The Effect of Endurance Training on Neurological Diseases
Jeremy Lynn
School of Exercise Science, Physical, and Health Education
Introduction
Endurance training (ET) is a form of exercise that is utilized to
improve the abilities of the aerobic energy system to use
oxygen1.
Specifically, ET alters the aerobic system by increasing the
ability of the circulatory system to transport oxygen to muscles
and the ability of the muscles to use available oxygen2.
Key adaptations include increased muscle capillarization,
number of aerobic enzymes, mitochondrial size and density, and
fat and carbohydrate oxidation2, and neural adaptations which
delaying muscle fatigue and increasing contractile efficiency3.
These changes allow the individual to increase locomotion
efficiency with lower energy expenditure3.
While the research is limited, there does appear to be some
benefit in incorporating ET into treatment regimes for several
neurological diseases.
Motor Control Aspects of Neurological Diseases
Physiology of Parkinsons Disease
Parkinsons disease (PD) is due to the deterioration of
neurons in the basal ganglia which produce dopamine.
Symptoms include tremor, rigidity, balance and walking
dysfunction4,5, fatigue, depression, and ultimately decreased
quality of life5. Gait deficiency is one of the most challenging
issues with PD because of its resulting in limiting mobility and
independence4.
Physiology of Multiple Sclerosis
Multiple sclerosis (MS) is due to demyelination of white
matter in the central nervous system. Symptoms include general
fatigue, weakness, spasticity, ataxia, sensory disturbances, as
well as cognitive and autonomic dysfunctions. The reduction in
motor function limits activities of daily living and social
interaction6.
Physiology of Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is due to a continuous
loss of both upper and lower motor neurons in the central
nervous system7,8. Motor unit damage and inhibited activation of
muscles can lead to fatigue9, muscle weakness, respiratory
deficiency7, and atrophy10.
Effects of Endurance Training
Table 1
Functional outcome by type of rehabilitation11
Table 2
Sick Impact Profile (SIP) scores of exercise and
nonexercise groups14
Figure 1. Change in spasticity, fatigue, and
quality of life over time9.
* Significant improvement in BWSTT compared with PT
Treadmill training has been shown ET can reduce the common Moderate ET has shown a beneficial
to be more effective in treating PD symptom of fatigue in MS patients effect on the Ashworth spasticity
than physiotherapy11 caused by issues such as detraining scale and the ALS fictional rating
and excessive muscle tone 6,13,14 scale, which are both measures of
ET can improve gait speed12 and a disability9
develop a more normalized gait Improvements in mobility and
pattern in PD patients4 ambulation have been reported in ET can slow the progression of
MS patients who experience ET14,15 respiratory failure in ALS patients16
Improvements in physical
functioning and improved quality of Measures of quality of life6,13,14, In the initial phase of ALS, ET has
life have been reported in PD mood, and depression in MS been shown to help prevent
patients who undertake ET11,12 patients improves with ET13,14 fatigue9,16
Conclusions & Recommendations
Endurance training has been shown to be useful in treating some symptoms of Parkinsons disease (PD), multiple sclerosis (MS), and
amyotrophic lateral sclerosis (ALS).
Based on the results of these studies, patients with PD, MS, and ALS should be encouraged to engage in regular ET. Patients should still seek
medical clearance and supervision before beginning an endurance training program.
Future research should include introspection into those with more advanced stages of the aforementioned neurological diseases, and should
also address specific parameters on quantity of aerobic prescription.
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