Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores
Introduction: The various types of clinical motor manifestations configure a clinical heterogeneity of presentation (phenotypes) in Parkinson's Disease (PD). In 2013, an empirical method was proposed to classify PD phenotypes, based on items of a validated scale for a disease, obtaining the sub...
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Doença de Parkinson, Escala Unificada de Avaliação da Doença de Parkinson, Equilíbrio postural, Análise da marcha. Parkinson's Disease, Unified Parkinson's Disease Scale, Postural Balance, Gait Analysis. |
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Doença de Parkinson, Escala Unificada de Avaliação da Doença de Parkinson, Equilíbrio postural, Análise da marcha. Parkinson's Disease, Unified Parkinson's Disease Scale, Postural Balance, Gait Analysis. Silva, Raquel Souza Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
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Introduction: The various types of clinical motor manifestations configure a clinical heterogeneity of presentation (phenotypes) in Parkinson's Disease (PD). In 2013, an empirical method was proposed to classify PD phenotypes, based on items of a validated scale for a disease, obtaining the subtypes: dominant tremor (DT); postural instability and difficulties with walking (PIGD); and the indeterminate subtype. However, an analysis of this classification based on instrumentation considered the gold standard has not yet been performed.
Objective: This study aims to classify a sample of individuals with PD in motor phenotypes and analyze this classification from specific instrumentation.
Methodology: This is an analytical cross-sectional study, with a sample of 38 individuals with PD, 24 men and 14 women with a mean age of 65.59 years, with 44.73% in stage 3 of the Hoenh & Yahr (H&Y) Disability scale. For the classification of motor phenotypes, the method proposed by Stebbins et al. (2013) was used, based on the Movement Disorders Society – Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Participants were then classified as: TD, PIGD and indeterminate. Stabilometry (Bertec® force platform) and kinemetry (Qualisys® motion analysis system) were used to obtain postural balance variables (95% area, mean lateral displacement, anteroposterior displacement, distance and velocity) and gait variables (speed, stride length, double support time and angular variables of hip extension, knee and ankle range of motion) of all participants. For statistical analysis, descriptive analysis of the groups and analysis of data normality were performed using the Shapiro-Wilk test. Inferential analysis was performed to compare balance and gait measures between PIGD and TD/ indeterminate phenotypes, with a significance level of 5%.
Results: According to the classification used, 2 patients were classified as TD phenotype, 28 as PIGD phenotype, 8 as indeterminate. Considering the analyzed groups (PIGD, n=28 and TD/indeterminate, n=10), the analysis of the postural balance and gait variables showed no statistically significant differences between the groups (P>0.05), except for the variable of ankle range of motion.
Conclusion: The results reinforce the heterogeneity of the clinical manifestations of PD, however, the greater impairment of balance and gait in the studied sample meant that there were no differences between the phenotypes when assessed by specific instruments. Still, it is necessary to develop works that use the categorization in motor phenotypes based on Stebbins (2013) - which seems to allow a better prediction of clinical progression, as well as the planning of treatment planning during the progression of DP. |
| author2 |
Ribeiro, Tatiana Souza |
| author_facet |
Ribeiro, Tatiana Souza Silva, Raquel Souza |
| format |
bachelorThesis |
| author |
Silva, Raquel Souza |
| author_sort |
Silva, Raquel Souza |
| title |
Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
| title_short |
Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
| title_full |
Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
| title_fullStr |
Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
| title_full_unstemmed |
Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores |
| title_sort |
classificação e análise de indivíduos com doença de parkinson nos fenótipos motores |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2021 |
| url |
https://repositorio.ufrn.br/handle/123456789/37975 |
| work_keys_str_mv |
AT silvaraquelsouza classificacaoeanalisedeindividuoscomdoencadeparkinsonnosfenotiposmotores |
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1773967398371590144 |
