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Bissolotti L, Rota M, Calza S, Romero-Morales C, Alonso-Pérez JL, López-Bueno R, Villafañe JH. Gender-Specific Differences in Spinal Alignment and Muscle Power in Patients with Parkinson's Disease. Diagnostics (Basel) 2024; 14:1143. [PMID: 38893669 PMCID: PMC11171582 DOI: 10.3390/diagnostics14111143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is an advancing neurodegenerative disorder characterized by spinal anomalies and muscular weakness, which may restrict daily functional capacities. A gender-focused examination of these effects could provide valuable insights into customized rehabilitation strategies for both sexes. PURPOSE This study investigates the influence of spinal alignment on lower-limb function during the sit-to-stand (STS) movement in patients with Parkinson's disease compared to healthy individuals. METHODS A cross-sectional study was conducted with 43 consecutive patients with PD (25 males and 18 females; average age 73.7 ± 7.1 years) and 42 healthy controls (22 males and 20 females; average age 69.8 ± 6.0 years). Assessments included the International Physical Activity Questionnaire (IPAQ), Hoehn and Yahr staging, and measurements of vertical deviations from several spinal landmarks. Lower-limb muscle power during the STS task was evaluated using the Muscle Quality Index (MQI). RESULTS Both absolute (Watts) and relative (Watts/Kg) muscle power in the lower limbs were notably decreased in the PD group compared to the control group. Within the PD cohort, muscle power showed a negative relationship with age and a positive association with the degree of lumbar lordosis (PL-L3). Importantly, gender-specific analysis revealed that male patients with PD had significantly higher lower-limb muscle power compared to female patients with PD, highlighting the need for gender-tailored therapeutic approaches. CONCLUSIONS The findings suggest that preserving lumbar lordosis is crucial for maintaining effective lower-limb muscle biomechanics in individuals with Parkinson's disease.
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Affiliation(s)
- Luciano Bissolotti
- Fondazione Teresa Camplani Casa di Cura Domus Salutis, 25123 Brescia, Italy;
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (M.R.); (S.C.)
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (M.R.); (S.C.)
| | - Carlos Romero-Morales
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - José Luís Alonso-Pérez
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, C/Inocencio García 1, 38300 La Orotava, Canary Islands, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Onelife Center, Multidisciplinary Pain Treatment Center, 28925 Alcorcón, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain;
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46100 Valencia, Spain
| | - Jorge Hugo Villafañe
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
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Bonde-Jensen F, Dalgas U, Hvid LG, Langeskov-Christensen M. Validity and reliability of linear encoder muscle power testing in persons with Parkinson's disease. Clin Rehabil 2024; 38:678-687. [PMID: 38193269 DOI: 10.1177/02692155231224987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To investigate the construct validity ON medication and the reliability both ON and OFF medication of linear encoder muscle power testing in persons with Parkinson's disease (pwPD). DESIGN A study using baseline data from one randomized controlled trial (study 1) and one cohort study (study 2). SETTING University exercise lab. PARTICIPANTS Study 1: 35 healthy controls and 70 pwPD. Study 2: 20 pwPD. INTERVENTION Study 1: baseline data. Study 2: 4 chair rise tests (2 ON and 2 OFF medication), in a randomized order, separated by 4 to 16 days. MAIN MEASURES Linear encoder data were collected from a chair rise test. Known groups validity and convergent validity (i.e., construct validity) were assessed by comparing peak power between pwPD and healthy controls and associations between peak power and functional performance (i.e., 6-Min Walk Test, Timed Up and Go Test, Six-Spot Step Test), respectively. Reliability was assessed as day-to-day variation and by intraclass correlation coefficients. RESULTS Peak power was comparable between pwPD and healthy controls (-7.2%, p = 0.17), but lower in moderately impaired pwPD compared to mildly impaired pwPD (-27%, p < 0.01) and healthy controls (-23%, p < 0.01). Moderate to strong associations were observed between peak power and functional performance (r2 = 0.44-0.51). Day-to-day variation ON and OFF medication were 1.0 and 1.3 W/kg, respectively, while intraclass correlation coefficients were 0.95 (0.87;0.98) and 0.93 (0.82;0.97), respectively. CONCLUSION Linear encoder muscle power testing shows inconsistent known groups validity, acceptable convergent validity ON medication, and excellent day-to-day reliability ON and OFF medication in pwPD.
