Energy cost of spontaneous walking in Parkinson’s disease patients
- 317 Downloads
In healthy subjects, comfortable walking minimizes the energy cost (E c) of locomotion. In Parkinson’s disease (PD) patients walking is slower than in healthy subjects: this may increase E c. Our aims were to analyze gait and E c 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 E c 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 E c 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 E c. 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.
KeywordsParkinson’s disease Gait Spontaneous walking Oxygen consumption Efficiency Clinical scores
This study was supported by the Italian Health Ministry (Project PS/03/12, Treatment of the Parkinsonian subject: integration between diagnostic and therapeutic aspects for the optimization of the total rehabilitative procedure).
- 11.Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, Stern MB, Tilley BC, Dodel R, Dubois B, Holloway R, Jankovic J, Kuliseversusky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, Van Hilten JJ, LaPelle N (2007) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord 22:41–47PubMedCrossRefGoogle Scholar
- 14.Margaria R (1976) Biomechanics and energetics of muscular exercise. Clarendon Press, OxfordGoogle Scholar