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

Abstract 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 ˙ o 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 ˙ o 2 , heart rate, and SBP at respiratory compensation point and peak exercise ( V ˙ o 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 ≤.05). They also had lower heart rate at AT (102±14beats/min vs 110±13beats/min; P ≤.05), whereas V ˙ o 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.