Objective: To compare cardiorespiratory fitness (CF), respiratory muscle strength and lung capacity (LC) after a high-intensity Aquatic Physiotherapeutic Exercise Program (APEP/PEFA).

Background: Dopaminergic degeneration and other changes in the central and peripheral nervous system result in motor and non-motor symptoms in Parkinson’s disease (PD), among which are cardiorespiratory impairments. Physiotherapeutic exercise (PE) associated with dopaminergic medication are considered the gold standard for stabilizing the progression of PD and interrupting this pathophysiological cycle, with the heated swimming pool being a safe environment for this practice.

Method: This is a quasi-experimental study, approved by the Research Ethics Committee of a brazilian university (CAAE:39816320.1.0000.0102), in which people with idiopathic PD, Hoehn and Yahr (HY) 1 to 4, both sexes, residing in southern Brazil. Assessments took place before and after the 12 weeks of APEP/PEFA. The 6-Minute Walk Test (6MWT) was used to indirectly verify lung capacity (LC), , Manovacuometry (MV) to assess the strength of the inspiratory (IMF) and expiratory (EMF) muscles, and Spirometry (EM) to verify LC through maximum voluntary ventilation (MVV). The APEP was performed twice a week, lasting 45 minutes, divided into warm-up, high-intensity interval training and cool-down. For data analysis, the Statistical Package for the Social Sciences version 20.0 (SPSS 20.0) was used, using the Shapiro-Wilk test for Gaussian distribution and the paired t test for parametric variables. P< 0.05 was adopted as significance.

Results: The study included 15 people with PD, mean age 62.06 ± 10.49, HY 1 to 3 (HY 1 n=1; HY 2 n=7; HY 3 n=7). In the 6MWT, the average distance covered before and after the APEP/PEFA increased from 344 ± 101 to 364 ± 79 meters (p= 0.06); IMF increased from 58 ± 29 to 69 ± 35 cmH20 (p=0.04); the EMF from 52 ± 21 to 62 ± 24 cmH20 (p=0.1) and the MVV from 74 (53% of predicted) to 78 liters (60% of predicted) (p=0.4).

Conclusion: APEP/PEFA was effective in improving inspiratory muscle strength, however, there was no significant difference in expiratory muscle strength, CF and LC. These data should be analyzed with caution, since PD is a degenerative health condition and the prescription of aquatic PE should be further explored.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-cardiorespiratory-fitness-respiratory-muscle-strength-and-lung-capacity-after-a-high-intensity-aquatic-physiotherapeutic-exercise-program-apep-pefa/