Novel, high-intensity exercise prescription improves muscle mass, mitochondrial function, and physical capacity in individuals with Parkinson's disease

• Published in: Journal of applied physiology (1985) Vol. 116; no. 5; pp. 582 - 592
• Main Authors: Kelly, Neil A, Ford, Matthew P, Standaert, David G, Watts, Ray L, Bickel, C Scott, Moellering, Douglas R, Tuggle, S Craig, Williams, Jeri Y, Lieb, Laura, Windham, Samuel T, Bamman, Marcas M
• Format: Journal Article
• Language: English
• Published: United States American Physiological Society 01-03-2014
• Subjects: Aged; Aged, 80 and over; Antiparkinson Agents - therapeutic use; Body Composition - physiology; Exercise Therapy - methods; Female; Genotype & phenotype; Hemodynamics - physiology; Humans; Isometric Contraction - physiology; Male; Middle Aged; Mitochondria; Mitochondria, Muscle - physiology; Motor Neurons - physiology; Muscle Fatigue - physiology; Muscle Fibers, Skeletal - physiology; Muscle Strength - physiology; Muscle, Skeletal - physiopathology; Musculoskeletal system; Neuropsychology; Parkinson Disease - physiopathology; Parkinson Disease - therapy; Parkinson's disease; Patient Compliance; Prescriptions; Psychiatric Status Rating Scales; Quality of Life; Sports training; Treatment Outcome; resistance training; Parkinson's disease; muscle hypertrophy; high-intensity exercise; mitochondria
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/japplphysiol.01277.2013

We conducted, in persons with Parkinson's disease (PD), a thorough assessment of neuromotor function and performance in conjunction with phenotypic analyses of skeletal muscle tissue, and further tested the adaptability of PD muscle to high-intensity exercise training. Fifteen participants with PD (Hoehn and Yahr stage 2-3) completed 16 wk of high-intensity exercise training designed to simultaneously challenge strength, power, endurance, balance, and mobility function. Skeletal muscle adaptations (P < 0.05) to exercise training in PD included myofiber hypertrophy (type I: +14%, type II: +36%), shift to less fatigable myofiber type profile, and increased mitochondrial complex activity in both subsarcolemmal and intermyofibrillar fractions (I: +45-56%, IV: +39-54%). These adaptations were accompanied by a host of functional and clinical improvements (P < 0.05): total body strength (+30-56%); leg power (+42%); single leg balance (+34%); sit-to-stand motor unit activation requirement (-30%); 6-min walk (+43 m), Parkinson's Disease Quality of Life Scale (PDQ-39, -7.8pts); Unified Parkinson's Disease Rating Scale (UPDRS) total (-5.7 pts) and motor (-2.7 pts); and fatigue severity (-17%). Additionally, PD subjects in the pretraining state were compared with a group of matched, non-PD controls (CON; did not exercise). A combined assessment of muscle tissue phenotype and neuromuscular function revealed a higher distribution and larger cross-sectional area of type I myofibers and greater type II myofiber size heterogeneity in PD vs. CON (P < 0.05). In conclusion, persons with moderately advanced PD adapt to high-intensity exercise training with favorable changes in skeletal muscle at the cellular and subcellular levels that are associated with improvements in motor function, physical capacity, and fatigue perception.