Walking Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training : Journal of Neurologic Physical Therapy

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Walking Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training

Pechstein, Andrew E. SPT, PhD; Gollie, Jared M. PhD, CSCS; Keyser, Randall E. PhD; Guccione, Andrew A. PT, DPT, PhD, FAPTA

Author Information

Department of Rehabilitation Science, George Mason University, Fairfax, Virginia (A.E.P., J.M.G., R.E.K., A.A.G.); Department of Physical Therapy, University of Delaware, Newark (A.E.P.); and Research Service, Veterans Affairs Medical Center, Washington, District of Columbia (J.M.G.).

Correspondence: Andrew E. Pechstein, SPT, PhD, Department of Rehabilitation Science, George Mason University, 4400 University Dr, MS 1E9, Fairfax, VA 22030 ([email protected]).

Some portions of the content in this article were presented at the 2020 Annual Meeting of the American College of Sports Medicine, and were included in the conference proceedings of the 2022 Combined Sections Meeting for the American Physical Therapy Association.

ClinicalTrials.gov registration number: NCT03864393.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jnpt.org).

Journal of Neurologic Physical Therapy 47(2):p 99-111, April 2023. | DOI: 10.1097/NPT.0000000000000423

Background and Purpose: 

Poor walking endurance in Parkinson disease (PD) may be attributable to both bioenergetic and biomechanical factors, but locomotor training methods addressing both these factors simultaneously are understudied. Our objective was to examine the effects of overground locomotor training (OLT) on walking endurance in individuals with mild-to-moderate PD, and to further explore potential cardiorespiratory contributions.

Methods: 

A single-arm, longitudinal design was used to examine the effects of 24 biweekly sessions of OLT in people with mild-to-moderate PD (n = 12). Walking endurance was measured as total distance walked during a 10-minute walk test (10minWT). Oxygen uptake (V˙o2) on-kinetic profiles were determined using a monoexponential function. Perceived fatigability was assessed following the 10minWT using a self-report scale. Magnitude of change in primary outcomes was assessed using Cohen's d and adjusted for sample size (Cohen's d(unbiased)).

Results: 

Participants executed 3036 (297) steps and maintained 65.5% (8%) age-predicted heart rate maximum in a typical session lasting 56.9 (2.5) minutes. Medium effects in total distance walked—885.9 (157.2) versus 969.5 (140.9); Cohen's d(unbiased) = 0.54—and phase II time constant of the V˙o2 on-kinetic profile—33.7 (12.3) versus 25.9 (15.3); Cohen's d(unbiased) = 0.54—were observed alongside trivial effects for perceived fatigability—4.7 (1.4) versus 4.8 (1.5); Cohen's d(unbiased) = 0.11—following OLT.

Discussion and Conclusions: 

These preliminary findings may demonstrate the potential for moderate-intensity OLT to improve walking endurance and enhance cardiorespiratory adjustments to walking activity in adults with mild-to-moderate PD.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, https://links.lww.com/JNPT/A407).

© 2022 Academy of Neurologic Physical Therapy, APTA.

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