Efeitos de um programa de exercícios domiciliares em sintomas motores e não-motores de indivíduos com Doença de Parkinson: ensaio clínico randomizado
Introduction: The alterations present in the trunk region in individuals with Parkinson's disease (PD) seem to be related to symptoms of motor and non-motor nature, such as postural balance, gait and intestinal constipation (IC). Objective: To evaluate the effects of a home exercise program a...
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| Formato: | Dissertação |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/29493 |
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| Resumo: | Introduction: The alterations present in the trunk region in individuals with Parkinson's
disease (PD) seem to be related to symptoms of motor and non-motor nature, such as
postural balance, gait and intestinal constipation (IC). Objective: To evaluate the effects of a home exercise program aimed at the trunk region on motor and non-motor symptoms of individuals with PD. Methodology: Controlled and randomized clinical trial, including 28 individuals with
PD - classified between 2 and 4 on the Hoehn & Yahr Scale, with symptoms of IC,
postural balance deficits and gait. The sample was randomized into a Control Group
(CG, n = 14) and an Experimental Group (GE, n = 14). The CG performed activities
involving the upper and lower limbs; the GE carried out an exercise protocol focused
on the trunk region. The protocols were carried out by the participants at home, daily
(three times a day) for three consecutive weeks, under the supervision of the caregiver
and daily monitoring by the study therapists. Participants were evaluated at the time of
medication before the start of interventions, immediately after and 30 days after the end
of interventions, regarding outcome measures: bowel function / IC (Bristol scale and
The Bowel Function in the Community - BFC questionnaire ); kinematic gait variables
(Qualisys Motion Capture System®); variables of postural balance (force platform);
quality of life (Parkinson Disease Questionnaire-39 - PDQ-39). Data analysis was
performed using Analysis of Variance (ANOVA) mixed with repeated measures to
compare the outcome measures between groups and between assessment times.
Correlation tests were applied between the CI variable (Bristol scale) and the motor
variables: number of falls in the last year, motor function (part of the Movement
Disorders Society - Unified Parkinson's Disease Rating Scale - MDS-UPDRS) and selfreported mobility (item the PDQ-39 scale). The significance adopted was 5% for all
analyzes. Results: Manuscript 1 - ANOVA demonstrated that there was no time * group
interaction for the Bristol Scale data, with no change in the outcome over time. The data
referring to BFC showed significant interaction time * group (F = 4.065; P = 0.038). As
for quality of life, there was no time * group interaction and there was no change in this
outcome over time. There was no correlation between IC measurement and motor
variables: number of falls in the last year, motor function and self-reported mobility. Manuscript 2 - According to ANOVA, there was no significant interaction between time
and group or changes over time for all outcomes related to gait: speed, stride length,
double support time, hip extension, range of motion of the knee and ankle; and related
to postural balance: 95% of the displacement area of the pressure center, displacement
distance, displacement speed, anteroposterior and mediolateral displacement.
Conclusion: Through the results obtained, it can be inferred that the protocol composed
of muscle strengthening exercises directed to the trunk (SG) improved intestinal
function when compared to the CG, from an increase in the frequency of evacuation,
approaching the standard normal intestinal. However, none of the protocols was able to
promote improvement regarding the quality of life. As for motor symptoms, there was
no benefit in gait and postural balance for participants in both groups. The findings
reinforce the need for studies on the current theme, involving home treatment of
symptoms that are not only motor, but also non-motor in PD. |
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