Resistance training with instability is more effective than resistance training in improving spinal inhibitory mechanisms in Parkinson's disease

Background: This study assessed: 1) the effects of 12 weeks 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 towards values of age-matched healthy controls (HC [Z-score analysis]); and 3) associations between PSI and DRI changes and clinical outcomes changes previously published. Methods: Thirteen patients in RT group, 13 in RTI group, and 11 in a non-exercising control group completed the trial. While RT and RTI groups performed resistance exercises twice a week for 12 weeks, only the RTI group used unstable devices. Soleus H-reflex was used to evaluate resting PSI and DRI before and after experimental protocol. The HC (n=31) was assessed at pre-test only. Results: There were significant groupxtime 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 post-training 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. Conclusions: 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.

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