Department of Kinesiology and Nutrition, Abilene Christian University, Abilene, TX, USA.
Department of Physical Therapy, Hardin-Simmons University, Abilene, TX, USA.
J Parkinsons Dis. 2024;14(4):761-775. doi: 10.3233/JPD-230259.
Autonomic dysfunction precedes endothelial dysfunction in Parkinson's disease (PD) and causes blood pressure and circulation abnormalities that are highly disruptive to one's quality of life. While exercise interventions have proven helpful for motor symptoms of PD, improving associated non-motor symptoms is limited. Low-intensity resistance training with blood flow restriction (LIRT-BFR) improves autonomic dysfunction in non-PD patients and high-intensity resistance training (HIRT) is recommended for motor symptom improvements for people with PD (PwPD).
To determine the effects of LIRT-BFR and HIRT on homocysteine and autonomic and endothelial function in PwPD and to determine the hemodynamic loads during LIRT-BFR and HIRT in PwPD using a novel exercise protocol.
Thirty-eight PwPD were assigned LIRT-BFR, HIRT or to a control (CNTRL) group. The LIRT-BFR and HIRT groups exercised three days per week for four weeks. The LIRT-BFR protocol used 60% limb occlusion pressure (LOP) and performed three sets of 20 repetitions at 20% of the one-repetition maximum (1RM). The HIRT group performed three sets of eight repetitions at 80% 1RM. The CNTRL group was asked to continue their normal daily routines.
LIRT-BFR significantly improved orthostatic hypotension (p = 0.026), homocysteine levels (p < 0.001), peripheral circulation (p = 0.003), supine blood pressure (p = 0.028) and heart rate variability (p = 0.041); LIRT-BFR improved homocysteine levels (p < 0.018), peripheral circulation (p = 0.005), supine blood pressure (p = 0.007) and heart rate variability (p = 0.047) more than HIRT; and hemodynamic loads for LIRT-BFR and HIRT were similar.
LIRT-BFR may be more effective than HIRT for autonomic and endothelial function improvements in PwPD and hemodynamic loads may be lessened in LIRT-BFR protocols using single-joint exercises with intermittent blood flow restriction. Further research is needed to determine if non-motor symptoms improve over time and if results are sustainable.
自主神经功能障碍先于帕金森病（PD）中的内皮功能障碍，并导致血压和循环异常，极大地破坏了生活质量。虽然运动干预已被证明对 PD 的运动症状有帮助，但改善相关的非运动症状却受到限制。低强度血流限制阻力训练（LIRT-BFR）可改善非 PD 患者的自主神经功能障碍，高强度阻力训练（HIRT）被推荐用于改善 PD 患者（PwPD）的运动症状。
确定 LIRT-BFR 和 HIRT 对 PwPD 中同型半胱氨酸和自主神经及内皮功能的影响，并使用新型运动方案确定 PwPD 中 LIRT-BFR 和 HIRT 的血液动力学负荷。
将 38 名 PwPD 分配到 LIRT-BFR、HIRT 或对照组（CNTRL）组。LIRT-BFR 和 HIRT 组每周锻炼三天，共四周。LIRT-BFR 方案使用 60%肢体闭塞压力（LOP）并以 20%的一次重复最大值（1RM）进行三组 20 次重复。HIRT 组以 80% 1RM 进行三组 8 次重复。CNTRL 组被要求继续进行日常活动。
LIRT-BFR 显著改善直立性低血压（p=0.026）、同型半胱氨酸水平（p<0.001）、外周循环（p=0.003）、仰卧位血压（p=0.028）和心率变异性（p=0.041）；LIRT-BFR 改善同型半胱氨酸水平（p<0.018）、外周循环（p=0.005）、仰卧位血压（p=0.007）和心率变异性（p=0.047）均优于 HIRT；LIRT-BFR 和 HIRT 的血液动力学负荷相似。
LIRT-BFR 可能比 HIRT 更有效改善 PwPD 的自主神经和内皮功能，并且在使用间歇性血流限制的单关节运动的 LIRT-BFR 方案中，可以减轻血液动力学负荷。需要进一步研究以确定非运动症状是否随着时间的推移而改善，以及结果是否可持续。
