Resistance training with instability is more effective than resistance training in improving spinal inhibitory mechanisms in Parkinson’s disease

Silva‐Batista, Carla; Mattos, Eugenia; Corcos, Daniel M.; Wilson, Jack L.; Heckman, C. J.; Kanegusuku, Hélcio; Piemonte, Maria Elisa Pimentel; Mello, Marco Túlio de; Forjaz, C. L. M.; Roschel, Hamilton; Tricoli, Valmor; Ugrinowitsch, Carlos

doi:10.1152/japplphysiol.00557.2016

Cited by 25 publications

(41 citation statements)

References 48 publications

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“…(18,34) Still, RT can improve muscle strength, functionality (e.g., walking capacity) and quality of life in patients with PD. (17,18,26,28,29,33,35) Findings of this study support recommendations of combined aerobic and strength training in exercise programs designed for patients in the mild to moderate stages of PD.…”

Section: Discussionsupporting

confidence: 62%

“…Neuroplastic changes in the primary motor cortex and neural adaptation to RT may explain the initial increase in lower limb strength in these patients. (28)(29)(30) Such strength gains may be of clinical significance in this population, given muscle mass and strength losses are correlated with poorer quality of life in patients with PD. (31) Significant similar VO 2peak increase at 12 weeks in both groups indicates improvements cannot be attributed to the RT program.…”

Section: Discussionmentioning

confidence: 99%

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Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease

Kanegusuku¹,

Peçanha²,

Silva‐Batista³

et al. 2021

Einstein (São Paulo)

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: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease. Methods: Twenty-four patients with Parkinson’s disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson’s disease without cardiovascular comorbidities.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease

Kanegusuku¹,

Peçanha²,

Silva‐Batista³

et al. 2021

Einstein (São Paulo)

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“…Presynaptic inhibition is a powerful spinal mechanism associated with poor mobility and postural instability in PD [47]. We have also demonstrated that RTI was more effective than RT in causing plastic changes in the presynaptic inhibitory pathway [24], which may have contributed to improve postural instability in subjects with PD and stability in gait observed herein. Thus, progression in instability and load (i.e., RTI) can be deemed as more effective than progression in load only (i.e., RT) to improve subjects with PD' postural control.…”

Section: Discussionsupporting

confidence: 53%

“…Recently, we found that compared to RT alone, RT performed on unstable devices (Resistance Training with Instability [RTI]) improved clinical (i.e., mobility, motor signs, cognitive function, and quality of life) [22], neuromuscular [23], and spinal inhibitory mechanisms outcomes [24] in subjects with PD. RTI requires not only muscle strength but also postural control while performing resistance exercises with unstable devices (e.g., BOSU ® and balance disc) due to the concomitant and progressive increases in load/resistance and degree of instability over time (i.e., high motor complexity) [22], which may impose a greater challenge to postural control and higher cognitive demand than RT alone.…”

Section: Introductionmentioning

confidence: 99%

Balance and fear of falling in subjects with Parkinson’s disease is improved after exercises with motor complexity

et al. 2018

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Resistance training with instability (RTI) uses exercises with high motor complexity that impose high postural control and cognitive demands that may be important for improving postural instability and fear of falling in subjects with Parkinson's disease (PD). Here, we hypothesized that: 1) RTI will be more effective than resistance training (RT) in improving balance (Balance Evaluation Systems Test [BESTest] and overall stability index [Biodex Balance System]) and fear of falling (Falls Efficacy Scale-International [FES-I] score) of subjects with Parkinson's disease (PD); and 2) changes in BESTest and FES-I after RTI will be associated with changes in cognitive function (Montreal Cognitive Assessment [MoCA] score - previously published) induced by RTI. Thirty-nine subjects with moderate PD were randomly assigned to a nonexercising control, RT, and RTI groups. While RT and RTI groups performed progressive RT twice a week for 12 weeks, the RTI group added progressive unstable devices to increase motor complexity of the resistance exercises. There were significant group × time interactions for BESTest, overall stability index, and FES-I scores (P < 0.05). Only RTI improved BESTest, overall stability index and FES-I scores, and RTI was more effective than RT in improving biomechanical constraints and stability in gait (BESTest sections) at post-training (P < 0.05). There were strong correlations between relative changes in BESTest and MoCA (r = 0.72, P = 0.005), and FES-I and MoCA (r = -0.75, P = 0.003) after RTI. Due to the increased motor complexity in RTI, RTI is recommended for improving balance and fear of falling, which are associated with improvement in cognitive function of PD.

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“…Besides motor abnormalities, patients with PD present non-motor symptoms such as dysautonomia (14) and sleep disturbances (15). Thus, physical exercise has been highly recommended as nonpharmacological intervention since it has shown to attenuate motor dysfunction, improve cognitive function, effectiveness of medications and sleep patterns, as well as prevent depression and cardiovascular complications (16).…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Effect Of The Combination Of Automated Peripheral Mechanical Stimulation And Physical Exercise On Aerobic Functional Capacity And Cardiac Autonomic Control: A Randomized Clinical Trial Protocol.

Zelada-Astudillo

Herrera-Santelices

Barbieri

et al. 2021

Preprint

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● Background: Automated peripheral mechanical stimulation (AMPS) has been proposed as a new complementary therapy with potential for improving motor and cardiovascular abnormalities in Parkinson's disease (PD). However, AMPS long-term effects and its combination with physical exercise is unknown. Thus, this study aims to compare the effects of a program of 12 weeks of physical exercise with a 12-week intervention program combining physical exercise and AMPS on the aerobic capacity, cardiac autonomic control and gait parameters in patients with PD.● Methods: A randomized, controlled clinical trial will be conducted. Volunteers will be randomly assigned to one of the two groups studied: 1) Exercise; or 2) AMPS + Exercise. Both groups will undergo an exercise program of 24 sessions, for 12 weeks, performed twice a week. Before exercise sessions, the group AMPS+Exercise will receive a session of active AMPS, while the group Exercise will receive an AMPS sham intervention. Shapiro-wilk’s and Levene’s tests will be used to check for data normality and homogeneity, respectively. In case parametric assumptions are fulfilled, per-protocol and intention-to-treat analyses will be performed using a mixed model analysis of variance to check for Group*Time interaction. Significance level will be set at 5%. ● Discussion: Several non-pharmacological treatment modalities have been proposed for PD, focusing primarily on the reduction of motor and musculoskeletal disorders. Regular exercise and motor training have been shown to be effective in improving quality of life. However, treatment options in general remain limited given the high prevalence and adverse impact of these disorders. So, developing new strategies that can potentiate the improvement of motor disabilities and also improve non-motor symptoms in PD is relevant. It is expected that the participants from both groups will improve their quality of life, gait parameters and their cardiac autonomic control, with greater improvements being observed in the group combining active AMPS and physical exercise.Trial registration: ClinicalTrials.gov, NCT04251728, registered February 05, 2020

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Resistance training with instability is more effective than resistance training in improving spinal inhibitory mechanisms in Parkinson’s disease

Cited by 25 publications

References 48 publications

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease

Balance and fear of falling in subjects with Parkinson’s disease is improved after exercises with motor complexity

Effect Of The Combination Of Automated Peripheral Mechanical Stimulation And Physical Exercise On Aerobic Functional Capacity And Cardiac Autonomic Control: A Randomized Clinical Trial Protocol.

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