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Affiliation(s)
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars Grøndahl Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish Multiple Sclerosis Hospitals, Ry and Haslev, Denmark
| | - Martin Langeskov-Christensen
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurology, Viborg Regional Hospital, Viborg, Denmark
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Leandro LA, Zotz TGG, Camilotti BM, Olandoski M, Moreira CA. Effect of physical therapy on the isokinetic performance of knee flexors and extensors and functional balance in older adults with Parkinson's disease, according to severity. J Bodyw Mov Ther 2023. [DOI: 10.1016/j.jbmt.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Muscle Strength and Power in People With Parkinson Disease: A Systematic Review and Meta-analysis. J Neurol Phys Ther 2023; 47:3-15. [PMID: 36318503 DOI: 10.1097/npt.0000000000000421] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE No studies have synthesized the literature regarding mechanical muscle function (ie, strength, power, rate of force development [RFD]) in people with Parkinson disease (PD). Here, we aimed to expand our understanding of mechanical muscle function in people with PD (PwPD) by systematically reviewing (1) the psychometric properties of isokinetic/isometric dynamometry in PD, (2) the literature comparing mechanical muscle function in PwPD with healthy controls (HC), and (3) reported associations between muscle mechanical muscle function and functional capacity and/or disease severity. METHODS Systematic literature search in 6 databases. Included studies had to (1) enroll and report data on PwPD, (2) include assessment(s) of psychometric properties (ie, validity, reliability, responsiveness) of isokinetic/isometric dynamometry in PD, and/or (3) assess mechanical muscle function in both PwPD and HC using isokinetic/isometric dynamometry. RESULTS A total of 40 studies were included. Aim 1 studies (n = 2) showed high reliability for isometric dynamometry (hip-abductor/dorsiflexor/trunk flexor-extensor/handgrip: intraclass correlations coefficients range = 0.92-0.98). Aim 2 studies (n = 40) showed impaired mechanical muscle function (ie, strength, power, RFD) in PwPD compared with HC (effect sizes range = 0.52-1.89). Aim 3 studies (n = 11) showed weak-to-strong associations between overall and lower extremities muscle strength and functional capacity and/or disease severity outcomes (ie, Unified Parkinson Disease Rating Scale). DISCUSSION AND CONCLUSIONS Sparse methodological evidence suggests high reliability when using dynamometry in PwPD. Muscle strength, power, and RFD are impaired in PwPD compared with HC. Muscle strength is associated with functional capacity and disease severity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A403 ).
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Bissolotti L, Rota M, Calza S, Sanchez Romero EA, Battaglino A, Villafañe JH. Relationship between Lower Limbs Performance and Spinal Alignment in Parkinson’s Disease Patients: An Observational Study with Cross Sectional Design. J Clin Med 2022; 11:jcm11133775. [PMID: 35807060 PMCID: PMC9267576 DOI: 10.3390/jcm11133775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disease determining spinal deformities and muscle rigidity, weakness and dystonia that can be related to a change in muscular output during sit-to-stand tasks (STS). Purpose: The aim of this study was to determine the impacts of spinal alignment on lower limbs performance during STS tasks in Parkinson’s disease (PD) patients and healthy controls. Methods: In total, 43 consecutive PD patients (“PD” Group, 25 males and 18 females; age 73.7 ± 7.1) and 42 people not affected by any type of neurological disease (“CON” Group, 22 males, 20 females; age 69.8 ± 6.0) participated in the observational study. The clinical assessment included: IPAQ (International Physical Activity Questionnaire), Hoehn Yahr score, plumb-line distance from the spinous process of C7, kyphosis apex and the spinous process of L3 and S1. We used the Muscle Quality Index test (MQI) to assess muscle power output during STS in both groups. Results: The MQI test measurements of absolute and relative lower limb power was significantly lower in the PD group, in addition to a negative correlation with age and a positive correlation with PL-L3 in that group of patients. Conclusions: A final consideration regarding our results leads to the possibility that the preservation of lumbar lordosis may be one of the factors for maintaining efficient biomechanics of the lower limb muscles, with the preservation of the physiological contractile characteristics of these muscles being the objective for a multidisciplinary rehabilitation based on postural exercises of the spine and a program of training exercises for the lower limb muscles.
