Sant Pau initiates a pioneering study on the potential benefits of sports in Parkinson’s patients

The Parkinson’s Disease and Movement Disorders Research Group at the Sant Pau Research Institute (IR Sant Pau) has launched a scientific study to evaluate the potential cognitive, motor, and emotional effects and benefits of sports in patients with this neurodegenerative disease. The study is supported by the Golf with Parkinson Association, the Barcelona Golf Club, the Barcelona Golf Academy, and the Catalan Golf Federation. Over a period of two and a half months, a group of volunteer patients will engage in weekly sports sessions lasting an hour and a half, every Friday morning, at the Barcelona Golf Club. Additionally, on April 12, coinciding with World Parkinson’s Day, a charity tournament will be organized to raise funds for this study with the participation of patients.

The Golf with Parkinson Association was founded by Juan Carlos Campillo, a passionate golfer who was diagnosed with the disease three years ago. “I didn’t know what was happening to me. I was a handicap 5 and my game deteriorated so much that I couldn’t even count the strokes anymore.” Parkinson’s was already affecting his movements, much slower, with a swing speed nowhere near his usual. However, he sought ways to continue training and adapt his new physical condition to this sport. He asserts that “maintaining body mobility and physical activity is fundamental. And practicing sports helps a lot.”

With this objective in mind, the Sant Pau Research Institute and the Golf with Parkinson Association have initiated a pioneering study to analyze the benefits that playing this sport can bring to these patients. The research team is led by Dr. Carmen García-Sánchez, a researcher at the Sant Pau Research Institute and a neuropsychologist at the Neurology Service of the Hospital.

The doctor explains that “while there are pharmacological treatments and rehabilitation therapies available, it is important to explore complementary approaches that can improve the quality of life of these patients. Interventions based on sports and social activities are a therapeutic resource used to treat motor, emotional, and behavioral disorders in patients with Parkinson’s disease, and in this sense, sports could provide benefits. But it needs to be investigated to support its inclusion in their management.”

Rigorous methodology for evaluating potential benefits

It is estimated that 1 in every 100,000 people over 60 years of age will suffer from Parkinson’s disease. It is a chronic, progressive, and multisystemic pathology. Symptoms worsen over time – although the progression varies greatly among patients – and in the late stages, complications such as motor and non-motor fluctuations, dyskinesias (disorders of voluntary movements and appearance of involuntary abnormal movements), cognitive disorders, and behavioral disturbances may appear.

There are different causes that intervene in the onset of Parkinson’s disease. Mainly, the degeneration of neurons called dopaminergic, which produce abnormal patterns of nerve activation in the brain and cause deterioration of movement. But there are also other known and unknown causes. “Between 10% and 15% of cases are genetic – dominant and recessive – and these cases usually affect very young people, around 40 years old or even younger. We often think it is a disease of older people, from the age of 60 onwards, but young people also suffer from it,” explains Dr. Jaume Kulisevsky, director of the Parkinson’s Disease and Movement Disorders Research Group at the Sant Pau Research Institute and director of the Parkinson’s Disease and Movement Disorders Unit at the Neurology Service of Sant Pau Hospital.

Practicing a low-impact sport (walking, yoga, pilates, swimming, skating, cross-country skiing, golf, etc.) provides a comprehensive workout that promotes range of motion, activates muscles in the upper and lower body, flexibility, and balance, which has been shown to be useful in reducing falls in people with Parkinson’s disease. Additionally, it combines moderate physical activity, fine motor coordination, concentration, and strategy, elements that could help improve motor function, coordination, flexibility, balance, cognition, and mood.

How will the study be conducted?

The research, entitled “Observational Pilot Study of Golf Practice on Gait, Cognition, and Behavior in Parkinson’s Disease”, involves a group of volunteer patients with the pathology in an early or moderate and stable stage recruited from the Movement Disorders Unit and the Neuropsychology Unit of Sant Pau Hospital.

The study is financially supported by the Golf with Parkinson Association and has the support of the Barcelona Golf Club, the Catalan Golf Federation, and the Barcelona Golf Academy, which provides the technology and software necessary for data capture and measurement that will allow the analysis of patients’ progress.

Every Friday morning, a bus will pick them up at the Hospital and take them to the Barcelona Golf Club based in Sant Esteve Sesrovires, which will provide all the necessary materials: clubs, putters, balls, etc. Once there, they will have a 90-minute session – with regular breaks to avoid fatigue – for 12 weeks led by coach Carlos Vivas. At the end of each session, the same bus will make the return trip to Sant Pau.

Regarding the study methodology, before and after each weekly session, researchers from the Sant Pau Research Institute will use a mood questionnaire to detect short-term emotional changes in these patients. Specifically, and for this purpose, they will use the Scale for Mood Assessment (EVEA) as a self-assessment of emotional state and feelings.

At the end of the 12-week study period, a final evaluation will be carried out, and the analysis and publication of the results are scheduled for June-July 2024.

Sant Pau, a reference in care and research in Parkinson’s disease

Sant Pau Hospital focuses a significant part of its care and research activity on movement disorders, where the Neurology Service Unit is CSUR (Centers, Services, and Units of Reference) and has extensive experience dedicated to all types of rare neurological diseases of great complexity characterized by the development of abnormal movements – such as Huntington’s disease, atypical parkinsonisms, early-onset Parkinson’s disease, ataxias, or Tourette syndrome, among others.

In Parkinson’s care, it provides cognitive stimulation in the Clinical School of Neuropsychology and Language Pathology, and among other initiatives, it has a patient choir composed of more than 30 people. Additionally, it is a reference center in deep brain stimulation for Parkinson’s disease, a technique it has been applying for 25 years and where it was a pioneer.

In research, it carries out various projects: the Sant Pau Research Institute was a pioneer in describing and designing specific tools to assess cognitive impairment in Parkinson’s, such as the Parkinson’s Disease Cognitive Rating Scale (PD-CRS) used in all studies focused on this area, and promotes studies independently or in collaboration.

One of the most recent, published this year, has evaluated the medical and emotional benefits of theater in twenty patients diagnosed with Parkinson’s, an initiative that included workshops on body awareness, movement, and improvisation conducted in collaboration with the Open University of Catalonia and the Teatre Lliure of Barcelona. The results showed an improvement in mood and anxiety and depression disorders and in immediate memory – with better concentration capacity.