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The objective of this study was to verify if adapted resistance training with instability \u2014 exercises with motor complexity will be more effective than traditional motor rehabilitation \u2014 exercises without motor complexity in improving freezing\u2010of\u2010gait severity, outcomes linked to freezing of gait, and brain function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Freezers were randomized either to the adapted resistance training with instability group (n = 17) or to the active control group (traditional motor rehabilitation, n = 15). Both training groups performed exercises 3 times a week for 12\u2009weeks. The primary outcome was the New Freezing of Gait Questionnaire. Secondary outcomes were freezing of gait ratio (turning task), cognitive inhibition (Stroop\u2010III test), motor signs (Unified Parkinson's Disease Rating Scale part\u2010III [UPDRS\u2010III]), quality of life (PD Questionnaire 39), anticipatory postural adjustment (leg\u2010lifting task) and brain activation during a functional magnetic resonance imaging protocol of simulated anticipatory postural adjustment task. Outcomes were evaluated before and after interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Only adapted resistance training with instability improved all the outcomes (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Adapted resistance training with instability was more effective than traditional motor rehabilitation (in improving freezing\u2010of\u2010gait ratio, motor signs, quality of life, anticipatory postural adjustment amplitude, and brain activation;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Our results are clinically relevant because improvement in the New Freezing of Gait Questionnaire (\u22124.4 points) and UPDRS\u2010III (\u22127.4 points) scores exceeded the minimally detectable change (traditional motor rehabilitation group data) and the moderate clinically important difference suggested for PD, respectively. The changes in mesencephalic locomotor region activation and in anticipatory postural adjustment amplitude explained the changes in New Freezing of Gait Questionnaire scores and in freezing\u2010of\u2010gait ratio following adapted resistance training with instability, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adapted resistance training with instability is able to cause significant clinical improvement and brain plasticity in freezers. \u00a9 2020 International Parkinson and Movement Disorder Society<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.28128","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T02:18:15Z","timestamp":1592533095000},"page":"1607-1617","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["A 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