Maximal strength training in patients with Parkinson's disease: impact on efferent neural drive, force-generating capacity, and functional performance

Velocity-Based-Training Frequency Impacts Changes in Muscle Morphology, Neuromuscular Performance, and Functional Capability in Persons With Parkinson's Disease

ABSTRACT

Calaway, C, Walls, K, Levitt, H, Caplan, J, Mann, B, Martinez, K, Gastaldo, R, Haq, I, and Signorile, JF. Velocity-based-training frequency impacts changes in muscle morphology, neuromuscular performance, and functional capability in persons with Parkinson's disease. J Strength Cond Res XX(X): 000-000, 2024-Velocity-based training (VBT) positively impacts muscle morphology and performance in persons with Parkinson's disease (PD); however, optimal training frequencies for VBT in patients with PD remain undetermined. Changes in ultrasound-determined muscle thickness (MT) and echo intensity (EI)-derived muscle quality of the rectus femoris (RF) and vastus lateralis (VL), neuromuscular performance, and functional capacity were examined following 2 VBT frequencies (2-3 d·wk -1 ) using 30% velocity loss thresholds for 12 weeks. Neuromuscular performance was assessed using computerized pneumatic resistance machines. For each variable, 2 (time) × 2 (group) repeated-measures analyses of variance (ANOVA) were used to determine significant main effects and interactions. Significant time effects were seen for MT and EI of all muscles ( p < 0.05). Muscle thickness improvements included right VL (RVL) (0.171 ± 0.065 cm; p = 0.019), left VL (LVL) (0.214 ± 0.101 cm; p = 0.049), right RF (RRF) (0.194 ± 0.077 cm; p = 0.023), and left RF (LRF) (0.318 ± 0.109 cm; p = 0.010). For EI, improvements occurred in RVL (-18.688 ± 3.600; p = <0.001), LVL (-10.959 ± 4.894; p = 0.040), RRF (-9.516 ± 3.537; p = 0.016), and LRF (-9.018 ± 3.444; p = 0.019). Time effects were seen for leg-press 1-repetition maximum and peak power ( p < 0.01) and habitual walking speed ( p = 0.022), with a group by time interaction for maximal gait speed favoring the 3 d·wk -1 condition (∆0.15 m·s -1 , p = 0.002). The results indicate that VBT at 2 or 3 d·wk -1 can significantly improve muscle morphology, neuromuscular performance, and functional capability in patients with PD; however, improvements in maximal gait speed require 3 d·wk -1 . These findings provide flexibility when developing exercise prescriptions for patients with PD.

Utilizing Entropy of Cadence to Optimize Cycling Rehabilitation in Individuals With Parkinson's Disease

BACKGROUND

Previous studies have established that increased Sample Entropy (SampEn) of cadence, a measure of non-linear variability, during dynamic cycling leads to greater improvements in motor function for individuals with Parkinson's disease (PD). However, there is significant variability in responses among individuals with PD due to symptoms and disease progression.

OBJECTIVES

The aim of this study was to develop and test a paradigm for adapting a cycling exercise intervention using SampEn of cadence and rider effort to improve motor function.

METHODS

Twenty-two participants were randomized into either patient-specific adaptive dynamic cycling (PSADC) or non-adaptive (NA) group. SampEn of cadence was calculated after each of the 12 sessions, and motor function was evaluated using the Kinesia test. Pearson's correlation coefficient was used to analyze the relationship between SampEn of cadence and motor function improvement. Multiple linear regression (MLR) was used to identify the strongest predictors of motor function improvement.

RESULTS

Pearson's correlation coefficient revealed a significant correlation between SampEn of cadence and motor function improvements (R2 = -.545, P = .009), suggesting that higher SampEn of cadence led to greater motor function improvement. MLR demonstrated that SampEn of cadence was the strongest predictor of motor function improvement (β = -8.923, t = -2.632, P = .018) over the BMI, Levodopa equivalent daily dose, and effort.

CONCLUSIONS

The findings show that PSADC paradigm promoted a greater improvement in motor function than NA dynamic cycling. These data will be used to develop a predictive model to optimize motor function improvement after cycling in individuals with PD.

