Effects of Levodopa on Pulmonary Function in Parkinson's Disease

Background: The effect of 3-month respiratory muscle training (RMT) on pulmonary and autonomic function and functional outcomes has been demonstrated in patients with Parkinson's disease (PD); however, there is a paucity of information on the durability of the training effect. In this study, we monitored the pulmonary and cardiovascular autonomic function and clinical severity scales until 18 months after the cessation of RMT to elucidate the detraining effect after RMT.Methods: All patients with PD receiving RMT were assessed with clinical severity scales as well as pulmonary and autonomic function tests at four different stages (baseline on enrollment, immediately after 3 months of RMT, and 6 and 18 months after cessation of RMT). A control group of PD patients who did not receive RMT was also recruited for comparison. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), were assessed. Cardiovascular autonomic function was assessed using measures including heart rate response to deep breathing (HRDB), Valsalva ratio, and baroreflex sensitivity. Clinical severity scores were also measured using the Hoehn and Yahr staging and the Unified Parkinson's Disease Rating Scale (UPDRS).Results: The results showed significant improvements in MIP, MEP, HRDB, and UPDRS immediately after RMT. Despite some decay, the improvements in pulmonary function (MIP and MEP) and functional outcomes (UPDRS) remained significant until 6 months of detraining (9 months after enrollment). However, the improvement in cardiovascular autonomic function (HRDB) was reversed after 6 months of detraining.Conclusions: Based on these findings, we recommend that RMT may be repeated after at least 6 months after previous session (9 months after enrollment) for patients with PD to maintain optimal therapeutic effects.

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Pulmonary function tests in patients with Parkinson's disease: A case-control study

Nigerian Journal of Clinical Practice ◽

10.4103/1119-3077.173714 ◽

2016 ◽

Vol 19 (1) ◽

pp. 66 ◽

Cited By ~ 5

Author(s):

LF Owolabi ◽

M Nagoda ◽

M Babashani

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Case Control Study ◽

Pulmonary Function Tests ◽

Case Control ◽

Function Tests ◽

Control Study

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Simultaneously Improved Pulmonary and Cardiovascular Autonomic Function and Short-Term Functional Outcomes in Patients with Parkinson’s Disease after Respiratory Muscle Training

Journal of Clinical Medicine ◽

10.3390/jcm9020316 ◽

2020 ◽

Vol 9 (2) ◽

pp. 316

Author(s):

Chih-Cheng Huang ◽

Yun-Ru Lai ◽

Fu-An Wu ◽

Nai-Ying Kuo ◽

Yuh-Chyn Tsai ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Functional Outcomes ◽

Respiratory Muscle ◽

Autonomic Function ◽

Respiratory Muscle Training ◽

Muscle Training ◽

Short Term ◽

Cardiovascular Autonomic Function

Both pulmonary function and autonomic function are impaired in patients with Parkinson’s diseases (PD). This study tested the hypothesis that respiratory muscle training (RMT) can not only improve pulmonary function, but also simultaneously improve cardiovascular autonomic function and short-term functional outcomes in patients with PD. Pulmonary function was measured by the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum inspiratory pressures (MIP), and maximum expiratory pressures (MEP). Cardiovascular autonomic function was measured by the heart rate response to deep breathing (HRDB), Valsalva ratio, baroreflex sensitivity, and spectral analysis. The functional and severity scores were measured by the Hoehn and Yahr stage and Unified Parkinson’s Disease Rating Scale (UPDRS). These measures were evaluated in patients with PD before and after 3 months of RMT, compared with a control group of PD patients without RMT. The results showed significant improvement of clinical scores (total UPDRS and UPDRS I, II and III) after RMT (p < 0.0001). Concerning pulmonary function, the parameters of MIP and MEP improved significantly. The parameters of cardiovascular function also improved after RMT, although only HRDB reached statistical significance. Based on the results of our study, RMT can not only improve both pulmonary and cardiovascular autonomic function, but can also improve short-term functional outcomes in patients with PD.

