Effectiveness of Exercise on the Sequence Effect in Parkinson's Disease

Objective: To determine the benefits of motor training on the sequence effect (SE), an essential component of bradykinesia in Parkinson's disease (PD). Methods: Seven patients with de novo PD participated in this study. The patients performed regular pentagon drawing tests and exercises during four visits. The first two visits occurred before the start of medication, and the last two visits occurred at least six months after the start of medication. We assessed the severity of bradykinesia and SE at each visit and compared the results before and after exercise in both the de novo and treatment conditions. Results: In the de novo condition, the severity of bradykinesia significantly improved after motor training (p = 0.018), but it did not resolve and only showed a trend of improvement after treatment (p = 0.068). The severity of the SE decreased significantly in the drug-naïve condition (p = 0.028) but not after medication (p = 0.273). Conclusion: Our study suggests that regular motor training may be beneficial for the SE in PD.ope