Exercise response in Parkinson’s disease: insights from a cross-sectional comparison with sedentary controls and a per-protocol analysis of a randomised controlled trial

Mavrommati, Foteini; Collett, Johnny; Franssen, Marloes; Meaney, Andrew; Sexton, Claire E.; Dennis-West, Andrea; Betts, Jill F.; Izadi, Hooshang; Bogdanovič, Marko; Tims, Martin; Farmer, Andrew; Dawes, Helen

doi:10.1136/bmjopen-2017-017194

Cited by 24 publications

(34 citation statements)

References 28 publications

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“…Studies conducted in patients with PD showed blunted cardiovascular responses to exercise when compared with healthy controls (Kanegusuku et al 2016;Ludin et al 1987;Mavrommati et al 2017;Nakamura et al 2010;Strano et al 2016;Werner et al 2006). This abnormality was observed irrespective of type (i.e., aerobic or strength) or intensity of exercise (Kanegusuku et al 2016;Ludin et al 1987;Mavrommati et al 2017;Nakamura et al 2010;Strano et al 2016;Werner et al 2006). Nonetheless, the underlying pathophysiologic mechanisms that potentially contribute to these blunted responses in patients with PD are still not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Sabino‐Carvalho

Teixeira

Samora

et al. 2018

Journal of Neurophysiology

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Patients with Parkinson's disease (PD) exhibit attenuated cardiovascular responses to exercise. The underlying mechanisms that are potentially contributing to these impairments are not fully understood. Therefore, we sought to test the hypothesis that patients with PD exhibit blunted cardiovascular responses to isolated muscle metaboreflex activation following exercise. For this, mean blood pressure, cardiac output, and total peripheral resistance were measured using finger photoplethysmography and the Modelflow method in 11 patients with PD [66 ± 2 yr; Hoehn and Yahr score: 2 ± 1 a.u.; time since diagnosis: 7 ± 1 yr; means ± SD) and 9 age-matched controls (66 ± 3 yr). Measurements were obtained at rest, during isometric handgrip exercise performed at 40% maximal voluntary contraction, and during postexercise ischemia. Also, a cold pressor test was assessed to confirm that blunted cardiovascular responses were specific to exercise and not representative of generalized sympathetic responsiveness. Changes in mean blood pressure were attenuated in patients with PD during handgrip (PD: ∆25 ± 2 mmHg vs. controls: ∆31 ± 3 mmHg; P < 0.05), and these group differences remained during postexercise ischemia (∆17 ± 1 mmHg vs. ∆26 ± 1 mmHg, respectively; P < 0.01). Additionally, changes in total peripheral resistance were attenuated during exercise and postexercise ischemia, indicating blunted reflex vasoconstriction in patients with PD. Responses to cold pressor test did not differ between groups, suggesting no group differences in generalized sympathetic responsiveness. Our results support the concept that attenuated cardiovascular responses to exercise observed in patients with PD are, at least in part, explained by an altered skeletal muscle metaboreflex. NEW & NOTEWORTHY Patients with Parkinson's disease (PD) presented blunted cardiovascular responses to exercise. We showed that cardiovascular response evoked by the metabolic component of the exercise pressor reflex is blunted in patients with PD. Furthermore, patients with PD presented similar pressor response during the cold pressor test compared with age-matched controls. Altogether, our results support the hypothesis that attenuated cardiovascular responses to exercise observed in patients with PD are mediate by an altered skeletal muscle metaboreflex.