Aerobic high-intensity interval training and maximal strength training in patients with unspecific musculoskeletal disorders improve V̇O2peak and maximal strength more than moderate training

Improving peak oxygen uptake (V̇O2peak) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although high-intensity training yield superior outcomes for these factors, patients with MSDs may not tolerate high-intensity due to pain and fear. Therefore, we examined the effect and feasibility of incorporating aerobic high-intensity intervals (HIITs) and maximal strength training (MST) in a standard clinical rehabilitation program for patients with unspecific MSDs. 73 patients (45 ± 10 years) with MSDs partaking in a standard, public, and 4-week rehabilitation program were randomized to high-intensity training (HG: 4 × 4 minutes intervals at ∼90% of maximal heart rate; HRmax, and 4 × 4 repetitions leg press at ∼90% of 1 repetition maximum; 1RM, with maximal intended velocity) or keep todays treatment of low-to moderate-intensity training (MG: various cycling, walking, and/or running activities at ∼70%-80% of HRmax and 3 × 8 - 10 repetitions leg press at ∼75% of 1RM without maximal intended velocity). HG improved V̇O2peak (12 ± 7%) and leg press 1RM (43 ± 34%) more than moderate-intensity group (V̇O2peak; 5 ± 6%, 1RM; 19 ± 18%, both p < 0.001). We observed that no adverse events and no between-group differences in dropout rate or self-reported quality of life (both p > 0.05). There were positive correlations between improved V̇O2peak and improved physical (p = 0.024) and emotional (0.016) role functioning. We conclude that both high-intensity interval training and MST are feasible and improve V̇O2peak and maximal strength more than standard low-to moderate-intensity treatment of patients with unspecific MSDs. Our findings suggest that high-intensity training should be implemented as a part of standard clinical care of this patient population.

Alterations in RNA editing in skeletal muscle following exercise training in individuals with Parkinson's disease

Parkinson's Disease (PD) is the second most common neurodegenerative disease behind Alzheimer's Disease, currently affecting more than 10 million people worldwide and 1.5 times more males than females. The progression of PD results in the loss of function due to neurodegeneration and neuroinflammation. The etiology of PD is multifactorial, including both genetic and environmental origins. Here we explored changes in RNA editing, specifically editing through the actions of the Adenosine Deaminases Acting on RNA (ADARs), in the progression of PD. Analysis of ADAR editing of skeletal muscle transcriptomes from PD patients and controls, including those that engaged in a rehabilitative exercise training program revealed significant differences in ADAR editing patterns based on age, disease status, and following rehabilitative exercise. Further, deleterious editing events in protein coding regions were identified in multiple genes with known associations to PD pathogenesis. Our findings of differential ADAR editing complement findings of changes in transcriptional networks identified by a recent study and offer insights into dynamic ADAR editing changes associated with PD pathogenesis.

Muscle redundancy is greatly reduced by the spatiotemporal nature of neuromuscular control

Animals must control numerous muscles to produce forces and movements with their limbs. Current theories of motor optimization and synergistic control are predicated on the assumption that there are multiple highly diverse feasible activations for any motor task ("muscle redundancy"). Here, we demonstrate that the dimensionality of the neuromuscular control problem is greatly reduced when adding the temporal constraints inherent to any sequence of motor commands: the physiological time constants for muscle activation-contraction dynamics. We used a seven-muscle model of a human finger to fully characterize the seven-dimensional polytope of all possible motor commands that can produce fingertip force vector in any direction in 3D, in alignment with the core models of Feasibility Theory. For a given sequence of seven force vectors lasting 300 ms, a novel single-step extended linear program finds the 49-dimensional polytope of all possible motor commands that can produce the sequence of forces. We find that muscle redundancy is severely reduced when the temporal limits on muscle activation-contraction dynamics are added. For example, allowing a generous ± 12% change in muscle activation within 50 ms allows visiting only ∼ 7% of the feasible activation space in the next time step. By considering that every motor command conditions future commands, we find that the motor-control landscape is much more highly structured and spatially constrained than previously recognized. We discuss how this challenges traditional computational and conceptual theories of motor control and neurorehabilitation for which muscle redundancy is a foundational assumption.

A Pilot Study of the Effect of a Non-Contact Boxing Exercise Intervention on Respiratory Pressure and Phonation Aerodynamics in People with Parkinson's Disease

This study investigated the effects of a non-contact boxing exercise program on maximum expiratory pressure and aerodynamic voice measurements.

