| Summary: | 碩士 === 長庚大學 === 物理治療學系 === 103 === Background : Fatigue is a common symptom affecting patients with idiopathic Parkinson’s disease(PD). Fatigue could be divided in central or peripheral fatigue, but the weighting of central v.s. peripheral fatigue and the contribution of fatigue to the related walking disability have not been established for individuals with PD. Electrical stimulation ( ES ) assisted strength training had been reported to be beneficial to fatigue in neurological patients. Whether the training can allievate different types of fatigue in patients with PD is not clear. Purpose : The purpose of this study was (1) to identify the effects of ES assisted strength training on central, peripheral and subjective fatigue, (2) to establish the correlation of fatigue severity and gait function
Method: Fifteen individuals with PD were divided as training (n=8) and control (n=7) groups. Subjects in the training group received eight weeks of ES assisted quadriceps muscle strength training. Subjects in the control group keep their daily life. Before and after training, subjects received maximum voluntary contraction (MVC) test, activation level test using interpolated twitch technique, and twitch force test induced the electrical simulation to represent the general, central, and peripheral components of strength. The MVC, activation level, and twitch force were tested again after 15 minutes of isotonic knee extensor fatigue exercise to calculate general fatigue index, central fatigue index, and peripheral fatigue index.
Result: There was no different in muscle property and muscle fatigue between health control and patients with PD. The healthy control had better performance of fastest and self-paced walking speed than patients with PD . The ES assisted strengthening training improved the central and peripheral fatigue and subjective fatigue in training group. No significant changes were found in individual gait parameters. The improvement of step length during fast walking can be explained partially by the improvement of peripheral fatigue index of quadriceps.
Conclusion: The ES assisted training had advantage on central and peripheral fatigue. Pure strength training could not improve gait function in individuals with PD. Future development of functional strength training that also focuses on gait control is suggested.
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