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The Effect of Skeletal Muscle-Pump on Blood Pressure and Postural Control in Parkinson's Disease

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Abstract

Purpose

Activation of the calf (gastrocnemius and soleus) and tibialis anterior muscles play an important role in blood pressure regulation (via muscle-pump mechanism) and postural control. Parkinson’s disease is associated with calf (and tibialis anterior muscles weakness and stiffness, which contribute to postural instability and associated falls. In this work, we studied the role of the medial and lateral gastrocnemius, tibialis anterior, and soleus muscle contractions in maintaining blood pressure and postural stability in Parkinson’s patients and healthy controls during standing. In addition, we investigated whether the activation of the calf and tibialis anterior muscles is baroreflex dependent or postural-mediated.

Methods

We recorded electrocardiogram, blood pressure, center of pressure as a measure of postural sway, and muscle activity from the medial and lateral gastrocnemius, tibialis anterior, and soleus muscles from twenty-six Parkinson’s patients and eighteen sex and age-matched healthy controls during standing and with eyes open. The interaction and bidirectional causalities between the cardiovascular, musculoskeletal, and postural variables were studied using wavelet transform coherence and convergent cross-mapping techniques, respectively.

Results

Parkinson’s patients experienced a higher postural sway and demonstrated mechanical muscle-pump dysfunction of all individual leg muscles, all of which contribute to postural instability. Moreover, our results showed that coupling between the cardiovascular, musculoskeletal, and postural variables is affected by Parkinson’s disease while the contribution of the calf and tibialis anterior muscles is greater for blood pressure regulation than postural sway.

Conclusion

The outcomes of this study could assist in the development of appropriate physical exercise programs that target lower limb muscles to improve the muscle-pump function and reduce postural instability in Parkinson’s disease.

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Acknowledgements

The authors would like to thank Mr. and Mrs. Joseph Peltier for their endowment to Sanford Parkinson’s disease laboratory. The authors appreciate the valuable help of the participants to complete this study.

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Author notes

  1. Jau-Shin Lou and Kouhyar Tavakolian have contributed equally to this study.

Authors and Affiliations

  1. Biomedical Engineering Program, University of North Dakota, Grand Forks, ND, USA

    Rabie Fadil, Ajay K. Verma & Kouhyar Tavakolian

  2. Parkinson Disease Research Laboratory, Department of Neurology, Sanford Health, Fargo, ND, USA

    Asenath X. A. Huether & Jau-Shin Lou

  3. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada

    Farshid Sadeghian, Andrew P. Blaber & Kouhyar Tavakolian

  4. Department of Neurology, University of North Dakota, School of Medicine, and Health Sciences, Grand Forks, USA

    Jau-Shin Lou

  5. Biomedical Engineering Program, University of North Dakota, 243 Centennial Drive, Upson Hall II, Room 11, Grand Forks, ND, 58202, USA

    Kouhyar Tavakolian

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  1. Rabie Fadil
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Correspondence to Kouhyar Tavakolian.

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Fadil, R., Huether, A.X.A., Sadeghian, F. et al. The Effect of Skeletal Muscle-Pump on Blood Pressure and Postural Control in Parkinson's Disease. Cardiovasc Eng Tech 14, 755–773 (2023). https://doi.org/10.1007/s13239-023-00685-z

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