ORIGINAL RESEARCH article
Front. Physiol.
Sec. Exercise Physiology
This article is part of the Research TopicExercise in Neurological Disorders: Benefits and Physiological Changes in Parkinson’s Disease and BeyondView all articles
Long-Term Multicomponent Exercise Enhances Functional Mobility in Early-Stage Parkinson’s Disease: A 48-Month Retrospective Cohort Study
Provisionally accepted
Marcos Moura1Marina Lívia Venturini Ferreira1Filipe Duo Speri1Lucas Celsius Matos Alves1João Vitor Cerávolo Rostirola1Edevaldo Donizetti de Campos2
MIGUEL SOARES CONCEIÇÃO1*- 1Universidade Sao Francisco, Bragança Paulista, Brazil
- 2Virtual University of the State of São Paulo, São Paulo, Brazil
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Background: Long-term effects of structured exercise on functional capacity in Parkinson’s disease (PD) remain poorly understood. Objective: To investigate the impact of a 48-month multicomponent exercise program on mobility, aerobic capacity, and muscle mass in individuals with early-stage PD, and to examine baseline predictors of functional performance. Methods: Thirty-three patients with PD (Hoehn & Yahr stages 1–2) participated in a supervised, thrice-weekly program including aerobic, resistance, balance, and flexibility exercises. Assessments at baseline and 48 months included the Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), peak oxygen uptake (VO₂peak), and muscle mass. Minimal detectable change (MDC), effect sizes, and linear regressions were computed. Results: After 48 months, TUG time decreased by −3.8 s (95% CI: −5.0 to −2.6; p < 0.001; dz = −1.12) and 6MWT distance increased by +88.8 m (95% CI: 45.1 to 133.0; p < 0.001; dz = 0.72), both exceeding MDC thresholds. VO₂peak (−1.1 mL·kg⁻¹·min⁻¹; p = 0.142) and muscle mass (−0.7 kg; p = 0.068) showed no significant changes. VO₂peak was the sole independent predictor of functional performance at baseline and follow-up, while muscle mass had limited explanatory value. Improvements were observed in both disease stages, with similar effect sizes. Conclusions: Long-term engagement in a multicomponent exercise program produces sustained functional improvements exceeding measurement error in mobility among individuals with early-stage PD, independent of changes in aerobic capacity or muscle mass. VO₂peak consistently predicted functional outcomes, highlighting aerobic fitness as a key therapeutic target. These findings support the systematic integration of structured, multicomponent exercise into standard care protocols to preserve mobility and independence in PD.
Keywords: Parkinson's disease, Exercise Therapy, functional mobility, TC6, TUG
Received: 06 Sep 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Moura, Ferreira, Speri, Alves, Rostirola, de Campos and CONCEIÇÃO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: MIGUEL SOARES CONCEIÇÃO, conceicao.miguel0106@gmail.com
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