Effect Of Eccentric Training On Stability And Cardiovascular Responses On Parkinson’s Patients

HISTORY: Three individuals diagnosed with Parkinson’s disease (PD) (age range within 70-80 years) first began experiencing motor and sensory changes within 10 years of their participation in this exercise treatment. All reported a reduction in gait and balance control, slight left-hand tremor with reduced and slower range of motion, loss of smell, and excess saliva accumulation. They all sought medical help as their functional abilities became more pronounced. PHYSICAL EXAMINATION: Along with self-reported symptoms, a physical examination identified left-side bradykinesia and abnormal rigidity in all 3 participants. A diagnosis of Parkinson’s disease (PD) was made and subsequently confirmed by a second source. DIFFERENTIAL DIAGNOSIS: 1. Motor/Neurological impairment2. PD TEST AND RESULTS: The study examined the effects of eccentric lower body exercise on PD symptoms. During exercise, participants stood upright on a solid platform that moved along the sagittal plane following an elliptical path. They were instructed to absorb all platform motion with their lower extremities. All three patients completed a two times per week training for eight weeks. All sessions consisted of three 45-second exercise bouts with 2-minute rest intervals between each exercise. Workload intensity utilizing the Borg Rate of Perceived Exertion (RPE) Scale (1-10) was reported at the end of each exercise bout. Biomechanical and physiological data were recorded pre- and post-exercise during each session. Over the course of the study, 30-second center of pressure balance migration measurements decreased for both eyes-open (73.4%) and eyes-closed (60.4%) conditions. Heart rate responses increased slightly from rest to exercise. However, unexpectedly, resting standing systolic blood pressure was significantly higher (126 + 7.53 mmHg) than all three-exercise bout systolic pressures: Bout 1 (110 + 3.19 mmHg), Bout 2 (117 + 4.44 mmHg), and Bout 3 (120 + 8.06 mmHg). RPE increased from Bout 1 (3.03) to Bout 2 (3.54) to Bout 3 (4.02). FINAL/WORKING DIAGNOSIS: PD with improved gross motor function TREATMENT AND OUTCOMES: 1. Continued eccentric lower body training2. Expansion and increase intensity of physical activities3. Continued monitoring of functional parameters4. Reduction in prescription use of Sinemet