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

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) over doto(2)), 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) over doto(2), heart rate, and SBP at respiratory compensation point and peak exercise ((V) over doto(2): 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 <= 0.5). They also had lower heart rate at AT (102 +/- 14beats/min vs 110 +/- 13beats/min; P <=.05), whereas (V) over doto(2) 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. (C) 2016 by the American Congress of Rehabilitation Medicine