Table of Contents Author Guidelines Submit a Manuscript
Neural Plasticity
Volume 2017, Article ID 1941980, 9 pages
https://doi.org/10.1155/2017/1941980
Research Article

Fatigue and Muscle Strength Involving Walking Speed in Parkinson’s Disease: Insights for Developing Rehabilitation Strategy for PD

1Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fusing St., Kweishan, Taoyuan 333, Taiwan
2School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan
3Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fusing St., Kweishan, Taoyuan 333, Taiwan
4Institute of Cognitive Neuroscience, National Central University, 300 Zhongda Rd., Zhongli, Taoyuan 320, Taiwan
5Department of Neurology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
6Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan
7Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fusing St., Kweishan, Taoyuan 333, Taiwan

Correspondence should be addressed to Ya-Ju Chang; wt.ude.ugc.liam@gnahcjy

Received 26 October 2016; Revised 2 January 2017; Accepted 29 January 2017; Published 22 February 2017

Academic Editor: Toshiyuki Fujiwara

Copyright © 2017 Ying-Zu Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Problems with gait in Parkinson’s disease (PD) are a challenge in neurorehabilitation, partly because the mechanisms causing the walking disability are unclear. Weakness and fatigue, which may significantly influence gait, are commonly reported by patients with PD. Hence, the aim of this study was to investigate the association between weakness and fatigue and walking ability in patients with PD. Methods. We recruited 25 patients with idiopathic PD and 25 age-matched healthy adults. The maximum voluntary contraction (MVC), twitch force, and voluntary activation levels were measured before and after a knee fatigue exercise. General fatigue, central fatigue, and peripheral fatigue were quantified by exercise-induced changes in MVC, twitch force, and activation level. In addition, subjective fatigue was measured using the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale (FSS). Results. The patients with PD had lower activation levels, more central fatigue, and more subjective fatigue than the healthy controls. There were no significant differences in twitch force or peripheral fatigue index between the two groups. The reduction in walking speed was related to the loss of peripheral strength and PD itself. Conclusion. Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.