METHODS

Eight adult males diagnosed with Parkinson's disease participated in the study. Individuals participated in twice-weekly exercise classes lasting one hour across 12-months. Dependent variables were measured on three baseline days and then at six additional time points. A pressure meter acquired maximum expiratory pressure, and a pneumotachograph system acquired transglottal airflow and subglottal air pressure.

RESULTS

Measures of average maximum expiratory pressure significantly increased after 9- and 12- months of exercise when compared to baseline. There was an increasing trend for these measures in all participants, with a corresponding large effect size. Measures of transglottal airflow and subglottal pressure did not change over the course of 9- or 12-months, although their stability may indicate that the exercise program influenced maintenance of respiratory-phonatory coordination during voicing.

CONCLUSIONS

A non-contact boxing exercise program had a significant effect on maximum expiratory pressure in people with Parkinson's disease. The aerobic nature of the program and challenges to the respiratory muscles potentially explain the "ingredient" causing this effect. The small sample size of this pilot study necessitates future research incorporating larger and more diverse participants.

Effects of home-based bodyweight squat training on neuromuscular properties in community-dwelling older adults

BACKGROUND

It is important to investigate neural as well as muscle morphological adaptations to evaluate the effects of exercise training on older adults.

AIMS

This study was aimed to investigate the effects of home-based bodyweight squat training on neuromuscular adaptation in older adults.

METHODS

Twenty-five community-dwelling older adults (77.7 ± 5.0 years) were assigned to squat (SQU) or control (CON) groups. Those in the SQU group performed 100 bodyweight squats every day and the others in the CON group only performed daily activities for 4 months. Maximum knee extension torque and high-density surface electromyography during submaximal contraction were assessed. Individual motor units (MUs) were identified and divided into relatively low or high-recruitment threshold MU groups. Firing rates of each MU group were calculated. The muscle thickness and echo intensity of the lateral thigh were assessed using ultrasound. As physical tests, usual gait speed, timed up and go test, grip strength, and five-time chair stand test were performed.

RESULTS

While no improvements in muscle strength, muscle thickness, echo intensity, or physical tests were noted in either group, the firing rate of relatively low recruitment threshold MUs significantly decreased in the SQU group after intervention.

CONCLUSIONS

These results suggest that low-intensity home-based squat training could not improve markedly muscle strength or physical functions even if high-repetition and high frequency exercise, but could modulate slightly neural activation in community-dwelling older adults.

ABDOMINAL CORE MUSCLE STRENGTH TRAINING IN WEIGHTLIFTERS

ABSTRACT Introduction: Lifting weights requires muscular capacity, strength, and determination. Strength training for weightlifters stimulates the nervous system and promotes muscle hypertrophy. Strength training is the most important point in weightlifters' training. Objective: Explore the effects of abdominal core strength training on the physical fitness of weightlifters. Methods: 26 weightlifters were selected by random sampling. The athletes participated in physical training for 26 weeks. Athletes' physical fitness was measured before and after training. Tests included the y-Balance test, stability exercises, and abdominal center strength. After each training session, the players used foam rollers and baseballs for recovery training. After the experiment was completed, the data was analyzed by mathematical statistics. Results: The left lower limb stability of the weightlifters was better than the right in the Ans direction; in all three directions, there were extremely significant ipsilateral differences before and after the experiment(P<0.05). There was a highly significant difference between the level and super level of the ipsilateral upper limbs of the athletes (P<0.05). Conclusion: Weightlifters who practiced abdominal core strength exercises significantly improved the dynamic stability of the lower limbs. Young male weightlifters' upper limb motion stability is more symmetrical during abdominal core strength exercises. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Strength versus endurance trained master athletes: Contrasting neurophysiological adaptations

