Effect of Multimodal Exercise Training on Walking Economy in Individuals With Parkinson's Disease

Background People with Parkinson’s disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants’ perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson’s disease. Methods Twenty adults with Parkinson’s disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach’s supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. Results Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. Conclusion Findings demonstrate that adults with Parkinson’s disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.

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Effects of treadmill training on walking economy in Parkinson’s disease: a pilot study

Neurological Sciences ◽

10.1007/s10072-009-0141-8 ◽

2009 ◽

Vol 30 (6) ◽

pp. 499-504 ◽

Cited By ~ 20

Author(s):

Elisa Pelosin ◽

Emanuela Faelli ◽

Francesco Lofrano ◽

Laura Avanzino ◽

Lucio Marinelli ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pilot Study ◽

Treadmill Training ◽

Walking Economy

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Effects of Endurance Exercise Training on The Motor and Non-Motor Features of Parkinson’s Disease: A Review

Journal of Parkinson s Disease ◽

10.3233/jpd-159002 ◽

2015 ◽

Vol 5 (4) ◽

pp. 993-993 ◽

Cited By ~ 7

Author(s):

Guillaume Lamotte ◽

Miriam R. Rafferty ◽

Janey Prodoehl ◽

Wendy M. Kohrt ◽

Cynthia L. Comella ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Exercise Training ◽

Endurance Exercise ◽

Endurance Exercise Training

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Effects of aging and Parkinson’s disease on motor unit remodeling: influence of resistance exercise training

Journal of Applied Physiology ◽

10.1152/japplphysiol.00563.2017 ◽

2018 ◽

Vol 124 (4) ◽

pp. 888-898 ◽

Cited By ~ 8

Author(s):

Neil A. Kelly ◽

Kelley G. Hammond ◽

C. Scott Bickel ◽

Samuel T. Windham ◽

S. Craig Tuggle ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Exercise Training ◽

Neuromuscular Junction ◽

Resistance Exercise ◽

Motor Unit ◽

Type I ◽

Resistance Exercise Training ◽

Age Related ◽

Myofiber Type

Aging muscle atrophy is in part a neurodegenerative process revealed by denervation/reinnervation events leading to motor unit remodeling (i.e., myofiber type grouping). However, this process and its physiological relevance are poorly understood, as is the wide-ranging heterogeneity among aging humans. Here, we attempted to address 1) the relation between myofiber type grouping and molecular regulators of neuromuscular junction (NMJ) stability; 2) the impact of motor unit remodeling on recruitment during submaximal contractions; 3) the prevalence and impact of motor unit remodeling in Parkinson’s disease (PD), an age-related neurodegenerative disease; and 4) the influence of resistance exercise training (RT) on regulators of motor unit remodeling. We compared type I myofiber grouping, molecular regulators of NMJ stability, and the relative motor unit activation (MUA) requirement during a submaximal sit-to-stand task among untrained but otherwise healthy young (YA; 26 yr, n = 27) and older (OA; 66 yr, n = 91) adults and OA with PD (PD; 67 yr, n = 19). We tested the effects of RT on these outcomes in OA and PD. PD displayed more motor unit remodeling, alterations in NMJ stability regulation, and a higher relative MUA requirement than OA, suggesting PD-specific effects. The molecular and physiological outcomes tracked with the severity of type I myofiber grouping. Together these findings suggest that age-related motor unit remodeling, manifested by type I myofiber grouping, 1) reduces MUA efficiency to meet submaximal contraction demand, 2) is associated with disruptions in NMJ stability, 3) is further impacted by PD, and 4) may be improved by RT in severe cases. NEW & NOTEWORTHY Because the physiological consequences of varying amounts of myofiber type grouping are unknown, the current study aims to characterize the molecular and physiological correlates of motor unit remodeling. Furthermore, because exercise training has demonstrated neuromuscular benefits in aged humans and improved innervation status and neuromuscular junction integrity in animals, we provide an exploratory analysis of the effects of high-intensity resistance training on markers of neuromuscular degeneration in both Parkinson’s disease (PD) and age-matched older adults.

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