Objective: To determine the association of performance on the 2-Minute Walking Test (2MWT) with aerobic fitness, motor and cognitive function, and brain health in mild Parkinson’s disease (PD).

Background: The distance traveled on 2MWT, part of the NIH Toolbox Motor Battery, is a measure of endurance and functional capacity.

Method: At baseline of an ongoing clinical trial on aerobic exercise, independently living, legally driving PD participants without significant systemic and neurologic comorbidities underwent morphometric 3T MRI (analyzed by FreeSurfer), motor, and cognitive testing, 2-Minute Walking Test (2MWT), a standardized road test, and cycle ergometry for aerobic fitness (VO₂max).

Results: Fifty-seven PD participants had clinical data and 50 participants completed the MRI. These participants had mild PD (Hoehn-Yahr stages I and II) without dementia or comorbidities that would preclude aerobic exercise. Multiple regression analyses adjusting for age and sex showed that the 2-MWT performance correlated 1) positively with VO₂max (p<0.001, Partial Eta Squared-PES 0.229); 2) negatively with the mean curvature (a measure of atrophy) across the whole brain and all four lobes of the brain (p<0.01, PES 0.146-0.192); 3) positively with the average cortical grey matter thickness in the whole brain and the parietal lobe (p<0.05, PES 0.090-0.107); 4) positively with timed motor test performances (4m-Walk and 9-Hole Peg Board) on NIH Toolbox (p<0.001 to p<0.05, PES 0.101-0.200) but not with any MDS-UPDRS section scores, and 5) positively with Flanker Task performance (p<0.01, PES 0.172) but not on other cognitive tests (after also adjusting for education). There was no significant correlation of the whole brain or lobar surface area and grey matter volume with 2MWT.

Conclusion: The performance on 2MWT predicts aerobic fitness, timed motor functions, response inhibition, and brain atrophy on morphometric MRI (as evidenced by negative correlation with mean curvature on FreeSurfer analysis) in mild PD. The 2MWT is a feasible standardized test of functional capacity that might be valuable in assessing aerobic endurance, motor function, response inhibition, and brain health in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-2-minute-walking-test-predicts-aerobic-fitness-motor-function-and-brain-health-in-parkinsons-disease/