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帕金森病患者心肺运动试验的最大和次最大反应减弱

Blunted Maximal and Submaximal Responses to Cardiopulmonary Exercise Tests in Patients With Parkinson Disease.

作者信息

Kanegusuku Hélcio, Silva-Batista Carla, Peçanha Tiago, Nieuwboer Alice, Silva Natan D, Costa Luiz A, de Mello Marco T, Piemonte Maria E, Ugrinowitsch Carlos, Forjaz Cláudia L

机构信息

School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.

Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.

出版信息

Arch Phys Med Rehabil. 2016 May;97(5):720-5. doi: 10.1016/j.apmr.2015.12.020. Epub 2016 Jan 9.

Abstract

OBJECTIVE

To investigate submaximal and maximal responses during maximal cardiopulmonary exercise tests in subjects with Parkinson disease (PD).

DESIGN

Cross-sectional.

SETTING

A PD association.

PARTICIPANTS

A sample (N=68) of subjects with PD (n=48; mean age, 66±8y; modified Hoehn and Yahr stage between 2 and 3; "on" state of medication) and age-matched controls without PD (n=20; mean age, 64±9y).

INTERVENTIONS

Maximal cardiopulmonary exercise test on a cycle ergometer.

MAIN OUTCOME MEASURES

Oxygen uptake (V˙o2), systolic blood pressure (SBP), and heart rate assessed at rest, submaximal intensities (ie, anaerobic threshold [AT] and respiratory compensation point), and maximal intensity (peak exercise).

RESULTS

Compared with control subjects, subjects with PD had lower V˙o2, heart rate, and SBP at respiratory compensation point and peak exercise (V˙o2: 14.6±3.6mL⋅kg⋅min vs 17.9±5.5mL⋅kg⋅min and 17.7±4.8mL⋅kg⋅min vs 21.5±6.6mL⋅kg⋅min; heart rate: 119±17beats/min vs 139±12beats/min and 132±20beats/min vs 158±13beats/min; SBP: 151±17mmHg vs 172±20mmHg and 166±21mmHg vs 187±24mmHg; P≤.05). They also had lower heart rate at AT (102±14beats/min vs 110±13beats/min; P≤.05), whereas V˙o2 and SBP at this intensity were similar to those of control subjects.

CONCLUSIONS

Subjects with PD demonstrated blunted metabolic and cardiovascular responses to submaximal and maximal exercise tests, especially at intensities above AT, which are in line with autonomic disturbances present in patients with PD. Future studies need to determine how this affects performance, participation, and responses of these patients to exercise training at different intensities.

摘要

目的

研究帕金森病(PD)患者在最大心肺运动试验中的次最大和最大反应。

设计

横断面研究。

地点

一个PD协会。

参与者

一组样本(N = 68),其中PD患者(n = 48;平均年龄,66±8岁;改良Hoehn和Yahr分期为2至3期;处于药物“开”状态)以及年龄匹配的无PD对照者(n = 20;平均年龄,64±9岁)。

干预措施

在功率自行车上进行最大心肺运动试验。

主要观察指标

静息、次最大强度(即无氧阈[AT]和呼吸补偿点)以及最大强度(运动峰值)时的摄氧量(V˙o2)、收缩压(SBP)和心率。

结果

与对照者相比,PD患者在呼吸补偿点和运动峰值时的V˙o2、心率和SBP较低(V˙o2:14.6±3.6mL·kg·min对17.9±5.5mL·kg·min以及17.7±4.8mL·kg·min对21.5±6.6mL·kg·min;心率:119±17次/分钟对139±12次/分钟以及132±20次/分钟对158±13次/分钟;SBP:151±17mmHg对172±20mmHg以及166±21mmHg对187±24mmHg;P≤.05)。他们在AT时的心率也较低(102±14次/分钟对110±13次/分钟;P≤.05),而此强度下的V˙o2和SBP与对照者相似。

结论

PD患者在次最大和最大运动试验中表现出代谢和心血管反应迟钝,尤其是在高于AT的强度时,这与PD患者存在的自主神经功能障碍一致。未来研究需要确定这如何影响这些患者在不同强度运动训练中的表现、参与度和反应。

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