for Outcomes in Parkinson’s Disease-Autonomic, Parkinson’s Fatigue Scale, King’s Parkinson’s Disease Pain Scale and Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) …

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  • Contributors RK and KB contributed to the conception and design of the study. RK, SC, NK, KP, HS, HL, HL and KB contributed to data acquisition, analysis and interpretation. RK contributed to statistical analysis. RK contributed to drafting of the manuscript. All authors contributed to revising the manuscript.

  • Funding This work was supported by the National Research Foundation grant funded by the Korea government (MSIT) (2021R1C1C1011822).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.