Parkinson's disease: An investigation of exercise capacity, respiratory function, and gait

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      Objective: To evaluate the exercise capacity of subjects with mild to moderate Parkinson's disease and determine whether abnormalities in respiratory function and gait affect exercise capacity.
      Design: Descriptive. Subjects were categorized according to exercise history, disease severity, and presence/absence of upper airway obstruction.
      Subjects and Setting: Sixteen volunteers with mild to moderate idiopathic Parkinson's disease attended a university research laboratory.
      Main Outcome Measures: Subjects performed a maximum exercise test on a cycle ergometer, together with respiratory function tests and a walking test. Peak values for oxygen consumption and work rate were recorded for the maximum exercise test. Measures of respiratory function included spirometry, flow-volume loops, lung volumes, and mouth pressures. Velocity, stride length, and cadence were measured for preferred and fast speeds of walking. The values obtained on each of these tests were compared with published predicted age- and gender-matched normal values.
      Results: Peak oxygen consumptions and peak work loads achieved by subjects with Parkinson's disease were not significantly different from normal values, despite evidence of respiratory and gait abnormalities typical of Parkinson's disease. Exercise category was significantly correlated with percent predicted Vo2peak (r = .64, p < .01), with sedentary subjects producing lower scores than exercising subjects. There was no significant correlation between disease severity and percent predicted Vo2 peak.
      Conclusion: Despite their neurological deficit, individuals with mild to moderate Parkinson's disease have the potential to maintain normal exercise capacity with regular aerobic exercise.


        • Marsden CD
        Parkinson's disease.
        J Neurol Neurosurg Psychiatry. 1994; 57: 672-681
        • Carr JH
        • Shepherd RS
        A motor learning model for rehabilitation of the movement-disabled.
        in: Ada L Canning C Key issues in neurological physiotherapy. Butterworth Heinemann, Oxford1990: 1-24
        • Turnbull G
        The role of physiotherapy intervention.
        in: Turnbull G Physical therapy management of Parkinson's disease. Churchill Livingstone, New York1992: 91-120
        • Saltin B
        • Landin S
        Work capacity, muscle strength and SDH activity in both legs of hemiparetic patients and patients with Parkinson's disease.
        Scand J Clin Lab Invest. 1975; 35: 531-538
        • Carter JH
        • Nutt JG
        • Woodward WR
        The effect of exercise on levodopa absorption.
        Neurology. 1992; 42: 2042-2045
        • Protas EJ
        • Stanley RK
        • Jankovic J
        • Mac Neill B
        Cardiovascular and metabolic responses to upper- and lower-extremity exercise in men with idiopathic Parkinson's disease.
        Phys Ther. 1996; 76: 34-40
        • Boggard JM
        • Hovestadt A
        • Meerwaldt JD
        • van der Meche FGA
        • Stigt J
        Maximal expiratory and inspiratory flow volume curves in Parkinson's disease.
        Am Rev Respir Dis. 1989; 139: 610-614
        • de Bruin PFC
        • de Bruin VMS
        • Lees AJ
        • Pride NB
        Effects of treatment on airway dynamics and respiratory muscle strength in Parkinson's disease.
        Am Rev Respir Dis. 1993; 148: 1576-1580
        • Hovestadt A
        • Boggard JM
        • Meerwaldt JD
        • van der Meche FGA
        • Stigt J
        Pulmonary function in Parkinson's disease.
        J Neurol Neurosurg Psychiatry. 1989; 52: 329-333
        • Izquierdo-Alonso JL
        • Jimenez-Jimenez FJ
        • Cabrera-Valdivia F
        • Mansilla-Lesmes M
        Airway dysfunction in patients with Parkinson's disease.
        Lung. 1994; 172: 47-55
        • Lilker ES
        • Woolf CR
        Pulmonary function in Parkinson's syndrome: the effect of thalatomy.
        Can Med Assoc J. 1968; 99: 752-757
        • Neu HC
        • Connolly JJ
        • Schwertley FW
        • Ladwig HA
        • Brody AW
        Obstructive respiratory dysfunction in Parkinsonian patients.
        Am Rev Respir Dis. 1967; 95: 33-47
        • Obenour WH
        • Stevens PM
        • Cohen AA
        • McCutchen JJ
        The cause of abnormal pulmonary function in Parkinson's disease.
        Am Rev Respir Dis. 1972; 105: 382-387
        • Schiffman PL
        A “saw-tooth” pattern in Parkinson's disease.
        Chest. 1985; 87: 124-126
        • Vincken WG
        • Gauthier SG
        • Dollfuss RE
        • Hanson RE
        • Darauay CM
        • Cosio MG
        Involvement of upper-airway muscles in extrapyramidal disorders: A cause of airflow limitation.