Neural factors play a critical role in the age-related decline in maximal strength and rate of force development (RFD). However, it is uncertain how the age-related attenuation in neuromuscular function may be mitigated in strength or endurance trained master athletes. In this study we applied evoked spinal motoneuron recordings to examine descending motor drive, i.e., efferent drive from supraspinal and spinal centres during maximal voluntary contraction (MVC; V-wave) and H-reflex excitability measured at 10 % MVC in older (>65 yrs) and younger (<35 yrs) strength athletes (n = 21), endurance athletes (n = 17) and untrained control participants (n = 30). Both strength (b = 0.09 [0.01-0.18], p = 0.038) and endurance training (b = 0.14 [0.04-0.23], p = 0.006) were associated with a high V-wave amplitude. This was likely explained by an elevated H-reflex excitability (b = 0.23 [0.11-0.35], p < 0.001) in endurance trained participants, which failed to be seen in strength trained participants. These contrasting neurophysiological properties were accompanied by different physiological traits; strength training was associated with high maximal strength (b = 107.5 [84.6 to 130.4] kg, p < 0.001) and RFD (b = 3171 [2248 to 4094] N‧s^-1, p < 0.001), whereas endurance training was associated with elevated maximal oxygen uptake (V̇O_2max; b = 13.6 [8.0-19.2] ml‧kg^-1‧min^-1, p < 0.001). This pattern was apparent irrespective of age, although all traits were negatively associated with advanced age (p < 0.05). In conclusion, strength trained individuals demonstrate higher descending motor drive (elevated V-wave responses), compared to age-matched untrained individuals. Endurance trained individuals also showed elevated V-wave responses, uniquely accompanied by enhanced α-motoneuron excitability and/or reduced pre/postsynaptic inhibition (elevated H-reflex responses). Since a high descending motor drive is a key component of strong muscle contractions, strength training should be emphasized to sustain the ability to carry out force-dependent tasks at older age.

Effects of a Resistance Training Protocol on Physical Performance, Body Composition, Bone Metabolism, and Systemic Homeostasis in Patients Diagnosed with Parkinson's Disease: A Pilot Study

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor impairments and it is correlated with loss of bone mineral density. This study aimed to analyze the effects of resistance training on bone metabolism, systemic homeostasis, body composition, and physical performance in people with PD. Thirteen subjects (age 64.83 ± 5.70) with PD diagnosis were recruited. Participants performed neuromuscular tests, body composition assessment, and blood sample analysis at baseline, and after an 11 weeks-training period. Each training session lasted 90 min, three times a week. The participants had significant improvements in the timed up and go (p < 0.01), sit to stand (p < 0.01), dominant peg-board (p < 0.05), dominant foot-reaction time (p < 0.01), and functional reach tests (p < 0.05). They showed better pressure foot distributions in the left forefoot (p < 0.05) and hindfoot (p < 0.05) and increased cervical right lateral bending angle (p < 0.05). The protocol affects bone metabolism markers osteocalcin (p < 0.05), calcium (p < 0.01), PTH (p < 0.01), the C-terminal telopeptide (CTX) (p < 0.01), and vitamin D (p < 0.05). Eleven weeks of resistance training improved manual dexterity, static and dynamic balance, reaction time, cervical ROM, and reduced bone loss in people with PD.

Maximal intended velocity enhances strength training-induced neuromuscular stimulation in older adults

The age-related attenuation in neuromuscular function can be mitigated with strength training. Current recommendations for untrained and elderly recommend performing the strength training with a controlled movement velocity (CON). However, applying maximal intended velocity (MIV) in the concentric phase of movement may augment neuromuscular stimulation and potentially enhance training adaptations. Thus, applying rate of electromyography (EMG) rise (RER) recordings, we examined the acute early phase neuromuscular response to these two contraction types in quadriceps femoris during leg extension, along with actual movement velocity, in 12 older (76 ± 6 years) and 12 young men (23 ± 2 years). Results revealed that older adults had a lower one repetition maximum (1RM) than young (33 ± 9 kg vs. 50 ± 9 kg; p = 0.001) and lower actual velocity across relative intensities of ~ 10%, 30%, 50%, 70% and 90% of 1RM for CON and MIV (all p < 0.05). Older adults also had consistently reduced RER compared to young during both conditions (old: 1043–1810 μV; young: 1844–3015 μV; all p < 0.05). However, RER was higher in contractions with MIV compared to CON for both age groups, and across all intensities (98–674%, all p < 0.05). In conclusion, despite decreased maximal strength and attenuated neuromuscular response with advancing age, our results document an augmented neuromuscular activation when repetitions are performed with MIV in the concentric phase of movement.

Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review

BACKGROUND

Individuals with severe mental disorders (SMDs; schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder) are not only suffering from their mental conditions; they also have an attenuated physical health, augmenting their overall critical condition.

