# Moderate versus High Volume Light-Moderate Intensity Exercise for People with Moderate Parkinson's Disease

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## Abstract

For the first time, this project will define the impact of high volume (HV) exercise compared to moderate
volume (MV) exercise for Veterans with moderate PD (Stages 2-3). Volume of aerobic exercise (AE) has not
been previously well studied in PD, in moderate PD, nor in Veterans. Exercise is now prescribed as a first line
therapy in PD. Exact combinations of frequency, duration (the product of which is volume) and intensity of AE
need to be determined for optimal delivery of exercise for PD. In contrast to studies of high intensity exercise,
which is being investigated in a major stage 3 clinical trial, SPARX3, few studies have examined the impact of
volume, in particular HV in PD. As such, AE volume is primed for evaluation, for its effects on gait measures,
and overall physical activity (PA). Like (SPARX3), evaluation of volume must include clinically-relevant
behavioral measures, e.g., gait parameters, and disease severity; biomarkers of neurodegeneration,
representing inflammatory, and neurotrophic mechanisms. Given the strong impact of PD on autonomic and
sympathetic processes in PD (Sabino-Carvalho et al., 2020) cardiovascular and vascular processes should
also be evaluated- particularly in moderate PD who have OFF-time and greater motor dysfunction. Our
published work shows HV light-moderate intensity Partnered dance AE (PDAE) (5 days/week, for 2-3 weeks) -
improved gait, motor function and neuromuscular control in people with moderate PD. These functional
changes were comparable to changes seen in programs of longer duration and lower weekly volume. PDAE
has been tailored for Veterans with PD since 2011 and is adaptable for MV or HV. This project explores effects
of exercise dosing that make good use of patients’ high functioning times and will lead to enhance gait
parameters and more PA. The primary outcome measure is preferred gait cadence, a clinically relevant
variable for gait training studies, and which our data show is strongly associated with PA. At the Atlanta VA,
for 13 years, Dr. Hackney (PI) and her team have developed a research infrastructure to investigate rehab
treatments for Veterans with PD -most of whom have moderate stage PD. The expertise, resources and
infrastructure the team has accumulated are crucial for the proposed work. This RCT assigns n=102 (34 per
group) older Veterans with PD to 52 weeks of PDAE at HV or moderate volume (MV) or to a MV control (MV-
WALK). Overall exercise dose will be 112.5 hours over 52 weeks. MV-PDAE and MV-WALK classes will meet
twice-weekly for 65-minutes. HV PDAE classes will meet 5 times a week for 90 minutes for three weeks at trial
onset followed by one HV week every 4 weeks for a year. Gait cadence will be measured with inertial sensors.
PA will be measured with accelerometry and a questionnaire. Outcomes will be assessed at baseline (before
intervention), and at 52 weeks (intervention end). We assume 20% attrition and will recruit 21 additional
participants, totaling 123 Veteran pa...

## Key facts

- **NIH application ID:** 10864280
- **Project number:** 1I01RX004817-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Madeleine Eve Hackney
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-04-01 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864280

## Citation

> US National Institutes of Health, RePORTER application 10864280, Moderate versus High Volume Light-Moderate Intensity Exercise for People with Moderate Parkinson's Disease (1I01RX004817-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10864280. Licensed CC0.

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