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Pulmonary function tests in Parkinson's disease

European Journal of Neurology ◽

10.1046/j.1468-1331.2001.00253.x ◽

2001 ◽

Vol 8 (4) ◽

pp. 341-345 ◽

Cited By ~ 27

Author(s):

M. Polatli ◽

A. Akyol ◽

O. Cildag ◽

K. Bayulkem

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Pulmonary Function Tests ◽

Function Tests

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Respiratory Disorders in Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212565 ◽

2021 ◽

pp. 1-18

Author(s):

Evelyn M. Guilherme ◽

Roberta de Fátima C.M. Padovez ◽

Adriele de Oliveira ◽

Alyne Montero Ferro ◽

Valéria A. P. di Lorenzo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Muscle Strength ◽

Pulmonary Function ◽

Respiratory Muscle ◽

Physical Capacity ◽

Respiratory Muscle Strength ◽

Respiratory Impairment ◽

Respiratory Disorders ◽

Electronic Search

Background: Parkinson’s disease (PD) non motor symptoms may present early in the disease course and worsen with advancing disease. Respiratory changes can affect individuals to remain physically active, contributing to a reductionof functionality and quality of life. Objective: The aim of this systematic review is to synthesize evidence of respiratory disorders in patients with PD. Methods: An electronic search was performed up to November 2020 on PubMed-MEDLINE, Embase, Web of Science, Lilacs, Cinahl, and Cochrane using the following keyword combination: [(“Parkinson disease”) AND (“respiratory function tests” OR “evaluation”) AND (“respiratory system” OR “respiration disorders” OR “respiratory muscles”)]. Results: The electronic search resulted in 601 references in English or Portuguese. The selection process and data extraction were made by two independent reviewers. We selected 19 studies including cross-sectional studies that investigated the respiratory disorders in patients with PD through pulmonary function, respiratory muscle strength, or physical capacity evaluation. We excluded studies that considered patients with other diseases. Eighteen studies evaluated the pulmonary function in patients with PD, eleven studies verified the influence of PD on respiratory muscle strength, and three studies assessed the physical capacity through functional tests. Conclusion: The evidence showed that PD patients have higher chances to present a pulmonary dysfunction, either obstructive or restrictive, when compared to healthy subjects. In addition, these patients present lower respiratory muscle strength and a consequent decrease in physical capacity in endurance exercises. The respiratory impairment in PD seems to be directly related to the progression of the disease.

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The Effect of Levodopa on Pulmonary Function in Parkinson's Disease: A Systematic Review and Meta-Analysis

Clinical Therapeutics ◽

10.1016/j.clinthera.2012.03.001 ◽

2012 ◽

Vol 34 (5) ◽

pp. 1049-1055 ◽

Cited By ~ 36

Author(s):

Larissa Monteiro ◽

Adelmir Souza-Machado ◽

Silvia Valderramas ◽

Ailton Melo

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Meta Analysis

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Influence of Thoracoabdominal Movement on Pulmonary Function in Patients with Parkinson's Disease: Comparison with Healthy Subjects

Neurorehabilitation and Neural Repair ◽

10.1177/154596830001400105 ◽

2000 ◽

Vol 14 (1) ◽

pp. 43-47 ◽

Cited By ~ 10

Author(s):

Akira Tamaki ◽

Yoshimi Matsuo ◽

Takehiko Yanagihara ◽

Kazuo Abe

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Forced Vital Capacity ◽

Healthy Subjects ◽

Vital Capacity ◽

Healthy Controls ◽

Pulmonary Dysfunction ◽

Average Volume ◽

Abdominal Movement

Patients with Parkinson's disease (PD) may develop pulmonary dysfunction, but the pathogenesis remains unclear. We investigated a correlation between thoracoab dominal movements and pulmonary function in seven patients with PD and 14 healthy controls. We measured vital capacity (VC) and forced vital capacity (FVC) using an autospirometer, and measured chest and abdominal movements using a respiraory in ductance plethysmography by fixing transducers on the rib cage and umbilicus. Pa tients with PD had significantly decreased % VC (90.3 ± 17.1 vs 105.8 ± 13.9%), chest movement (271.3 ± 79.6 vs. 375.2 ± 126.7% VT) and abdominal movement (217.6 ± 93.5 vs. 247.4 ± 100.2% VT) with 100% VT being an average volume of chest and abdomen at rest during measurement of VC. Patients with PD also had sig nificantly decreased % FVC (74.4 ± 20.6 vs. 97.6 ± 14.1%), chest movement (246.2 ± 115.2 vs. 344.5 ± 126.4% VT) and abdominal movement (160.3 ± 105.6 vs 207.6 ± 104.7% VT) with 100% VT being an average volume of chest and abdomen at rest during forced maximal inspiration. Based on the results, we conclude that a reduction of % VC in patients with PD correlated with chest movements, while a reduction of % FVC correlated with ab dominal movement in patients with PD.

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