OBJECTIVES

We review and critically appraise the evidence based on (1) key physiological factors relating to aerobic endurance and skeletal muscle strength; (2) implications for physical function and health; and (3) effects of training interventions with different intensities evaluated in individuals with SMDs.

FINDINGS

Reductions in aerobic endurance factors, peak oxygen uptake (VO_2peak) and walking work efficiency, are paralleled by reductions in maximal skeletal muscle strength and power. In turn, the poor aerobic endurance and muscle strength lead to impaired physical function, increased risk of lifestyle-related diseases, and ultimately early death. Exercise has the potential to counteract the attenuated physical health in people with SMDs. While aerobic endurance training is shown to increase VO_2peak due to plasticity of the oxygen transport system, strength training is documented to improve maximal muscle strength, power, and walking work efficiency as a result of adaptations in neuromuscular force developing factors.

CONCLUSIONS

In conclusion, improvements in these key determinants for physical health appear to be achievable in people with SMDs despite many being challenged by motivational difficulties with attending regular exercise and have beneficial implications for physical function during activities of daily living, lifestyle-related diseases, and early death.

Can strength training modify voluntary activation, contractile properties and spasticity in Multiple Sclerosis?: a randomized controlled trial

BACKGROUND

A randomized controlled trial was conducted to analyze the effects of 10 weeks of strength training (ST) on voluntary activation, muscle activity, muscle contractile properties, and spasticity in people with MS.

METHODS

30 participants were randomized to either an experimental [EG](n=18) or a control [CG](n=12) group. The EG carried out 10-weeks of ST, where the concentric phase at maximum voluntary velocity. Muscle activity of the vastus lateralis (surface electromyography (sEMG) during the first 200 ms of contraction), maximal neural drive (peak sEMG), voluntary activation (central activation ratio), and muscle contractile function (via electrical stimulation) of the knee extensor muscles, as well as spasticity, were measured pre- and post-intervention.

RESULTS

The EG showed a significant improvement with differences between groups in muscle activity in EMG_0-200 (p=0.031;ES=-0.8) and maximal neural drive (p=0.038;ES=-0.8), as well as improvement in the ST group with a trend towards significance in EMG_0-100 (p=0.068;ES=-0.6). CAR increased after intervention in ST group (p=0.010;ES=-0.4). Spasticity also improved in the ST group, with differences between group after intervention, in first swing excursion (right leg: p=0.006;ES=-1.4, left leg: p=0.031;ES=-1.2), number of oscillations (right leg: p=0.001;ES=-0.4, left leg: p=0.031;ES=-0.4) and duration of oscillations (left leg: p=0.002; ES=-0.6). Contractile properties remain unchanged in both ST group and control group.

CONCLUSIONS

10 weeks of ST improves muscle activity during the first 200 ms of contraction, maximal neural conduction, and spasticity in people with MS. However, ST does not produce adaptations in muscle contractile properties in people with MS.

Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis

In 2015, Uhrbrand et al. published the first review on Parkinson´s disease (PD) and exercise entirely based on randomized controlled trials (RCT) applying strict exercise definitions. The present review aimed to update the PD literature by assessing the effects of different intensive exercise modalities: resistance training (RT), endurance training (ET), and other intensive exercise modalities (OITM). An updated systematic literature search identified 33 new RCTs. Qualitative and quantitative analyses were performed. A total of 18 RT, 14 ET, and 1 OITM studies were identified (adding to the 8 RT, 6 ET, and 4 OITM studies identified by Uhrbrand et al. in 2015). RT, ET, and OITM were feasible, safe, and did not worsen PD symptoms. Furthermore, RT, ET, and OITM may positively affect functional outcomes (e.g., balance) and depressive symptoms in PD but inconsistencies across these findings warrant cautious conclusions. Meta-analyses showed that RT had a positive impact on muscle strength (standardized mean difference (SMD) = 0.83 [95% CI;0.54, 1.12]), functional capacity (Timed Up and Go Test (TUG): SMD = -0.62 [-1.01, -0.24]), and quality of life (SMD = -0.41 [-0.72, -0.09]), while ET had a positive impact on cardiorespiratory fitness (SMD = 0.27 [0.07, 0.47]) and functional capacity (TUG: SMD = -0.21 [-0.46, 0.04], 6-Min Walk Test: SMD = 0.89 [0.17, 1.62]), and a potentially positive impact on "on-medication" UPDRS-III (SMD = -0.15 [-0.38, 0.09]) and "off-medication" UPDRS-III (SMD = -0.19 [-0.41, 0.04]). In conclusion, RT, ET, and OITM all represent safe, feasible, and beneficial adjunct rehabilitation strategies in PD, with particularly RT and ET showing solid effects.