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Section: Introductionmentioning

confidence: 99%

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Sabino‐Carvalho

Teixeira

Samora

et al. 2018

Journal of Neurophysiology

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“…Consequently, nine studies were included in the review: one was a non-randomized controlled pilot study 14 and eight were randomized controlled trials. [15][16][17][18][19][20][21][22] Figure 1 represents the findings of the search.…”

Section: Resultsmentioning

confidence: 99%

“…Scores ranged from 5 14 to 8. [16][17][18][19][20][21] To assess the feasibility of running meta-analysis, data were extracted and summarized in Table 3…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Seven studies assessed the effects of aerobic training on cardiopulmonary function. Aerobic training (including walking Bergen et al 14 1 0 0 1 0 0 0 1 1 1 1 5 Bridgewater and Sharpe 18 1 1 1 1 0 0 1 1 1 1 1 8 Burini et al 16 1 1 1 1 0 0 1 1 1 1 1 8 Corbianco et al 15 1 1 1 1 0 0 0 1 1 1 1 7 Fernández-del-Olmo et al 22 1 1 0 1 0 0 0 1 1 1 1 6 Mavrommati et al 17…”

Section: Effects Of Aerobic Training On Cardiopulmonary Functionmentioning

confidence: 99%

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Cardiopulmonary Function and Aerobic Exercise in Parkinson's: A Systematic Review of the Literature

Aburub

Ledger

Sim

et al. 2020

Movement Disord Clin Pract

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Background Cardiorespiratory impairments are considered the main cause of mortality in the late stages of Parkinson's. Aerobic exercise has been shown to improve pulmonary function in asthmatic patients and in healthy people. However, effects of aerobic exercise on cardiopulmonary function in people with Parkinson's have not been investigated. Therefore, this study aimed to review the effects of aerobic exercise on cardiopulmonary function in people with Parkinson's. Methods A systematic search was conducted using MEDLINE, AMED, CINHAL Plus, and relevant associated keywords, from January 1970 to January 2020. Inclusion criteria for the studies were: aerobic exercise as part of the intervention, pulmonary function test, and/or cardiopulmonary exercise test as outcome measures. Results In total, 329 citations were identified from the search, of which nine were included in this review. In general, aerobic exercise was found to have positive effects on cardiac function for people with Parkinson's, but there is a lack of studies on the effects of aerobic exercise on pulmonary function. Conclusion People with early stages of Parkinson's may experience positive effects of aerobic exercise on cardiac fitness. Further research is needed in this area, particularly into the effects of aerobic exercise on pulmonary function in early stages of the disease.

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“…The intensity of conventional physiotherapy programs is less than 30% HRR, and thus contributes to low levels of cardiorespiratory fitness; therefore, increasing the exercise intensity during the rehabilitation programs is useful [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Is Group Physical Therapy in the Circuit Format a Model of Cardiovascular Conditioning in Parkinson's Disease?

Cc¹

2018

NNOAJ

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Introduction: In order to decline the progression of signs and symptoms and improve the functional condition of parkinsonians, physical exercise is important during rehabilitation, being intensity a relevant factor. However, still unclear whether group physiotherapy in the circuit format (CF) is capable of triggering better conditioning and positive cardiovascular changes in parkinsonians. Objective: To analyze the heart rate performance in Parkinsonians submitted to CF and correlate with the functional capacity to evaluate the effectiveness of the group physiotherapy in circuit format as a conditioning method. Material and Methods: Parkinsonians of both men and women, with Hoehn and Yahr between 1 and 3 participated in CF. Participants were submitted to an initial evaluation, in which Time Up and Go (TUG) were applied and Berg Balance Scale (BSE). After that, the blood pressure was measured, the cardiofrequencimetre device was placed and the participants were directed to the CF session, which consists of the practice of exercises in 10 different stations, assembled with sticks, chairs, ladder, ramp, cones, elastic tube and sign maps. The time station was 2 minutes and the total duration of each CF session was 50 minutes. Results: There was a significant difference when compared to BHR with MHR in each season, and training intensity provided by CF to parkinsonians was classified as very light and mild. In addition, there was no correlation between the values of MHR with TUG and BSE during CF.

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Exercise response in Parkinson’s disease: insights from a cross-sectional comparison with sedentary controls and a per-protocol analysis of a randomised controlled trial

Cited by 24 publications

References 28 publications

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Cardiopulmonary Function and Aerobic Exercise in Parkinson's: A Systematic Review of the Literature

Is Group Physical Therapy in the Circuit Format a Model of Cardiovascular Conditioning in Parkinson's Disease?

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