Effects of leg muscle fatigue on gait in patients with Parkinson's disease and controls with high and low levels of daily physical activity

Abstract

Patients with Parkinson's disease (PD) are more susceptible to muscle fatigue, which can damage their gait. Physical activity can improve muscle condition, which is an important aspect during walking. The aim of this study was to analyze the effects of lower limb muscle fatigue on gait in patients with PD and healthy individuals, grouped according to physical activity level. Twenty Patients with PD (PD group) and 20 matched individuals (control group) were distributed according to physical activity level into four subgroups of ten individuals (active and inactive). Participants performed three walking trials before and after lower limb muscle fatigue, induced by a repeated sit-to-stand task on a chair. Kinematic (stride length, width, duration, velocity and percentage of time in double support) and kinetic (propulsive and breaking anterior-posterior and medio-lateral impulse) gait parameters were analyzed. In both groups, participants increased stride length and velocity and decreased stride duration and braking vertical impulse after lower limb muscle fatigue. The PD groups presented higher step width and percentage of double time support than the control groups before muscle fatigue. The control groups increased step width and decreased percentage of time in double support, while the PD groups did not change these parameters. For physical activity level, active individuals presented longer stride length, greater stride velocity, higher braking and propulsive anterior-posterior impulse and shorter step width than inactive individuals. Groups sought more balance and safety after lower limb muscle fatigue. Physical activity level does not appear to modify the effects of lower limb muscle fatigue during unobstructed walking in individuals with PD or controls.

Prolonged Walking with a Wearable System Providing Intelligent Auditory Input in People with Parkinson’s Disease

“…Given the strong correlation between arm swing and stride amplitude (44), spontaneous overflow from one parameter to the other may also have occurred. Recent work also showed a significant increase in stride length following a repeated sit-to-stand protocol in both PD and age-matched HE (45). These effects, not demonstrated during short gait trials in gait laboratories, support the European guideline’s recommendation to undertake 30 min bouts of brisk walking as a rehabilitation strategy for PD (21).…”

Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

“…Nonetheless, the underlying pathophysiologic mechanisms that potentially contribute to these blunted responses in patients with PD are still not fully understood. This becomes important because exercise is frequently employed as a coping resource to manage quality of life, motor function, physical capacity, fatigue perception, and disease progression of PD (Allen et al 2017;David et al 2016;Kelly et al 2014;Krumpolec et al 2017;Santos et al 2016;Silva-Batista et al 2018;Silveira et al 2018;Zhou et al 2017). Importantly, the abnormal responses to exercise could make exercise prescription more difficult to be managed to some patients with PD.…”

Can fatigue predict walking capacity of patients with Parkinson’s disease?

“…27 . Few studies investigated the impact of fatigue on mobility and walking capacity in individuals with PD 11,28,29 . Our results showed that patients with higher scores of PFS16 had worse performance in a basic mobility skill (TUG), gait speed over a short distance (10MWT), and endurance and ability to walk over longer distances (6MWT).…”