Graded peak cycle ergometer test for cognitively impaired patients with Parkinson’s disease: a pilot study

ABSTRACT

Background

Cognitive decline affects up to 50% of patients with Parkinson’s disease (PD) in the course of the disease and may be amenable to exercise interventions. To accurately set adequate training intensities, standardized exercise testing is required but such testing takes considerable time and effort. The aim of this pilot study was to investigate the feasibility of a graded peak cycle ergometer exercise test in cognitively impaired patients with Parkinson’s Disease (PD), and to define whether age-predicted maximal heart rate (HRmax) matched measured HRmax.

Methods

A convenience sample of seven patients with PD (Hoehn and Yahr: 2–4, and cognitive impairment (Montreal Cognitive Assessment (MoCA) ≤ 26) completed a graded peak cycle ergometer test to voluntary exhaustion. Borg Rating of Perceived Exertion was used to record the individual’s perception of exertion. Pre-defined age-predicted HRmax (calculated as 208-(0.7 × age) was compared with the measured HRmax using Bland-Altman plot and a two-one-sided test.

Results

All PD patients completed the graded exercise test between 8–12 minutes, showing therefore 100% compliance to the test protocol. No adverse events occurred. Predicted HRmax and measured HRmax did not differ.

Conclusion

We demonstrate feasibility of graded peak cycle ergometer testing in PD patients with cognitive impairment. The good correspondence of age-predicted HRmax equation with measured HRmax, in this small sample, may in the future provide clinicians with a tool to define training intensities in cognitively impaired PD, without cardiac disease. However, further research is needed to confirm these results.

KEYWORDS:

• Bicycle ergometry test
• cognitive symptom
• heart rate
• Parkinson disease

Acknowledgments

We thank the patients who participated in this study. We are also very thankful to PD Dr. med. Simon Stämpfli for his valuable contributions to this paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary materials

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

This work was supported by the Jacques und Gloria Gossweiler-Stiftung and the Dutch Brain Foundation