*Poster 165: Qi Gong for Physical Rehabilitation for Parkinson-Related Falls: A Neuroplasticity Approach

Objective: To discuss bench and translational research findings that exercise influences neuroplasticity and neuroprotection with the results of 2 statistically significant balance improvement and fall prevention studies with Qi Gong exercise and persons with Parkinson's disease (PD). Design: Repeated measures design, the results of 2 studies will be presented. Setting: The community of New York City. Participants: Patients with Hoehn & Yahr Scale I-IV stage PD. Intervention: Qi Gong exercise. Main Outcome Measures: Improvement in Berg Balance Scale (BBS) scores, decreased number of falls, statistically significant. Results: Study I: the mean number of falls pre-Qi Gong compared to post-Qi Gong results for the matched pairs t test was statistically significant (P=.004). The BBS score pre- and post-Qi Gong were compared and the difference was statistically significant (P=.001). Study II: the mean number of falls pre-Qi Gong compared to post-Qi Gong results for the matched pairs t test was statically significant (P=.021). The BBS score pre- and post-Qi Gong were compared; the difference was statistically significant (P=.000). Conclusions: For many years, exercise was a recommended nursing therapy for persons diagnosed with PD. Early nursing studies indicated exercise could influence quality of life by improved sucking (which may improve nutrition), mobility, functional ability, and incontinence. The professional shift to evidence-based practice has re-examined exercise as a strategy for maintaining activities of daily living and preventing falls. Recent bench and translational research indicates nonpharmacological, nonsurgical interventions, especially exercise, has an effect on Parkinson-related symptoms. Brain repair or reorganization, also known as neuroplasticity, may be induced by exercise. Research suggests exercise leads to compensatory changes in dopamine handling and neurotransmission, and exercise-induced cortical changes have been demonstrated in the brains of people diagnosed with PD. Exercise may also influence the availability of glial-derived neurotrophic factor providing neuroprotection and or slowing disease progression. Enriched diverse exercise targeted to diminish symptoms and promote neurorestoration has the potential to help people with PD to maintain their functional status by preventing immobility, and related morbidity and mortality from falls. Qi Gong exercises ameliorate axial rigidity which contributes to postural instability and falls. Qi Gong also includes Qi walking, which is deliberate walking backward and forward, diminishing falls related to retropulsion and propulsion. Qi Gong lunge position and stretch side to side challenges and improves balance. Two repeated measures design Qi Gong interventional studies have been completed with statistically significant decreases in falls and improvement in balance as indicated by the BBS. These studies included 71 people diagnosed with idiopathic PD 55 years of age and older, Hoehn and Yahr Stage I-IV PD (early to advanced stages), and cognitively intact. Loss of balance and falls are associated with PD progression. Qi Gong exercise decreasing these symptoms may indicate these measured outcomes are a result of neuroplasticity and neuroprotection.