        New Engl J Med. 1984; 311: 438-442
        • Blin O
        • Ferrandez AM
        • Serratrice G
        Quantitative analysis of gait in Parkinson patients: increased variability of stride length.
        J Neurol Sci. 1990; 98: 91-97
        • Morris ME
        • Ianseck R
        • Matyas TA
        • Summers JJ
        The pathogenesis of gait hypokinesia in Parkinson's disease.
        Brain. 1994; 117: 1169-1181
        • Morris ME
        • Ianseck R
        • Matyas TA
        • Summers JJ
        Ability to modulate walking cadence remains intact in Parkinson's disease.
        J Neurol Neurosurg Psychiatry. 1994; 57: 1532-1534
        • Wall JC
        • Turnbull G
        The kinematics of gait.
        in: Turnbull G Physical therapy management of Parkinson's disease. Churchill Livingstone, New York1992: 49-67
        • Fertl E
        • Doppelbauer A
        • Auff E
        Physical activity and sports in patients suffering from Parkinson's disease in comparison with healthy seniors.
        J Neural Trans. 1993; 5: 157-161
        • Hoehn MM
        • Yahr MD
        Parkinsonism: onset, progression and mortality.
        Neurology. 1967; 17: 427-442
        • Cherniack RM
        • Raber MB
        Normal standards for ventilatory function using an automated wedge spirometer.
        Am Rev Respir Dis. 1972; 106: 38-46
        • American Thoracic Society
        Standardization of spirometry—1994 update.
        Am J Respir Crit Care Med. 1995; 152: 1107-1136
        • Knudson RJ
        • Slatin RC
        • Lebowitz MD
        • Burrows B
        The maximal expiratory flow-volume curve.
        Am Rev Respir Dis. 1976; 113: 587-600
        • Hathirat S
        • Renzetti AD
        • Mitchell M
        Measurement of the total lung capacity by helium dilution in a constant volume system.
        Am Rev Respir Dis. 1970; 102: 760-770
        • Goldman HI
        • Becklake MR
        Respiratory function tests: normal values at medium altitudes and the prediction of normal.
        Am Rev Respir Dis. 1959; 79: 457-467
        • Wilson SH
        • Cooke NT
        • Edwards RHT
        • Spiro SG
        Predicted normal values for maximal respiratory pressures in caucasian adults and children.
        Thorax. 1984; 39: 535-538
        • Fransen M
        • Heussler J
        • Margiotta E
        • Edmonds J
        Quantitative gait analysis—comparison of rheumatoid arthritic and non-arthritic subjects.
        Aust J Physiother. 1994; 40: 191-199
        • Jones N
        • Campbell EJM
        • Edwards RHT
        • Robertson DG
        Clinical exercise testing.
        W.B. Saunders Company, Philadelphia1975
        • Astrand P
        • Rodahl K
        Textbook of work physiology: physiological bases of exercise.
        3rd ed. McGraw-Hill, New York1986
        • Burdon JG
        • Juniper EF
        • Killian KJ
        • Hargreave FE
        • Campbell EJM
        The perception of breathlessness in asthma.
        Am Rev Respir Dis. 1982; 126: 825-828
        • Calvert AF
        • Bernstein L
        • Bailey IK
        Physiological responses to maximal exercise in a normal Australian population—comparative values in patients with anatomically defined coronary artery disease.
        Aust N Z J Med. 1977; 7: 497-506
        • Jones N
        Normal standards for an incremental progressive cycle ergometer test.
        Am Rev Respir Dis. 1985; 131: 700-708
        • Freedman S
        Sustained maximum voluntary ventilation.
        Respir Physiol. 1970; 8: 230-244
        • Jones N
        Clinical exercise testing.
        3rd ed. W.B. Saunders Company, Philadelphia1988
        • National Centre for Health Promotion and New South Wales Health Department
        New South Wales Health Promotion Survey, 1994.
        in: 7th ed. Technical Report. NSW Health Department, Sydney1995
        • Bridgewater KJ
        • Frick RA
        • Sharpe MH
        Effects of aerobic exercise on cardiorespiratory fitness in early Parkinson's disease patients.
        ([abstract])in: Jones S Strauss G Proceedings of the Fourth International Congress of the Australian Physiotherapy Association, 1994 July 25–29; Bali, Indonesia Australian Physiotherapy Association (WA Branch), Perth1994: 22-23
        • Landin S
        • Hagenfeldt L
        • Saltin B
        • Wahren J
        Muscle metabolism during exercise in patients with Parkinson's disease.
        Clin Sci Mol Med. 1974; 47: 493-506
        • Kinnunen E
        • Viljanen A
        Pleuropulmonary involvement during bromocriptine treatment.
        Chest. 1988; 94: 1034-1036
        • Mier A
        Measurement, implications and modification of human respiratory muscle performance: An introductory review.
        J Hum Muscle Perf. 1991; 1: 1-10