EFFECTS OF MULTIMODAL EXERCISE ASSOCIATED WITH INTER-EFFORT RECOVERY HYPOXIA IN PEOPLE WITH PARKINSON'S DISEASE

• Grant number: 23/06865-5
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: September 01, 2024
• End date: August 31, 2026
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Fabio Augusto Barbieri
• Grantee: Carlos Augusto Kalva Filho
• Host Institution: Faculdade de Ciências (FC). Universidade Estadual Paulista (UNESP). Campus de Bauru. Bauru , SP, Brazil

Abstract

The aim of this project is to investigate the acute and cumulative responses of multimodal exercise associated with intermittent hypoxia recovery (EX-HIR) on gait and sleep quality in people with Parkinson's disease (PD). Two experimental studies with randomized, crossover, and controlled designs will be proposed. In the first study, we will test the acute effects of multimodal exercise associated with different oxygen availabilities (EX-HIR or control condition; EX-CON). Participants (n = 24) will undergo two experimental sessions consisting of i) mobility and strength stimuli (10 min), ii) exposure to the experimental condition (10 min), iii) balance stimuli and recreational ball games (10 min), iv) exposure to the experimental condition (10 min), and v) walking practice (10 min). Spatial-kinematic parameters of the gait will be evaluated before and immediately after the session. Actigraphs (Act Trust® - Condor Instruments, São Paulo, Brazil) will be used to assess sleep quality, allowing determination of habitual values (average of seven nights prior to the experiment) and acute effects induced by the experimental sessions (recovery night after each session). The second study will test the cumulative effects during a typical microcycle (3 sessions/week) of EX-HIR in people with PD. Participants (n = 20) will undergo two assessment blocks, consisting of i) gait assessment, ii) three sessions of multimodal exercise associated with different oxygen availabilities, separated by 48 hours, and iii) gait assessment. The blocks will be separated by a 15-day period. Sessions will be conducted as Study 1. Gait will be assessed before the first session and after 24 h from the last session of the block. Actigraphy will be continuously monitored from the first session to the last gait assessment of each block (5 days and 5 nights), allowing assessment of both sleep quality and circadian rhythm. In both experiments, to apply hypoxia (13% O2) or the control condition (21% O2) during exposure periods, participants will be connected to a previously standardized apparatus using bidirectional masks. Hypoxia/normoxia generators (Sierra 100, Hypoxico, USA) connected to the apparatus will allow application of the experimental conditions (EX-HIR or EX-CON). We believe the main advancement of this project will be to present and discuss the possible practical limitations of the EX-HIR model applied to people with PD. To apply EX-HIR in practical settings, our results should demonstrate that i) this strategy does not attenuate the already established acute responses of physical exercise on the gait of people with PD, ii) its cumulative effects are positive after a typical microcycle, and iii) no negative effects are evidenced on the circadian rhythm and sleep quality of people with PD.