Parkinson's disease (PD) is characterized by progressive neurological deterioration, typically accompanied by reductions in skeletal muscle force-generating capacity (FGC) and functional performance. Physical activity has the potential to counteract this debilitating outcome, however, it is elusive if high-intensity strength training included in conventional treatment may improve results. Therefore, we randomly assigned 22 PD patients (74 +/- 9 yr) to conventional rehabilitation with or without maximal strength training (MST) performed as leg press and chest press at approximately 90% of one repetition maximum (1RM), five times per week for 4 wk. FGC, physical performance, and efferent neural drive assessed as evoked potentials (V-wave normalized to M-wave in muscle soleus) were measured following training. Results revealed that only MST improved 1RM leg press (101 +/- 23 to 118 +/- 18 kg) and chest press (36 +/- 15 to 41 +/- 15 kg), plantar flexion maximal voluntary contraction (235 +/- 125 to 293 +/- 158 Nm), and rate of force development (373 +/- 345 to 495 +/- 446 Nm/s; all p < 0.05; different from controls p < 0.05). FGC improvements were accompanied by an increased efferent neural drive to maximally contracting musculature (V-to-M ratio: 0.17 +/- 0.12 to 0.24 +/- 0.15; p < 0.05; different from controls p < 0.05), improved physical performance (stair climbing 21.0 +/- 9.2 to 14.4 +/- 5.2 s; Timed Up and Go 7.8 +/- 3.3 to 6.2 +/- 2.5 s; both p < 0.05), and self-perceived improvement in health (3.1 +/- 0.5 to 2.6 +/- 0.9) and social activities functioning (2.2 +/- 1.0 to 1.5 +/- 1.1; both p < 0.05). No changes were observed in the control group. In conclusion, this study shows that MST improves FGC, neuromuscular function, and functional performance and advocates that high-intensity strength training should be implemented as an adjunct therapy in the treatment of PD patients.

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