Intensive amplitude-specific therapeutic approaches for Parkinson's disease: Toward a neuroplasticity-principled rehabilitation model

Recent scientific advances in animal models of Parkinson disease suggest exercise is a legitimate disease-modifying therapeutic option that contributes to behavioral recovery and neurochemical sparing. These data challenge current rehabilitative assumptions and emphasize the need for neuroplasticity-principled exercise-based approaches to challenge the impaired system. We suggest one novel solution - the intensive practice of amplitude - a global motor control parameter. Training a single focus (amplitude) across (1) disciplines (physical, occupational, speech therapy), (2) tasks (transfers, activities of daily living, recreation), and (3) motor systems (speech, locomotion, reaching) may provide the complexity, difficulty, and repetition necessary for disease-modification in human Parkinson disease.