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Respiratory Function and the Influence of Inspiratory Muscle in Vital Capacity in Parkinsons Disease

Roberta Lins Gonçalves, Jerônimo Correia Barbosa Neto, Cássio Daniel Araújo da Silva, Elisa Brosina de Leon and Fernanda Figueiroa Sanchez

Background: Pulmonary disorders have been identified in Parkinson's disease (PD) since its description. They are associated with high mortality. However, there have been limited investigations on respiratory function in the patients with PD. The mechanisms mediating this association need to be better clarified. The relationship between maximal inspiratory pressure (MIP) and the forced vital capacity (FVC) in these individuals has not been investigated yet.
Objective: The objective was to assess and compare the respiratory function in older elderly with and without PD in order to determine the prevalence of respiratory dysfunction and the influence of MIP in FCV. Methodological design: Cross-sectional study which evaluated 41 elderly with PD and 41 elderly without (control group).
Inclusion criteria: For patients with PD: level of disability 0-3 Hoehn and Yahr scale and levodopa substitution therapy. For all participants: more than 60 years, no smoking, and no diagnosis of respiratory dysfunction and have physical and cognitive conditions to perform the tests. Pulmonary function was investigated by spirometry and MIP through manovacuometry. For the comparison between the groups was used the Student's t test and Mann Whitney and the correlation between the variables of interest was investigated by linear regression model. Results: There was a higher prevalence of respiratory disorder in patients with PD, whose major ventilation dysfunction was restrictive. There were significantly lower values % FVC and forced expiratory volume in the first minute (FEV1) in patients with PD and a direct association between FVC and MIP. This association can only be observed in the control group in the elderly who presented restrictive disturbance.
Conclusion: Patients with PD showed important modifications of pulmonary function even in the early stages of the disease. Thus, the pulmonary evaluation must be systematically performed in subjects with PD and the impact of pulmonary rehabilitation on these dysfunctions should be the focus of further research.