{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:01:37Z","timestamp":1791450097262,"version":"4.3.3"},"reference-count":43,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPD"],"published-print":{"date-parts":[[2021,8,2]]},"abstract":"<jats:p>Background: In Parkinson\u2019s disease (PD), sustained aerobic exercise is a promising therapy in delaying motor disability. Brisk walking is a moderate intensity aerobic training, which could be translated to community practice at low cost, but its effects on motor symptoms remains unclear. Objective: To determine the effectiveness of a six-month brisk walking and balance program in alleviating motor symptoms, and promoting functional, gait, and balance performance in people with PD. Methods: Seventy individuals with mild to moderate PD were randomly assigned to a brisk walking (BW) group or an active control (CON) group. BW group received ten 90-minute supervised brisk walking and balance exercise for six months (weeks 1\u20136: once\/week, weeks 7\u201326: once\/month). CON group received upper limb training. Both groups performed 2-3 self-practice sessions weekly. Primary outcome was Movement Disorder Society Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS) motor score. Secondary outcomes were fast gait speed (FGS), timed-up-and-go (TUG) time, six-minute walk distance (6MWD), and Mini-Balance Evaluation Systems Test (Mini-BEST) score. Results: Sixty-four participants (33 BW\/31 CON) completed training. BW group showed greater significant decreases from baseline than CON group in MDS-UPDRS motor score after six weeks (\u20135.5 vs \u20131.6, p\u200a&lt;\u200a0.001) and 6 months (\u20136.0 vs \u20131.4, p\u200a&lt;\u200a0.001) of training. BW group also showed greater significant improvement from the baseline than CON group for TUG time, FGS, 6MWD, and mini-BEST score (all p\u200a&lt;\u200a0.05). Conclusion: The six-month brisk walking and balance program alleviates motor symptoms, promotes functional and gait performance, walking capacity, and dynamic balance in people with mild to moderate PD.<\/jats:p>","DOI":"10.3233\/jpd-202503","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T05:36:28Z","timestamp":1620192988000},"page":"1431-1441","source":"Crossref","is-referenced-by-count":59,"title":["Six-Month Community-Based Brisk Walking and Balance Exercise Alleviates Motor Symptoms and Promotes Functions in People with Parkinson\u2019s Disease: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"11","author":[{"given":"Margaret K.Y.","family":"Mak","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene S.K.","family":"Wong-Yu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JPD-202503_ref1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1001\/jamaneurol.2017.3299","article-title":"The Parkinson pandemic\u2014a call to action","volume":"75","author":"Dorsey","year":"2018","journal-title":"JAMA Neurol"},{"key":"10.3233\/JPD-202503_ref2","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","article-title":"Parkinson\u2019s disease","volume":"386","author":"Kalia","year":"2015","journal-title":"Lancet"},{"key":"10.3233\/JPD-202503_ref3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.parkreldis.2016.02.006","article-title":"Identifying clinical measures that most accurately reflect the progression of disability in Parkinson disease","volume":"25","author":"Ellis","year":"2016","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202503_ref4","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson\u2019s disease, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"17","author":"Dorsey","year":"2018","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-202503_ref5","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/mds.27579","article-title":"The long-term direct and indirect economic burden among Parkinson\u2019s disease caregivers in the United States","volume":"34","author":"Martinez-Martin","year":"2019","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref6","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.14108","article-title":"Parkinson disease","volume":"27","author":"Balestrino","year":"2020","journal-title":"Eur J Neurol"},{"key":"10.3233\/JPD-202503_ref7","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/mds.27360","article-title":"Disease modification in Parkinson\u2019s disease: Current approaches, challenges, and future considerations","volume":"33","author":"Lang","year":"2018","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref8","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1002\/mds.27372","article-title":"International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson\u2019s disease","volume":"33","author":"Fox","year":"2018","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref9","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1038\/nrneurol.2017.128","article-title":"Long-term effects of exercise and physical therapy in people with Parkinson disease","volume":"13","author":"Mak","year":"2017","journal-title":"Nat Rev Neurol"},{"key":"10.3233\/JPD-202503_ref10","doi-asserted-by":"crossref","unstructured":"Ahlskog JE (2018) Aerobic exercise: Evidence