Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

Background. Problems with gait in Parkinson’s disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this...

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Main Authors: Ying-Zu Huang, Fang-Yu Chang, Wei-Chia Liu, Yu-Fen Chuang, Li-Ling Chuang, Ya-Ju Chang
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Neural Plasticity
Online Access:http://dx.doi.org/10.1155/2017/1941980
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author Ying-Zu Huang
Fang-Yu Chang
Wei-Chia Liu
Yu-Fen Chuang
Li-Ling Chuang
Ya-Ju Chang
author_facet Ying-Zu Huang
Fang-Yu Chang
Wei-Chia Liu
Yu-Fen Chuang
Li-Ling Chuang
Ya-Ju Chang
author_sort Ying-Zu Huang
collection DOAJ
description Background. Problems with gait in Parkinson’s disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods. We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results. The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion. Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.
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spelling doaj-art-52bd6252df384308afbb5e361e4ec8f92025-08-20T02:05:10ZengWileyNeural Plasticity2090-59041687-54432017-01-01201710.1155/2017/19419801941980Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PDYing-Zu Huang0Fang-Yu Chang1Wei-Chia Liu2Yu-Fen Chuang3Li-Ling Chuang4Ya-Ju Chang5Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fusing St., Kweishan, Taoyuan 333, TaiwanDepartment of Neurology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, JapanDepartment of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, TaiwanDepartment of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, TaiwanDepartment of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, TaiwanNeuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fusing St., Kweishan, Taoyuan 333, TaiwanBackground. Problems with gait in Parkinson’s disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods. We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results. The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion. Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.http://dx.doi.org/10.1155/2017/1941980
spellingShingle Ying-Zu Huang
Fang-Yu Chang
Wei-Chia Liu
Yu-Fen Chuang
Li-Ling Chuang
Ya-Ju Chang
Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
Neural Plasticity
title Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
title_full Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
title_fullStr Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
title_full_unstemmed Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
title_short Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD
title_sort fatigue and muscle strength involving walking speed in parkinson s disease insights for developing rehabilitation strategy for pd
url http://dx.doi.org/10.1155/2017/1941980
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