Exercise Intolerance and Oxygen Desaturation in Patients with Parkinson’s Disease: Triggers for Respiratory Rehabilitation?

Michele Vitacca, Adriana Olivares, Laura Comini, Giuliana Vezzadini, Annamaria Langella, Alberto Luisa, Anna Petrolati, Gianluigi Frigo and Mara Paneroni
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Michele Vitacca: Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Adriana Olivares: Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Laura Comini: Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Giuliana Vezzadini: Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy
Annamaria Langella: Neurorehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Alberto Luisa: Neurorehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy
Anna Petrolati: Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy
Gianluigi Frigo: Neurorehabilitation of the Institute of Castel Goffredo, Istituti Clinici Scientifici Maugeri IRCCS, 46042 Castel Goffredo, Italy
Mara Paneroni: Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy

IJERPH, 2021, vol. 18, issue 23, 1-11

Abstract: The role that oxygen desaturation plays in exercise tolerance and its rehabilitative implications in patients with Parkinson’s disease (PD) are unclear. We aimed to test exercise tolerance and oxygen saturation levels both during exercise and at night in PD patients to better define their rehabilitative needs. In clinically stable PD patients, undergoing inpatient rehabilitation, and in “ON” phase, we prospectively assessed clinical data, sleepiness, comorbidities, PD severity (Hoehn&Yahr, HY), motor function (ADLs, UPDRSII and UPDRSIII, Barthel Index, Functional Independence Measure), balance, spirometry, respiratory muscles (MIP/MEP), peak cough expiratory flow (PCEF), continuous night oxygen monitoring, and meters at 6MWT. Of 55 patients analyzed (28 with moderate–severe PD, HY ≥ 2.5), 37% and 23% showed moderate–severe impairment on UPDRSII and UPDRSIII, respectively; 96% had reduced exercise tolerance and severe respiratory muscles impairment (MIP/MEP < 45% pred.); 21.8% showed desaturations during exercise; and 12.7% showed nocturnal desaturations. At multiple regression, low exercise tolerance and low mean nocturnal and exercise-induced saturation correlated with several respiratory and motor function and disability indices (all p < 0.03). Exercise tolerance, exercise-induced desaturations, and nocturnal desaturations were extremely frequent in PD patients and were worse in more severe PD patients. This suggests considering a combined role for motor and respiratory rehabilitation in these patients.

Keywords: Parkinson’s disease; respiratory function; exercise tolerance; oxygen saturation; rehabilitation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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