Key result
Higher autonomic dysfunction was associated with lower maximum heart rate (β = -0.72; P=0.040), while higher step counts were associated with higher VO2peak (β = 1.16; P=0.032) in Parkinson's disease.
Why the study?
Autonomic dysfunction and low physical activity may reduce cardiorespiratory fitness in Parkinson's disease, but their interrelationship is not well understood.
Cross-Sectional (n=59)
Effect estimate: β -0.72 (95% CI -1.40 to -0.04)
p-value: p=0.040
In patients with Parkinson's disease, autonomic dysfunction and physical activity levels are associated with distinct parameters of reduced cardiorespiratory response to exercise.
Autonomic dysfunction and low activity may independently limit exercise responses in PD; leaves open whether targeting either improves fitness.
Background Both autonomic dysfunction and low levels of physical activity could contribute to reduced cardiorespiratory fitness in people with Parkinson's disease (PD). However, the interrelationship between these concepts is not well understood. Objectives Our aim was to gain more insight into autonomic dysfunction and physical activity in relation to cardiorespiratory fitness in PD. Methods We included 59 individuals with PD (37% women, mean age 65.1 years; mean disease duration 4.5 years; Hoehn and Yahr stage 1–3). All participants completed a cardiopulmonary exercise test (CPET). We examined the association between parameters assessed during a CPET (peak oxygen consumption [VO 2peak ], maximum heart rate [HR max ], heart rate recovery at 1 and 3 mins [HR rec1 , HR rec3 ]), autonomic dysfunction (Scales for Outcomes in Parkinson's disease‐Autonomic dysfunction, SCOPA‐AUT), and physical activity in daily life (step counts, measured using a smartphone for a period of 4 weeks). Using multivariable regression, we adjusted for age, sex, and beta blocker use. Results Higher SCOPA‐AUT was associated with lower HR max ( β = −0.72, 95% CI = [−1.40, −0.04], P = 0.040). Higher step counts were associated with higher HR rec3 ( β = 3.21, 95% CI = [0.56, 5.86], P = 0.019), and with higher VO 2peak ( β = 1.16, 95% CI = [0.10, 2.22], P = 0.032). No statistically significant associations were found between both SCOPA‐AUT and step counts with HR rec1 . Conclusions Both autonomic dysfunction and physical activity are associated with a reduced cardiorespiratory response to exercise in PD, but affected different CPET parameters. Future studies should determine the responsiveness of these CPET parameters to change, in order to implement such parameters as endpoints in clinical trials.
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Veldkamp et al. (2025) conducted a cross-sectional in Parkinson's disease (n=59). Autonomic dysfunction and physical activity was evaluated on Maximum heart rate (HR max) during cardiopulmonary exercise test (β -0.72, 95% CI -1.40 to -0.04, p=0.040). Higher autonomic dysfunction was associated with lower maximum heart rate (β = -0.72; P=0.040), while higher step counts were associated with higher VO2peak (β = 1.16; P=0.032) in Parkinson's disease.
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