for a direct brain effect to slow Parkinson disease progression. In Mayo Clinic Proceedings, Elsevier, pp. 360\u2013372.","DOI":"10.1016\/j.mayocp.2017.12.015"},{"key":"10.3233\/JPD-202503_ref11","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1002\/mds.26728","article-title":"The best medicine? The influence of physical activity and inactivity on Parkinson\u2019s disease","volume":"31","author":"LaHue","year":"2016","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref12","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1001\/jamaneurol.2017.3517","article-title":"Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: A phase 2 randomized clinical trial","volume":"75","author":"Schenkman","year":"2018","journal-title":"JAMA Neurol"},{"key":"10.3233\/JPD-202503_ref13","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S1474-4422(19)30285-6","article-title":"Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson\u2019s disease: A double-blind, randomised controlled trial","volume":"18","author":"van der Kolk","year":"2019","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-202503_ref14","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3233\/NRE-151257","article-title":"Effects of a Nordic Walking program on motor and non-motor symptoms, functional performance and body composition in patients with Parkinson\u2019s disease","volume":"37","author":"Cugusi","year":"2015","journal-title":"Neurorehabilitation"},{"key":"10.3233\/JPD-202503_ref15","doi-asserted-by":"crossref","first-page":"232473","DOI":"10.4061\/2011\/232473","article-title":"Effects of a flexibility and relaxation programme, walking, and nordic walking on Parkinson\u2019s disease","volume":"2011","author":"Reuter","year":"2011","journal-title":"J Aging Res"},{"key":"10.3233\/JPD-202503_ref16","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.2522\/ptj.20100390","article-title":"Factors associated with exercise behavior in people with Parkinson disease","volume":"91","author":"Ellis","year":"2011","journal-title":"Phys Ther"},{"key":"10.3233\/JPD-202503_ref17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.2165\/00007256-200030020-00002","article-title":"Detraining: Loss of training-induced physiological and performance adaptations. Part I","volume":"30","author":"Mujika","year":"2000","journal-title":"Sport Med"},{"key":"10.3233\/JPD-202503_ref18","first-page":"153","article-title":"Efficacy of a mobile technology-based brisk walking program in improving dynamic balance and motor performance in people with Parkinson disease - a randomized controlled trial","volume":"9","author":"Wong-Yu","year":"2019","journal-title":"J Parkinsons Dis"},{"key":"10.3233\/JPD-202503_ref19","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jphys.2019.08.003","article-title":"Home-based prescribed exercise improves balance-related activities in people with Parkinson\u2019s disease and has benefits similar to centre-based exercise: A systematic review","volume":"65","author":"Flynn","year":"2019","journal-title":"J Physiother"},{"key":"10.3233\/JPD-202503_ref20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1136\/jnnp.55.3.181","article-title":"Accuracy of clinical diagnosis of idiopathic Parkinson\u2019s disease: A clinico-pathological study of 100 cases","volume":"55","author":"Hughes","year":"1992","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JPD-202503_ref21","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.parkreldis.2017.01.012","article-title":"Evaluating the performance of the Montreal Cognitive Assessment in early stage Parkinson\u2019s disease","volume":"37","author":"Kletzel","year":"2017","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202503_ref22","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"key":"10.3233\/JPD-202503_ref24","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1002\/pon.802","article-title":"Predictors of adherence and contamination in a randomized trial of exercise in colorectal cancer survivors","volume":"13","author":"Courneya","year":"2004","journal-title":"Psychooncology"},{"key":"10.3233\/JPD-202503_ref25","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/mds.20213","article-title":"Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: Status and recommendations the Movement Disorder Society Task Force on rating scales for Parkinson\u2019s disease","volume":"19","author":"Goetz","year":"2004","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref26","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref27","doi-asserted-by":"crossref","first-page":"462","DOI":"10.2340\/16501977-0953","article-title":"Validation and reliability of the Physical Activity Scale for the Elderly in Chinese population","volume":"44","author":"Ngai","year":"2012","journal-title":"J Rehabil Med"},{"key":"10.3233\/JPD-202503_ref28","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1002\/mds.23429","article-title":"Systematic review of levodopa dose equivalency reporting in Parkinson\u2019s disease","volume":"25","author":"Tomlinson","year":"2010","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref29","doi-asserted-by":"crossref","first-page":"e000106","DOI":"10.1136\/bmjsem-2015-000106","article-title":"How