Metabolic and kinematic parameters during walking with poles in Parkinson’s disease

Abstract

In healthy people, energy expenditure is generally higher during walking with poles (WP) than during conventional walking (W). In persons with Parkinson's disease (PD), walking is slower and may be associated with greater energy consumption, stride-to-stride variability, and difficulty in regulating stride length. The aim of this study was to determine whether treadmill WP at three different speeds could induce changes in gait kinematics and oxygen consumption in PD patients. The study sample was 20 patients with mild-to-moderate PD and 20 age-matched healthy controls. Subjects underwent 5-min W and WP treadmill tests at three different speeds (2.5, 3.5, and 4.5 km/h). Metabolic and gait parameters (ventilation, gas exchange, stride count and length) were recorded. As compared with the healthy controls, higher energy consumption (P < 0.05) (and other metabolic parameters), shorter stride, and reduced cadence (P < 0.05) were observed for the PD patients, independent of the walking technique. All subjects were noted to take longer strides during WP (P < 0.001), especially at the lowest treadmill speed. However, significantly higher energy consumption was observed only for the healthy controls (P < 0.05). No changes in metabolic parameters during WP were recorded; however, a substantial improvement in gait cycle length was noted for the PD patients.

Biomechanical responses of Nordic walking in people with Parkinson's disease

“…2 In general, at 1.8 km h −1 , the external work did not change because there was compensation regarding greater variations in the forward and vertical energies, which in turn produced a high recovery. Therefore, contrary to healthy people, where the greater total work using poles is due to internal work from the arms, 4 Parkinson's disease people maintain the total work. The improved pendulum-like mechanism using poles in comparison with FW affected the gait mechanics in people with Parkinson's disease resulting in an unaltered external and total mechanical work between walking modalities.…”

“…8 Moreover, it has been suggested that metabolic cost in people with Parkinson's disease does not increase during NW when compared to FW. 4 Many previous studies have examined the effect of NW in Parkinson's disease people after a training program. Several studies have evaluated walking trials in treadmill conditions, and modifications are expected in gait parameters when compared to overground conditions.…”

“…2,8 In addition, fewer ecologic trials are performed without walking poles. 4 We aimed to compare mechanical work, pendulum-like recovery, and spatiotemporal parameters of gait with and without NW poles between people with Parkinson's disease and healthy controls at different speeds. We hypothesized that the use of NW poles would increase recovery and decrease external mechanical work compared to FW at all walking speeds in people with Parkinson's disease.…”

Parkinson’s Disease–Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge

“…According to Fayyaz et al (2018), optimally prescribed physical exercise programs may modulate neurophysiological processes possibly slowing down PD symptoms, especially for patients with moderate cognitive and physical impairment. PA has been shown to attenuate dopaminergic neuron damage and reduce cellular inflammation and oxidative stress (Nardello et al, 2017), thus playing a pivotal role in non-pharmacological interventions. Regular and moderate PA induces positive modification on cortisol level, endothelium function, and reduced inflammation.…”

Effect of Parkinson’s disease and two therapeutic interventions on muscle activity during walking: a systematic review

“…Gait disturbance is characterised by slow shuffling steps 4 , asymmetry 5 and high stride-to-stride variability 6,7 . The increased energy expenditure associated with dysfunctional gait makes even a short walk a major physical effort 8 , thereby restricting mobility which impacts on quality of life. Fall risk is higher in people with PD 9,10 , which imposes a social and economic burden through hospitalisation 11 and subsequent health care costs 12,13 .…”