{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:42:39Z","timestamp":1782546159380,"version":"3.54.5"},"reference-count":69,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2R01NS073717-06A1"],"award-info":[{"award-number":["2R01NS073717-06A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Previous short duration studies have demonstrated that high-intensity aerobic exercise improves aspects of motor and non-motor function in people with Parkinson disease (PwPD); however, the effectiveness of a long-term exercise intervention on slowing disease progression is unknown. The primary aim of this study is to determine the disease-altering effects of high-intensity aerobic exercise, administered on an upright stationary cycle, on the progression of PD. A secondary aim is to develop a prognostic model for 12-month changes in the Movement Disorder Society Unified Parkinson's Disease Rating Scale III (MDS-UPDRS III) of PwPD undergoing an aerobic exercise intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This pragmatic, multisite, single-rater blinded, randomized controlled trial will recruit PwPD from 2 large, urban, academic medical centers. Participants (N = 250 PwPD) will be randomized to (1) home-based aerobic exercise or (2) usual and customary care. Those in the aerobic exercise arm will be asked to complete in-home aerobic exercise sessions at 60% to 80% of heart rate reserve 3 times per week for 12\u00a0months utilizing a commercially available upright exercise cycle. The usual and customary care group will continue normal activity levels. Daily activity will be monitored for both groups throughout the 12-month study period. The primary outcome, both to assess disease-modifying response to aerobic exercise and for prognostic modeling in the aerobic exercise arm, is 12-month rate of change in the MDS-UPDRS III. Clinical and biomechanical measures will also be used to assess upper and lower extremity motor function as well as non-motor functions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>Should long-term aerobic exercise demonstrate disease-modifying capability, this study will provide evidence that \u201cExercise is Medicine\u201d for PwPD. Further, the derived prognostic model will inform a patient-specific exercise prescription for PwPD and expected effects on PD progression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzab191","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T19:11:48Z","timestamp":1628017908000},"source":"Crossref","is-referenced-by-count":19,"title":["Effectiveness of a Long-Term, Home-Based Aerobic Exercise Intervention on Slowing the Progression of Parkinson Disease: Design of the Cyclical Lower Extremity Exercise for Parkinson Disease II (CYCLE-II) Study"],"prefix":"10.1093","volume":"101","author":[{"given":"Jay L","family":"Alberts","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Cleveland Clinic , Cleveland, Ohio, USA"},{"name":"Center for Neurological Restoration , Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5468-8208","authenticated-orcid":false,"given":"Anson B","family":"Rosenfeldt","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Cleveland Clinic , Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cielita","family":"Lopez-Lennon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Suttman","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Elizabeth","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Cleveland Clinic , Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0533-4603","authenticated-orcid":false,"given":"Peter B","family":"Imrey","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic , Cleveland, Ohio, USA"},{"name":"Mellen Center for Multiple Sclerosis Treatment and Research , Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University , Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leland E","family":"Dibble","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah, 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