Clinical applications of exercise in Parkinson's disease: what we need to know?

INTRODUCTION

Exploring the potential of exercise in the rehabilitation process of patients with Parkinson's (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated.

AREAS COVERED

Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined.

EXPERT OPINION

It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function.

It's About Time: The Circadian Network as Time-Keeper for Cognitive Functioning, Locomotor Activity and Mental Health

A variety of organisms including mammals have evolved a 24h, self-sustained timekeeping machinery known as the circadian clock (biological clock), which enables to anticipate, respond, and adapt to environmental influences such as the daily light and dark cycles. Proper functioning of the clock plays a pivotal role in the temporal regulation of a wide range of cellular, physiological, and behavioural processes. The disruption of circadian rhythms was found to be associated with the onset and progression of several pathologies including sleep and mental disorders, cancer, and neurodegeneration. Thus, the role of the circadian clock in health and disease, and its clinical applications, have gained increasing attention, but the exact mechanisms underlying temporal regulation require further work and the integration of evidence from different research fields. In this review, we address the current knowledge regarding the functioning of molecular circuits as generators of circadian rhythms and the essential role of circadian synchrony in a healthy organism. In particular, we discuss the role of circadian regulation in the context of behaviour and cognitive functioning, delineating how the loss of this tight interplay is linked to pathological development with a focus on mental disorders and neurodegeneration. We further describe emerging new aspects on the link between the circadian clock and physical exercise-induced cognitive functioning, and its current usage as circadian activator with a positive impact in delaying the progression of certain pathologies including neurodegeneration and brain-related disorders. Finally, we discuss recent epidemiological evidence pointing to an important role of the circadian clock in mental health.

Physical Activity, Boredom and Fear of COVID-19 Among Adolescents in Germany

Background

The effectiveness of physical activity (PA) as an intervention against anxiety disorders and depression is undeniable in clinical psychology. Therefore, the question arose whether these effects also occur when a fear stimulus, like the COVID-19 pandemic, affects otherwise healthy adolescents. Boredom is closely linked to symptoms of fear and anxiety, but the connection between PA, boredom and fear is partly unclear.

Methods

A cross-sectional online study was conducted that involved 122 students. Participants were 13–19 years old (M_age = 15.83, SD = 1.73). The survey was available online from April 27th to May 3rd, 2020. At this time, schools in Germany had already been closed for 6 weeks. A self-report questionnaire was used to measure physical activity, boredom, and fear of COVID-19. A multiple linear regression model was conducted.

Results

The reported fear of COVID-19 significantly correlates with total PA, quantity of strenuous PA, and boredom. Furthermore, a significant regression equation was found. The variables boredom, PA, and age contribute significantly to predicting the fear of COVID-19 [R² = 0.127, F(3,118) = 6.876, p < 0.000], among adolescents.

Conclusion

Our results indicate that there is an association between PA, boredom and the quarantine experience of adolescents. Students who were physically more active, especially with strenuous intensity, did not feel bored and showed less fear of COVID-19.

Effects of chronic exercise on the inhibitory control of children and adolescents: A systematic review and meta-analysis

Inhibitory control is a main component of executive functions that relate to the ability to control prepotent responses and to resist interferences. Deficits in inhibitory control have been associated with numerous disorders, but exercise has become a promising approach to benefit this domain. This systematic review and meta-analysis aims to provide synthesized information and effect size calculations of the benefits of chronic exercise interventions on the inhibitory control of healthy children and adolescents. A systematic search of PubMed, PsycINFO, MEDLINE, ERIC, SPORTDiscus, and PsycArticles identified 4166 articles to be screened for eligibility. A total of 10 studies (3138 participants) met the inclusion criteria. A random-effects analysis model was performed in three variables: accuracy, reaction time and combined scores. The results showed a very small but statistically significant effect in accuracy (d = 0.14, 95% CI 0.01 to 0.27, P =.04), and two almost null effects (statistically non-significant), in the reaction time (d = 0.03, 95% CI -0.10 to 0.16, P =.62) and the combined scores (d = 0.06, 95% CI -0.03 to 0.15, P =.17). Despite the high number of studies that reported positive outcomes, this meta-analysis found only modest benefits in the inhibitory control of healthy children and adolescents after they participated in different chronic exercise interventions. The strict inclusion criteria of this study and the high variability in the designs of the exercise interventions included, among other reasons, might explain the obtained results.

The Endocannabinoid System as Modulator of Exercise Benefits in Mental Health

According to the World Health Organization (WHO), 47 million people display mental health disorders Worldwide. In addition, epidemiological studies have shown that the extension of life expectancy and the increase in aged population will significantly impact the prevalence of several mental impairments. Although there are strategies for preventing and alleviating mental illnesses, such as pharmacological and psychological approaches, limited results have been observed. Thus, the search for new therapeutics for managing psychiatric disorders has explored multiple roads. In recent years, it has been demonstrated that physical activity and exercise promote health benefits. On the other hand, among the neurobiological systems that participate in the genesis and development of mental disruptions, the endocannabinoid system has been suggested as an active player. Supporting this hypothesis, data suggest that the elements comprising the endocannabinoid system, such as the CB₁/CB₂ cannabinoid receptors, endogenous ligands (N-arachidonoylethanolamine [anandamide, AEA] and 2-arachidonoylglycerol [2-AG]), transporters and the enzymes involved in the biosynthesis and degradation of the AEA and 2-AG, modulate mental diseases. In this review, we discuss that the endocannabinoid system might be considered as a modulator for the positive outcomes of exercise in the management of mental disorders. Clinically, this promising field might be exploited by targeting the elements of the endocannabinoid system aimed to increase the exercise benefits applied to patients with mental illnesses.

Benefits of physical activity and physical exercise in the time of pandemic

Physical activity and physical exercise are key factors to help the population to mitigate the effects that the current pandemic is causing on the mental and physical health of citizens worldwide. In such an extreme situation, it is highly recommended to be physically active. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents

BACKGROUND

Depression is a common threat to children and adolescents in terms of affecting psychosocial development and increasing their risk of suicide. Apart from conventional treatments for depression, physical exercise has become a promising alternative. This paper aims to systematically review the existing meta-analyses that focus on the impact of physical exercise on clinical and nonclinical depression in children and adolescents.

METHODS

A systematic literature search was conducted using PsycINFO, PsycARTICLES, MedLine, PubMed, and hand searching. Risk of bias analysis, effect sizes calculations, and evaluation of the methodological characteristics (AMSTAR 2) were carried out.

RESULTS

Four meta-analyses met the inclusion criteria. After analysing the overlap, the total sample contained 30 single studies (mostly including gender mixed samples) and 2,110 participants (age range 5-20 years). The medium duration of the interventions was 11.5 weeks. The sessions had a medium length of 41 min, and the frequency of implementation was three sessions per week. The most implemented intervention type was aerobic exercise, while control groups mainly continued with their regular routine, among other related options. The overall mean effect of physical exercise on depression was medium (d = -0.50). The additional analysis in clinically depressed samples documented a small to medium mean effect (d = -0.48) in favor of the intervention.

CONCLUSION

The small to medium but consistently positive effects that were found in the present study place physical exercise as a promising and helpful alternative for children and adolescents with clinical and nonclinical depression. The limited literature focused on children and adolescents in comparison with adult samples points to the need for further research.