Resistance training with instability is more effective than resistance training in improving spinal inhibitory mechanisms in Parkinson's disease.
This study assessed 1) the effects of 12 wk of resistance training (RT) and resistance training with instability (RTI) on presynaptic inhibition (PSI) and disynaptic reciprocal inhibition (DRI) of patients with Parkinson's disease (PD); 2) the effectiveness of RT and RTI in moving PSI and DRI values of patients toward values of age-matched healthy controls (HC; Z-score analysis); and 3) associations between PSI and DRI changes and clinical outcomes changes previously published. Thirteen patients in RT group, 13 in RTI group, and 11 in a nonexercising control group completed the trial. While RT and RTI groups performed resistance exercises twice a week for 12 wk, only the RTI group used unstable devices. The soleus H reflex was used to evaluate resting PSI and DRI before and after the experimental protocol. The HC (n = 31) was assessed at pretest only. There were significant group × time interactions for PSI (P < 0.0001) and DRI (P < 0.0001). RTI was more effective than RT in increasing the levels of PSI (P = 0.0154) and DRI (P < 0.0001) at posttraining and in moving PSI [confidence interval (CI) 0.1-0.5] and DRI (CI 0.6-1.1) levels to those observed in HC. There was association between DRI and quality of life changes (r = -0.69, P = 0.008) and a strong trend toward association between PSI and postural instability changes (r = 0.60, P = 0.051) after RTI. RTI increased PSI and DRI levels more than RT, reaching the average values of the HC. Thus RTI may cause plastic changes in PSI and DRI pathways that are associated with some PD clinical outcomes.



Patients with Parkinson's disease (PD) have motor dysfunction. Spinal inhibitory mechanisms are important for modulating both supraspinal motor commands and sensory feedback at the spinal level. Resistance training with instability was more effective than resistance training in increasing the levels of presynaptic inhibition and disynaptic reciprocal inhibition of lower limb at rest of the patients with PD, reaching the average values of the healthy controls.
Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil; csilvabatista@usp.br.
Carla
C
Silva-Batista
Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Eugenia Casella Tavares
EC
Mattos
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois.|Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
Daniel M
DM
Corcos
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois.
Jessica M
0000-0003-2966-0398
JM
Wilson
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois.|Department of Physiology, Northwestern University, Chicago, Illinois.
Charles J
CJ
Heckman
Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Hélcio
H
Kanegusuku
Faculty of Medical Science, University of São Paulo, São Paulo, Brazil; and.
Maria Elisa Pimentel
ME
Piemonte
Department of Psychobiology, Center for Psychobiology and Exercise Studies University Federal de São Paulo, São Paulo, Brazil.
Marco
M
Túlio de Mello
Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Cláudia
C
Forjaz
Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Hamilton
H
Roschel
Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Valmor
V
Tricoli
Laboratory of Adaptations to Strength Training, School of Physical Education and Sport, University of São Paulo at São Paulo, São Paulo, Brazil.
Carlos
C
Ugrinowitsch
D000368:Aged; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006181:H-Reflex / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D010300:Parkinson Disease / Q000503:physiopathology*; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods; D012146:Rest / Q000502:physiology; D013131:Spine / Q000503:physiopathology*
descending drive; disynaptic reciprocal inhibition; motor complexity exercise; presynaptic inhibition; proprioception