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Affiliation(s)
- Luciano Bissolotti
- Rehabilitation Service, Fondazione Teresa Camplani Casa di Cura Domus Salutis, 25123 Brescia, Italy;
- LARIN: Neuromuscular and Adapted Physical Activity Laboratory, 25123 Brescia, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (M.R.); (S.C.)
| | - Stefano Calza
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (M.R.); (S.C.)
| | - Eleuterio A. Sanchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (E.A.S.R.); (J.H.V.); Tel.: +39-393-9064-922 (E.A.S.R.); Fax: +34-633-115-328 (E.A.S.R.)
| | | | - Jorge H. Villafañe
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
- Correspondence: (E.A.S.R.); (J.H.V.); Tel.: +39-393-9064-922 (E.A.S.R.); Fax: +34-633-115-328 (E.A.S.R.)
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Yokote A, Hayashi Y, Yanamoto S, Fujioka S, Higa K, Tsuboi Y. Leg Muscle Strength Correlates with Gait Performance in Advanced Parkinson Disease. Intern Med 2022; 61:633-638. [PMID: 34393165 PMCID: PMC8943390 DOI: 10.2169/internalmedicine.7646-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective Leg muscle strength (LMS) is decreased in early-stage Parkinson disease (PD) patients and is associated with slower walking and falls. However, LMS in advanced PD has not been well investigated. The purpose of this study was to evaluate LMS in advanced PD patients and its effects on gait performance, activities of daily living, and the cognitive function. Methods The medical records of 132 patients with idiopathic advanced PD [Hoehn and Yahr (H&Y) stages 3 and 4] with a mean disease duration of 9.6 years were retrospectively reviewed. Leg extensor muscle strength of the patients was measured using a Strength Ergo 240. The associations between the LMS and gait performance, Barthel index, H&Y stage, and Mini-Mental State Examination (MMSE) score were analyzed. Results A Spearman's correlation analysis showed that LMS was correlated with the sex, age, age of disease onset, H&Y stage, Barthel index, MMSE score, and gait parameters. A multivariable linear regression analysis for identifying predictors of LMS showed that the gait velocity (β=0.377), Barthel index (β=0.281), sex (β=-0.187), and disease duration (β=-0.155) were significant. A receiver operating characteristic curve analysis for discriminating between H&Y stage 3 and 4 was performed for LMS; the area under the curve was 0.774 (95% confidence interval=0.696-0.851). Conclusions LMS was strongly associated with multiple domains of clinical characteristics, especially gait velocity and the Barthel index. Our study also suggested that LMS can be a predictor of PD progression.
