Work capacity, muscle strength and SDH activity in both legs of hemiparetic patients and patients with Parkinson's disease.

In recent muscle metabolic studies, patients with moderate upper motor neuron lesions showed marked difficulty in performing an equal submaximal work load (bilaterally) in two-legged exercise. For a better evaluation of these patients, studies were performed on each leg separately. Six patients with Parkinson's disease and six with moderate hemiparesis were studied. During one-legged submaximal and maximal exercise heart rate, oxygen uptake, and blood lactate were determined. Maximal voluntary contraction in knee and ankle flexion and extension for each leg was measured. Succinate dehydrogenase (SDH) activity in the thigh muscles was determined. During submaximal exercise, oxygen uptake, heart rate and blood lactate increased more in the paretic leg of hemiparetic patients and in the more affected leg of the Parkinson patients. In hemiparetic patients maximal voluntary contraction of flexors and extensors of the knee was significantly reduced in the paretic leg but was reduced even in the nonparetic knee flexors. SDH activity was very low in both legs in all patients and lowest in the paretic and more affected leg, respectively. It is concluded that (a) the general muscle inactivity per se, secondary to the neurological disorder, may lead to a reduced work capacity; (b) the increased heart rate and blood lactate level seem to be correlated to the relative exercise level of each leg; and (c) in patients with impaired muscle function of one or both legs, evaluation of each leg separately with regard to work capacity and muscle metabolism is of value.