Neurological Sciences

, Volume 33, Issue 4, pp 779–784

Energy cost of spontaneous walking in Parkinson’s disease patients

  • Martina A. Maggioni
  • Arsenio Veicsteinas
  • Susanna Rampichini
  • Emiliano Cè
  • Raffaello Nemni
  • Giulio Riboldazzi
  • Giampiero Merati
Original Article

DOI: 10.1007/s10072-011-0827-6

Cite this article as:
Maggioni, M.A., Veicsteinas, A., Rampichini, S. et al. Neurol Sci (2012) 33: 779. doi:10.1007/s10072-011-0827-6

Abstract

In healthy subjects, comfortable walking minimizes the energy cost (Ec) of locomotion. In Parkinson’s disease (PD) patients walking is slower than in healthy subjects: this may increase Ec. Our aims were to analyze gait and Ec in PD patients during walking, particularly at self-selected speed, and the possible pathological, mechanical, and cardiorespiratory limitations. Fourteen mild-to-moderate PD and 14 control subjects were enrolled. Subjects underwent 5-min walking tests at two speeds: self-selected and as-fast-as-possible speeds. Cardiopulmonary and gait parameters (heart rate, ventilation, gas exchanges, step count) were recorded. Velocity was reduced in PD compared to control subjects at both speeds (P < 0.05), and PD patients had shorter strides (P < 0.05) at both speeds and reduced cadence (P = 0.01) at fastest speed. No significant difference was found in Ec at self-selected (0.12 ± 0.04 versus 0.11 ± 0.02 mLO2 kg−1 m−1 in PD and control subjects, respectively) and maximal (0.14 ± 0.03 versus 0.15 ± 0.02  mLO2 kg−1 m−1 in PD and control subjects, respectively) speed. However, the Ec increment from self-selected to fastest velocity was significantly lower (P = 0.02) in PD patients. PD patients failed to walk at a self-selected speed, which minimizes the Ec. This could be mainly due to the inability to develop a wider stride. Cardiorespiratory adaptation was not affected, except for the possible reduced cardiac adaptation observed in some (28%) cases. Presumably, rehabilitation procedures that improve flexibility and step length may help maintain walking ability.

Keywords

Parkinson’s diseaseGaitSpontaneous walkingOxygen consumptionEfficiencyClinical scores

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Martina A. Maggioni
    • 1
  • Arsenio Veicsteinas
    • 1
    • 2
  • Susanna Rampichini
    • 1
  • Emiliano Cè
    • 1
    • 2
  • Raffaello Nemni
    • 3
  • Giulio Riboldazzi
    • 4
  • Giampiero Merati
    • 1
    • 2
  1. 1.Department of Sport, Nutrition and Health SciencesUniversity of MilanMilanItaly
  2. 2.Centre of Sports Medicine Don C. Gnocchi FoundationMilanItaly
  3. 3.Centre of Neurology Don C. Gnocchi FoundationMilanItaly
  4. 4.Parkinson’s Disease and Movement Disorders’ CentreOspedale di CircoloVareseItaly