{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:45:49Z","timestamp":1782920749137,"version":"3.54.5"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Geriatr Psychiatry Neurol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical exercise is a promising approach to address non-motor symptoms (NMS) in Parkinson\u2019s disease (PD), although the most effective modalities remain under investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effects of three upper limb (UL) exercise modalities\u2014resistance training (RES), aerobic exercise (AER), and task-specific training (TST)\u2014on NMS in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-seven community-dwelling individuals with PD (mean age = 62 \u00b1 10\u00a0years; mean diagnosis duration = 7 \u00b1 5\u00a0years; mean Hoehn &amp; Yahr stage = 2 \u00b1 0.4) were randomized into three intervention groups (RES, AER, TST) and a usual care control group. Interventions were performed three times per week, 40-50 minutes per session, over 8 weeks. Clinical outcomes included overall NMS (Movement Disorder Society-Unified Parkinson\u2019s Disease Rating Scale Part I, MDS-UPDRS I), global and domain-specific cognition (Mini-Mental State Examination [MMSE], Addenbrooke\u2019s Cognitive Examination-Revised [ACE-R], Trail Making Test), depression (Geriatric Depression Scale [GDS]), and anxiety (Beck Anxiety Inventory [BAI]). Intervention effects were analyzed using mixed-effects models and non-parametric factorial analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between-group analyses showed that UL exercises similarly reduced overall NMS severity and cognitive dysfunction, while maintaining baseline fatigue levels, in contrast to deterioration in the CON. RES and TST reduced anxiety (BAI), and RES also reduced apathy. Within-group improvements in cognitive domains, depression, hallucinations, and sleep problems were observed in the RES and TST groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first study to demonstrate that isolated UL exercise modalities exert clinically relevant effects on NMS in PD. These modalities may be valuable additions to multidimensional rehabilitation strategies in PD care. [Brazilian Registry of Clinical Trials: RBR-7zjgnrx].<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08919887251409414","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T17:13:08Z","timestamp":1766769188000},"page":"624-637","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Upper Limb Exercises Reduce Non-motor Symptoms and Increase Cognitive Function in Parkinson\u2019s Disease: Randomized Controlled Trial"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2356-7523","authenticated-orcid":false,"given":"Valton","family":"Costa","sequence":"first","affiliation":[{"name":"Federal University of Sao Carlos"},{"name":"Federal University of Sao Carlos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryela","family":"Menacho","sequence":"additional","affiliation":[{"name":"Federal University of Sao Carlos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalita","family":"Frigo da Rocha","sequence":"additional","affiliation":[{"name":"Federal University of Sao Carlos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Fregni","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa Pires","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Federal University of Sao Carlos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Carolyna","family":"Gianloren\u00e7o","sequence":"additional","affiliation":[{"name":"Federal University of Sao Carlos"},{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.09.004"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827deb74"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70373-8"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-002-0808-2"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00037"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23462"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.2737"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzab302"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/08919887241237223"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/02703181.2024.2380993"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27602"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-020-01617-w"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12905"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jjns.12418"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2020.05.011"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756286420986744"},{"key":"e_1_3_8_18_2","volume-title":"Acsm's Exercise Testing and Prescription","author":"Bayles MP","year":"2023","unstructured":"Bayles MP. 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