Power Training Effects on Motor Function and Neuromuscular Performance in Older Adults with Parkinson’s Disease

Abstract

Parkinson’s disease (PD) compromises strength, power and motor function in older adults. The loss of mobility due to PD can be characterized by rigidity, bradykinesia, and gait disturbances; while reduced movement speed in PD is characterized by motor programming and execution deficits characterized by freezing and movement initiation problems. Physical exercise can reduce these neuromuscular performance and motor deficits; however, the benefits of high-speed resistance training, i.e., power training (PT), an intervention shown to increase power and physical performance in older persons, has yet to be examined in PD patients. PURPOSE: To quantify the effects of PT on UPDRS motor scores, muscular strength and power in PD patients. METHODS: Fourteen patients (9M/5F; H&Y stage: I-III; age: 71.6 ± 6.6 y; weight: 77.8 ± 18.8 kg; height: 1.73 ± .12 m; PD duration: 6.9 ± 4.4 y) enrolled in the program. The Unified Parkinson’s Disease Rating Scale (UPDRS) motor score, 1 repetition maximum (1RM) as a measure of strength and peak power (PP) were tested before and after 3 months of PT. 1RM and PP were tested on 5 pneumatic machines (biceps curl, chest press, leg press, hip abduction and seated calf). PT used 8 wks of high-speed resistance training (twice/week) at established optimal power loads on 11 pneumatic machines (biceps curl, triceps push-down, chest press, seated row, lat pull-down, shoulder press, leg press, leg curl, hip abduction, hip adduction, seated calf) with two 2-wk transitional periods featuring balance and agility training on weeks 5 and 10. Loading was adjusted weekly based on the power plateaus. Subjects had no change in medication or activity levels across the 3-month training period. RESULTS: Significant improvement in UPDRS motor score was seen after training (Meandiff±SE= 11.0±1.1; p<.001). Significant increases (p<.05) in 1RM (kg) and peak power (W) were detected in biceps curl (Meandiff±SE: 1RM=2.31±0.35 kg; PP =14.62±5.70 W), hip abduction (10.66±2.33 kg; 26.38±9.18 W), chest press (3.36±0.61 kg; 45.19±14.23 W), leg press (14.38±3.55 kg; 207.18±39.47 W) and seated calf (31.79±4.79 kg; 51.50±20.65 W). CONCLUSION: A 3-month power training program can improve neuromuscular function and motor performance in older adults with PD and should be considered an important intervention for these patients.