Evidence that Neuromuscular Fatigue Is not a Dogma in Patients with Parkinson's Disease

PURPOSE

Given the increased level of fatigue frequently reported by patients with Parkinson's disease (PD), this study investigated the interaction between central and peripheral components of neuromuscular fatigue (NF) in this population compared with healthy peers.

METHODS

Changes in maximal voluntary activation (ΔVA, central fatigue) and potentiated twitch force (ΔQtw,pot, peripheral fatigue) pre-post exercise were determined via the interpolated twitch technique in 10 patients with PD and 10 healthy controls (CTRL) matched for age, sex, and physical activity. Pulmonary gas exchange, femoral blood flow, and quadriceps EMG were measured during a fatiguing exercise (85% of peak power output [PPO]). For a specific comparison, on another day, CTRL repeat the fatiguing test matching the time to failure (TTF) and PPO of PD.

RESULTS

At 85% of PPO (PD, 21 ± 7 W; CTRL, 37 ± 22 W), both groups have similar TTF (~5.9 min), pulmonary gas exchange, femoral blood flow, and EMG. After this exercise, the maximal voluntary contraction (MVC) force and Qtwpot decreased equally in both groups (-16%, P = 0.483; -43%, P = 0.932), whereas VA decreased in PD compared with CTRL (-3.8% vs -1.1%, P = 0.040). At the same PPO and TTF of PD (21 W; 5.4 min), CTRL showed a constant drop in MVC, and Qtwpot (-14%, P = 0.854; -39%, P = 0.540), instead VA decreased more in PD than in CTRL (-3.8% vs -0.7%, P = 0.028).

CONCLUSIONS

In PD, central NF seems exacerbated by the fatiguing task which, however, does not alter peripheral fatigue. This, besides the TTF like CTRL, suggests that physical activity may limit NF and counterbalance PD-induced degeneration through peripheral adaptations.

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease

Objective:

To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease.

Methods:

Twenty-four patients with Parkinson’s disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated.

Results:

Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks.

Conclusion:

Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease without cardiovascular comorbidities.

The key role of physical activity against the neuromuscular deterioration in patients with Parkinson's disease

AIM

Decreased muscle strength has been frequently observed in individuals with Parkinson's disease (PD). However, this condition is still poorly examined in physically active patients. This study compared quadriceps (Q) maximal force and the contribution of central and peripheral components of force production during a maximal isometric task between physically active PD and healthy individuals. In addition, the correlation between force determinants and energy expenditure indices were investigated.

METHODS

Maximal voluntary contraction (MVC), resting twitch (RT) force, pennation angle (θp), physiological cross-sectional area (PCSA) and Q volume were assessed in 10 physically active PD and 10 healthy control (CTRL) individuals matched for age, sex and daily energy expenditure (DEE) profile.

RESULTS

No significant differences were observed between PD and CTRL in MVC (142 ± 85; 142 ± 47 N m), Q volume (1469 ± 379; 1466 ± 522 cm³ ), PCSA (206 ± 54; 205 ± 71 cm² ), θp (14 ± 7; 13 ± 3 rad) and voluntary muscle-specific torque (MVC/PCSA [67 ± 35; 66 ± 19 N m cm^-2 ]). Daily calories and MVC correlated (r = 0.56, P = .0099). However, PD displayed lower maximal voluntary activation (MVA) (85 ± 7; 95 ± 5%), rate of torque development (RTD) in the 0-0.05 (110 ± 70; 447 ± 461 N m s^-1 ) and the 0.05-0.1 s (156 ± 135; 437 ± 371 N m s^-1 ) epochs of MVCs, whereas RT normalized for PCSA was higher (35 ± 14; 20 ± 6 N m cm^-2 ).

CONCLUSION

Physically active PDs show a preserved strength of the lower limb. This resulted by increasing skeletal muscle contractility, which counterbalances neuromuscular deterioration, likely due to their moderate level of physical activity.