A 12-Week Cycling Training Regimen Improves Upper Limb Functions in People With Parkinson's Disease

Abstract

Background: It has been proposed that physical exercise can help improve upper limb functions in Parkinson's disease (PD) patients; yet evidence for this hypothesis is limited. Objective: To assess the effects of aerobic exercise training (AET) on general upper limb functions in sedentary people with PD and healthy adults (HA). Methods: Two groups, 19 PD patients (Hoehn & Yahr ≤ 2) and 20 HA, matched on age and sedentary level, followed a 3-month stationary bicycle AET regimen. We used the kinematic theory framework to characterize and quantify the different motor control commands involved in performing simple upper-limb movements as drawing lines. Repeated measures ANCOVA models were used to assess the effect of AET in each group, as well as the difference between groups following the training regimen. Results: At baseline, PD individuals had a larger antagonist response, a longer elapsed time between the visual stimulus and the end of the movement, and a longer time of displacement of the stylus than the HA. Following the 12-week AET, PD participants showed significant decreases of the agonist and antagonist commands, as well as the antagonist response spread. A significant group ^∗ session interaction effect was observed for the agonist command and the response spread of the antagonist command, suggesting a significant change for these two parameters only in PD patients following the AET. Among the differences observed at baseline, only the difference for the time of movement remained after AET. Conclusion: A 3-month AET has a significant positive impact on the capacity to draw lines in a more efficiency way, in PD patients, indicating an improvement in the upper limb motor function.

Keywords: Parkinson’s disease; aerobic; exercise; stationary bicycle; upper limb function.

FIGURE 1

Description of the target directed fast simple RT task. (A) Tablet display and target zone. (B) Speed curve obtained for each line drawn. (C) Kinematic parameters (t₀, time occurrence of the input commands to the neuromuscular system; D₁, agonist component; μ₁, time delay of D₁; σ₁, response spread of D₁; D₂, antagonist component; μ₂, time delay of D₂; σ₂, response spread of D₂; ET, time between visual stimulus and the immobilization of the stylus; RT, reaction time; MT, movement time).

FIGURE 2

Agonist and antagonist responses before and after AET for PD and HA groups. AET, aerobic exercise training; PD, Parkinson’s disease patients; HA, healthy adults.

FIGURE 3

Normalization of antagonist parameters in PD group after AET. AET, aerobic exercise training; PD, Parkinson’s disease patients, HA, healthy adults; D₂, antagonist component; σ₂, response spread of D₂.