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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.

BACKGROUND: Rehabilitation has proven effective in improving motor symptoms (i.e., weakness, tremor, gait and balance disorders) in patients with Functional Motor Disorders (FMDs). Its effects on non-motor symptoms (NMSs) such as fatigue, pain, depression, anxiety and alexithymia, have not been explored yet. OBJECTIVE: To explore the effects of a validated inpatient 5-day rehabilitation program, followed by a home-based self-management plan on functional motor symptoms, NMSs, self-rated perception of change, and quality of life (QoL). METHODS: 33 FMD patients were enrolled. Measures for motor symptoms and NMSs were primary outcomes. Secondary outcomes included measures of self-perception of change and QoL. Patients were evaluated pre-treatment (T0), post-treatment (T1), and 3-month follow-up (T2). RESULTS: There was an overall significant decrease in functional motor symptoms, general, physical, and reduced-activity fatigue (for all, p <  0.001). Post hoc comparison showed significant improvements at T1, whereas effects remained significant at T2 for motor symptoms and physical fatigue. Gait and balance, alexithymia, and physical functioning (QoL) significantly improved at T2. More than 50% of patients reported marked improvement at T1 and T2. CONCLUSIONS: Our study suggests the benefits of rehabilitation and self-management plan on functional motor symptoms and physical fatigue in the medium-term. More actions are needed for the management of pain and other distressing NMSs in FMDs.

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