Quadriceps Muscle Weakness, Activation Deficits, and Fatigue With Parkinson Disease

Stevens-Lapsley, Jennifer E.; Kluger, Benzi M.; Schenkman, Margaret

doi:10.1177/1545968311425925

Cited by 81 publications

(106 citation statements)

References 59 publications

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“…Weakness of the lower extremities has been reported to be a risk factor for indoor falls in patients with PD [3]. Fatigue that occurs at the early stage and then progresses as the disease advances affects about half of the patients with idiopathic PD [2, 4], and PD-related weakness and fatigue have been linked to the severity and duration of PD, levodopa dose, activation failure, and comorbidities such as depression and anxiety [4–6]. Chou and colleagues [7] reported that deep brain stimulation surgery did not change levels of PD-related fatigue.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, peripheral fatigue may result from neuromuscular transmission failure along α motor neurons, neuromuscular junctions, muscle cell membranes, and factors within muscle fibers such as E-C coupling failure [16]. Recent studies have reported that the activation level (VA) of the maximum voluntary muscle contraction (VA) is lower in patients with PD than in age-matched controls [4, 17]. This suggests that PD patients are prone to have central fatigue; however this phenomenon has never been quantified.…”

Section: Introductionmentioning

confidence: 99%

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Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

et al. 2017

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Background. Problems with gait in Parkinson's disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods. We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results. The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion. Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

et al. 2017

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“…Previous studies [5] strongly suggested a harmful upregulation of inducible nitric oxide synthase (iNOS) in the brain of animals and humans following MPTP administration. Moreover, iNOS has been reported to be involved in the muscle loss occurring in muscle wasting syndromes like sarcopenia and cachexia [6].…”

Section: Introductionmentioning

confidence: 99%

Endurance Exercise Training Attenuates the up Regulation of iNOS in the Skeletal Muscles of Chronic/Progressive Mouse Model of Parkinson’s Disease

Erekat

2013

J Neurol Res

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Background: Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the elderly. PD complications include muscle weakness and fatigue, these complications lead in part to decrease the endurance of PD patients. Strength of skeletal muscles has a major role in ADL performance, which is one of the challenges that PD patients have. The main goals of this study are to study the expression of inducible nitric oxide synthase (iNOS) in the skeletal muscles of PD and to examine the effect of treadmill exercise training on iNOS expression in these skeletal muscles.

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“…However, despite these indications, there are still many doubts with regard to the muscle strength behavior of individuals affected by PD, when compared to neurologically healthy individuals of the same age and gender (10). There are few studies which quantified muscle strength in PD and the results found are inconsistent (12). The specific cause of a possible strength deficit in these subjects is not known, yet, and it is still a matter of debate if it is of a central or peripheral origin, as well as if it is inherent to the disease or secondary to an external phenomenon.…”

Section: Introductionmentioning

confidence: 94%

Força muscular isocinética dos extensores do joelho em indivíduos com doença de Parkinson

et al. 2013

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INTRODUÇÃO: Apesar do tremor, bradicinesia e rigidez serem os sintomas motores clássicos da doença de Parkinson (DP), a fraqueza muscular também tem sido apontada como um dos mais importantes sintomas motores associados a essa doença, porém, essa condição ainda é pouco estudada e os resultados são inconsistentes. OBJETIVOS: O presente estudo teve o propósito de comparar a força muscular do quadríceps entre indivíduos portadores de DP e indivíduos neurologicamente saudáveis pareados por idade e gênero. Foi comparada também a força muscular do membro mais acometido e menos acometido pela doença. MATERIAIS E MÉTODOS: Participaram deste estudo 26 voluntários, 13 do grupo Parkinson (GP: 64,08 ± 6,87 anos; 73,82 ± 13,03 Kg; 1,66 ± 0,07m;) e 13 do grupo controle (GC: 62,73 ± 6,42 anos; 79,46 ± 11,40 kg; 1,71 ± 0,07 m). Foi mensurado o pico de torque (PT) dos extensores do joelho por meio da dinamometria isocinética, na velocidade de 90º.s-1. Foi utilizado o teste t para comparar as médias intra e entre os grupos (p < 0,05). RESULTADOS: O PT absoluto foi significativamente menor no GP (119,29 ± 40,06 N.m) quando comparado ao GC (145,15 ± 20,05 N.m). Entre os indivíduos com DP, foram encontrados valores significativamente inferiores de força muscular do membro mais acometido quando comparado com o menos acometido (119,29± 40,06 N.m vs. 128,86 ± 35,56 N.m; p < 0,05). CONCLUSÃO: Com base nos resultados, conclui-se que portadores da DP apresentam reduzido PT isocinético dos extensores do joelho, sendo esses achados exacerbados no membro mais acometido pela doença.

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Quadriceps Muscle Weakness, Activation Deficits, and Fatigue With Parkinson Disease

Cited by 81 publications

References 59 publications

Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

Endurance Exercise Training Attenuates the up Regulation of iNOS in the Skeletal Muscles of Chronic/Progressive Mouse Model of Parkinson’s Disease

Força muscular isocinética dos extensores do joelho em indivíduos com doença de Parkinson

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