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Affiliation(s)
- Akira Yokote
- Department of Neurology, Fukuseikai Minami Hospital, Japan
- Department of Neurology, Fukuoka University School of Medicine, Japan
| | - Yuka Hayashi
- Department of Neurology, Fukuseikai Minami Hospital, Japan
- Department of Neurology, Fukuoka University School of Medicine, Japan
| | - Shozaburo Yanamoto
- Department of Neurology, Fukuseikai Minami Hospital, Japan
- Department of Neurology, Fukuoka University School of Medicine, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Fukuoka University School of Medicine, Japan
| | - Kazuo Higa
- Department of Anesthesiology, Fukuseikai Minami Hospital, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University School of Medicine, Japan
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Siega J, Iucksch DD, Da Silva AZ, Zotz TGG, Israel VL. Parkinson's disease and multicomponent aquatic exercise: Effects on motor aspects, functional mobility, muscle function and aquatic motor skills. J Bodyw Mov Ther 2021; 27:314-321. [PMID: 34391251 DOI: 10.1016/j.jbmt.2021.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/10/2021] [Accepted: 03/29/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Analyze the effects of a multicomponent aquatic exercise program on motor aspects, functional mobility, muscle function and aquatic motor skills of people with PD. METHODS Eighteen people with a PD diagnosis were assessed before and after a 12-week multicomponent aquatic exercise program, twice a week, with each session lasting 50 min. The terrestrial variables analyzed were motor aspects, through the Unified Parkinson Disease Rating Scale (UPDRS); functional mobility, through the Five Times Sit to Stand Test (FTSST); Peak Torque (PT) and Mean Power (MP) of hip, knee and ankle flexors and extensors, assessed using an isokinetic dynamometer. In water, aquatic motor skill levels were assessed by means of the Aquatic Functional Assessment Scale (AFAS). RESULTS Significant improvements were found after the intervention in the following outcomes: motor aspects (p = 0.038, Δ = 5-61); MP of knee flexors at 90°/s on the most affected side (p = 0.026, Δ = 5.14), MP of knee extensors at 90°/s on the most affected side (p = 0.008, Δ = 8.69), MP of knee extensors at 120°/s on the most affected side (p = 0.005, Δ = 8.35), and AFAS in the domain of specialized therapeutic exercises (p = 0.014, Δ = 1.28). CONCLUSIONS The completed multicomponent aquatic exercise program promoted changes in muscle function and terrestrial and aquatic functional outcomes in people with PD.
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Renee S, Elisabeth P, Niruthikha M, Allyson F, Louise A. People with mild PD have impaired force production in all lower limb muscle groups: A cross-sectional study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1897. [PMID: 33464710 DOI: 10.1002/pri.1897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/15/2020] [Accepted: 12/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Power is reduced in people with Parkinson's disease as a consequence of bradykinesia, but it is not clear whether reduced power is also due to a deficit in force production. The aim of this study was to quantify force production in all major lower limb muscle groups in people with PD during the "on" phase after medication, compared with aged-matched neurologically normal control participants. METHOD Design: A cross-sectional study was undertaken. PARTICIPANTS Thirty ambulatory people with PD and 24 neurologically normal controls. OUTCOME MEASURES Isometric force production of the hip flexors and extensors, hip adductors and abductors, hip internal rotators and external rotators, knee flexors and extensors, ankle dorsiflexors and plantarflexors, ankle invertors and evertors using hand-held dynamometry. RESULTS There was a significant deficit in force production in participants with PD in all lower limb muscle groups tested, compared with control participants. On average, force production of participants with PD was 78% (range 67%-87%) of control participants, despite participants with PD regularly participating in exercise, being measured during their "on" phase after medication and having normal walking ability. The most severely affected muscle groups were the hip adductors (67%) and ankle plantarflexors (68%). CONCLUSION People with PD have a significant loss of force production in all lower limb muscle groups compared with age-matched neurologically-normal controls. IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE Clinicians should regularly assess the strength of all lower limb muscle groups, regardless of participation in physical activity, responsiveness to levodopa medication and walking ability.
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Affiliation(s)
- Salmon Renee
- University of Canberra, Faculty of Health, Physiotherapy, Bruce, Australian Capital Territory, Australia
| | - Preston Elisabeth
- University of Canberra, Faculty of Health, Physiotherapy, Bruce, Australian Capital Territory, Australia
| | - Mahendran Niruthikha
- University of Canberra, Faculty of Health, Physiotherapy, Bruce, Australian Capital Territory, Australia
| | - Flynn Allyson
- University of Canberra, Faculty of Health, Physiotherapy, Bruce, Australian Capital Territory, Australia
| | - Ada Louise
- University of Sydney, Faculty of Health Sciences, Physiotherapy, Lidcombe, New South Wales, Australia
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