accurate are the wrist-based heart rate monitors during walking and running activities? Are they accurate enough?","volume":"2","author":"Stahl","year":"2016","journal-title":"BMJ Open Sport Exerc Med"},{"key":"10.3233\/JPD-202503_ref30","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/s00415-012-6624-1","article-title":"Expanded and independent validation of the Movement Disorder Society-Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS)","volume":"260","author":"Martinez-Martin","year":"2013","journal-title":"J Neurol"},{"key":"10.3233\/JPD-202503_ref31","doi-asserted-by":"crossref","first-page":"733","DOI":"10.2522\/ptj.20070214","article-title":"Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism","volume":"88","author":"Steffen","year":"2008","journal-title":"Phys Ther"},{"key":"10.3233\/JPD-202503_ref32","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1093\/ptj\/85.2.134","article-title":"Testing functional performance in people with Parkinson disease","volume":"85","author":"Brusse","year":"2005","journal-title":"Phys Ther"},{"key":"10.3233\/JPD-202503_ref33","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2340\/16501977-0537","article-title":"Using psychometric techniques to improve the Balance Evaluation Systems Test: The mini-BESTest","volume":"42","author":"Franchignoni","year":"2010","journal-title":"J Rehabil Med"},{"key":"10.3233\/JPD-202503_ref34","first-page":"375419","article-title":"Comparing the Mini-BESTest with the Berg Balance Scale to evaluate balance disorders in Parkinson\u2019s disease","volume":"2012","author":"King","year":"2012","journal-title":"Parkinsons Dis"},{"key":"10.3233\/JPD-202503_ref35","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.parkreldis.2015.03.022","article-title":"Multi-dimensional balance training programme improves balance and gait performance in people with Parkinson\u2019s disease: A pragmatic randomised controlled trial with 12-month follow-up","volume":"21","author":"Wong-Yu","year":"2015","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202503_ref36","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1249\/FIT.0b013e31821eca84","article-title":"Parkinson\u2019s disease: A comprehensive approach to exercise prescription for the health fitness professional","volume":"15","author":"Gallo","year":"2011","journal-title":"ACSMs Health Fit J"},{"key":"10.3233\/JPD-202503_ref37","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc"},{"key":"10.3233\/JPD-202503_ref38","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.2522\/ptj.20140374","article-title":"Levels and patterns of physical activity and sedentary behavior in elderly people with mild to moderate Parkinson disease","volume":"95","author":"Benka Wall\u00e9n","year":"2015","journal-title":"Phys Ther"},{"key":"10.3233\/JPD-202503_ref39","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1159\/000213521","article-title":"Clinical parameters associated with falls in an elderly population","volume":"39","author":"Clark","year":"1993","journal-title":"Gerontology"},{"key":"10.3233\/JPD-202503_ref41","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/j.parkreldis.2015.10.006","article-title":"Minimal clinically important difference on the motor examination part of MDS-UPDRS","volume":"21","author":"Horv\u00e1th","year":"2015","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-202503_ref42","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/mds.23790","article-title":"Balance and falls in Parkinson\u2019s disease: A meta-analysis of the effect of exercise and motor training","volume":"26","author":"Allen","year":"2011","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202503_ref43","doi-asserted-by":"crossref","first-page":"703","DOI":"10.3233\/JPD-171173","article-title":"Motivators and barriers to exercise in Parkinson\u2019s disease","volume":"7","author":"Afshari","year":"2017","journal-title":"J Parkinsons Dis"},{"key":"10.3233\/JPD-202503_ref44","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1080\/09638288.2019.1638975","article-title":"Determinants of exercise behaviour in persons with Parkinson\u2019s disease","volume":"43","author":"Zaman","year":"2021","journal-title":"Disabil Rehabil"},{"key":"10.3233\/JPD-202503_ref45","doi-asserted-by":"crossref","first-page":"280","DOI":"10.2522\/ptj.20090091","article-title":"Striding out with Parkinson disease: Evidence-based physical therapy for gait disorders","volume":"90","author":"Morris","year":"2010","journal-title":"Phys Ther"}],"container-title":["Journal of Parkinson's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JPD-202503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:49:40Z","timestamp":1777610980000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JPD-202503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,2]]},"references-count":43,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3233\/jpd-202503","relation":{},"ISSN":["1877-7171","1877-718X"],"issn-type":[{"value":"1877-7171","type":"print"},{"value":"1877-718X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,2]]}}}