Study Suggests Table Tennis Exercises May Benefit Motor Symptoms in Parkinson Disease

In a preliminary study released today, researchers found that patients with Parkinson disease (PD) who participated in a table tennis exercise program once a week for 6 months exhibited an improvement in their motor skills.

Study findings will additionally be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, occurring from April 25 to May 1, 2020.

Recent innovations within rehabilitation for patients with PD (PwP) has shown the potential efficacy of physical and cognitive exercises in improving motor and non-motor symptoms. Exercises such as balance training have also exhibited an anti-inflammatory response that could improve incidence of exacerbation and symptom recurrence in PwP.

While promising, researchers highlighted that it is not clear what exercises may optimally improve symptoms of PD in patients. Study author Ken-ichi Inoue, MD, Fukuoka University in Fukuoka, Japan, noted that table tennis, a popular sport worldwide, “is a form of aerobic exercise that has been shown in the general population to improve hand-eye coordination, sharpen reflexes, and stimulate the brain,” said Inoue. "We wanted to examine if people with Parkinson disease would see similar benefits that may in turn reduce some of their symptoms."

Researchers conducted a 6-month prospective trial involving 12 participants (average age = 73 years) with mild to moderate PD, defined as stage 3 of or less of the Hoehn & Yahr rating scale, who had been diagnosed with PD for an average of 7 years. PwP participated in 5-hour exercise sessions once a week for 6 months where they performed stretching exercises followed by table tennis exercises with instruction from an experienced table tennis player.

Participants were assessed at baseline, 3 months, and 6 months with MDS Unified Parkinson Disease Rating Scale (MDS-UPDRS) part 1-4, Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Self-Rating Depression Scale (SDS), and Apathy Scale.

In the study findings, MDS-UPDRS part 2 and part 3 were significantly improved among PwP at 3 months (part 2, P < .001; part 3, P = .002) and 6 months (part 2, P < .001; part 3, P < .001) after intervention.

Researchers noted that in UPDRS part 2, significant improvements were observed in subscores of speech, saliva and drooling, dressing, handwriting, doing hobbies and other activities, getting out of a bed, car, or deep chair, and walking and balance. In MDS-UPDRS part 3, significant improvements were shown in subscores of facial expression, rigidity, postural stability, posture, bradykinesia, and kinetic tremor of the hands.

Conversely, there were no observed improvements in MDS-UPDRS part 1 and 4, MoCA, FAB, SDS, and Apathy scale. Adverse events included fall and backache for 1 patient each.

Several limitations, including no control group and a single specialist assessing patients, warrant further research. “While this study is small, the results are encouraging because they show pingpong, a relatively inexpensive form of therapy, may improve some symptoms of Parkinson's disease," said Inoue. "A much larger study is now being planned to confirm these findings.”

Reference

Inoue KI, Fujioka S, Suenaga M, et al. Table tennis exercise for patients with Parkinson disease: a prospective pilot study [published online February 25, 2020]. Presented at: The American Academy of Neurology’s 72nd Annual Meeting, April 25 to May 1, 2020; Toronto, Canada.