Author(s): NATALE, D., MELONI, M., CARIA, A., PORCO, I.G., BANDIERA, P., PAULUS, K., SOLLA, P., DELLA CROCE, U., MANCA, A., CUGUSI, L., Institution: UNIVERSITY OF SASSARI, Country: ITALY, Abstract-ID: 1982

INTRODUCTION:
Outdoor land- and water-based activities are considered non-conventional, promising activities for individuals with motor disorders deriving from neurological conditions. The aim of this pilot study was to investigate the anthropometric, body composition, functional and psychological effects of a 10-week, multisport outdoor program (i.e., hiking, surf, kayak, and sailing) in mildly disabled individuals with Parkinsons disease (PD).
METHODS:
The research design was set as a single-group pre-test/post-test interventional study. Ten subjects (9M:1W; median Hoehn-Yahr: 2; range: 1-3) were recruited from those referring to the neurology unit and volunteered to participate in a 10-week outdoor program consisting of 8 hiking sessions (2/week), and 12 sessions of different water-sports activities (i.e., surf, kayak, and sailing; 2 sessions/week). Main outcomes (anthropometrics, body composition, balance, muscular strength, flexibility, cardiorespiratory fitness, quality of life) were assessed at baseline (PRE), end of the hiking sessions (MID), at the completion of the water-sports intervention (POST) and at three months from the program completion (follow_up, F_UP).
RESULTS:
Repeated-measures ANOVA and adjusted post-hoc comparisons revealed significant changes in body weight (PRE-POST: -3%; p=0.014; MID-POST: -2.4%; p=0.008; POST-F_UP: +3.4%; p=0.005) and in Body Mass Index (PRE-MID: -2%; p=0.014; PRE-POST: -2.7%; p=0.014), waist circumferences (POST-F_UP: +5.3%; p=0.033), and Waist-to-Hip Ratio (PRE-POST: -2.5%; p=0.029; POST-F_UP: +5.8%; p=0.005). A significant decrease was observed in the time to complete the Five-Times-Sit-to-Stand Test (PRE-MID: -17.2%; p=0.005). Flexibility was found changed both in the Back Scratch (PRE-POST: +24.6%; p=0.042) and Sit-and-Reach Tests (PRE-POST: +87%; p=0.015). Regarding cardiorespiratory fitness, as estimated by distance covered during the 2-Minute and 6-Minute Walk Tests (2MWT, 6MWT), data showed a significant increase in distance both for the 2MWT (PRE-POST: +9.7%; p=0.035), and 6MWT (PRE-POST: +9.4%; p=0.011; MID-POST: +4.9%; p=0.032). Wilcoxon U-tests run on clinical scores revealed significant changes in UPDRS-1 (mentation/behavior/mood sections: PRE-POST: -29.5%; p=0.008), UPDRS-3 (motor sections: PRE-POST: -6.1%; p=0.05), and Beck Depression Inventory (PRE-POST: -33.5%; p=0.028).
CONCLUSION:
Preliminary data showed that a 10-week program combining land- and water-based outdoor activities proved safe and feasible in mildly disabled individuals with PD, also showing potential for improving mood as well as selected anthropometrics, motor-functional and cardiorespiratory outcomes. However, the significant drops in performance detected at the 3-month F_UP should be taken into proper account as they may suggest the need for involving people with PD in longer-term interventions to induce a stable behavioral change in lifestyle.