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ri-123456789-379752021-09-28T16:55:07Z Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores Silva, Raquel Souza Ribeiro, Tatiana Souza Vasconcellos, Liliane Santos de Ribeiro, Tatiana Souza Lucena, Larissa Coutinho de Tavares, Larissa Bastos Doença de Parkinson, Escala Unificada de Avaliação da Doença de Parkinson, Equilíbrio postural, Análise da marcha. Parkinson's Disease, Unified Parkinson's Disease Scale, Postural Balance, Gait Analysis. Introduction: The various types of clinical motor manifestations configure a clinical heterogeneity of presentation (phenotypes) in Parkinson's Disease (PD). In 2013, an empirical method was proposed to classify PD phenotypes, based on items of a validated scale for a disease, obtaining the subtypes: dominant tremor (DT); postural instability and difficulties with walking (PIGD); and the indeterminate subtype. However, an analysis of this classification based on instrumentation considered the gold standard has not yet been performed. Objective: This study aims to classify a sample of individuals with PD in motor phenotypes and analyze this classification from specific instrumentation. Methodology: This is an analytical cross-sectional study, with a sample of 38 individuals with PD, 24 men and 14 women with a mean age of 65.59 years, with 44.73% in stage 3 of the Hoenh & Yahr (H&Y) Disability scale. For the classification of motor phenotypes, the method proposed by Stebbins et al. (2013) was used, based on the Movement Disorders Society – Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Participants were then classified as: TD, PIGD and indeterminate. Stabilometry (Bertec® force platform) and kinemetry (Qualisys® motion analysis system) were used to obtain postural balance variables (95% area, mean lateral displacement, anteroposterior displacement, distance and velocity) and gait variables (speed, stride length, double support time and angular variables of hip extension, knee and ankle range of motion) of all participants. For statistical analysis, descriptive analysis of the groups and analysis of data normality were performed using the Shapiro-Wilk test. Inferential analysis was performed to compare balance and gait measures between PIGD and TD/ indeterminate phenotypes, with a significance level of 5%. Results: According to the classification used, 2 patients were classified as TD phenotype, 28 as PIGD phenotype, 8 as indeterminate. Considering the analyzed groups (PIGD, n=28 and TD/indeterminate, n=10), the analysis of the postural balance and gait variables showed no statistically significant differences between the groups (P>0.05), except for the variable of ankle range of motion. Conclusion: The results reinforce the heterogeneity of the clinical manifestations of PD, however, the greater impairment of balance and gait in the studied sample meant that there were no differences between the phenotypes when assessed by specific instruments. Still, it is necessary to develop works that use the categorization in motor phenotypes based on Stebbins (2013) - which seems to allow a better prediction of clinical progression, as well as the planning of treatment planning during the progression of DP. Introdução: Os variados tipos de manifestações clínicas motoras configuram uma heterogeneidade clínica de apresentação (fenótipos) na Doença de Parkinson (DP). Em 2013 foi proposto um método empírico para classificar os fenótipos da DP, com base nos itens de uma escala validada para a doença, obtendo os subtipos: tremor dominante (TD); instabilidade postural e dificuldades com a marcha (PIGD); e o subtipo indeterminado. Contudo, uma análise dessa classificação a partir de instrumentação considerada padrão-ouro ainda não foi realizada. Metodologia: Trata-se de um estudo transversal analítico, com amostra de 38 indivíduos com DP, 24 homens e 14 mulheres com idade média de 65,59 anos, estando 44,73% no estágio 3 da escala de Incapacidade de Hoenh & Yahr (H&Y). Para a classificação dos fenótipos motores, foi utilizado o método proposto por Stebbins e colaboradores (2013), a partir da escala Movement Disorders Society – Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Os participantes foram então classificados como: TD, PIGD e indeterminado. A partir da estabilometria (plataforma de força Bertec®) e cinemetria (sistema Qualisys® de análise de movimento) foram obtidas variáveis de equilíbrio postural (área 95%, deslocamento médio lateral, deslocamento ântero-posterior, distância e velocidade) e variáveis de marcha (velocidade, comprimento da passada, tempo de duplo apoio e variáveis angulares de extensão do quadril, amplitude de movimento do joelho e do tornozelo) de todos os participantes. Para análise estatística foi feita análise descritiva dos grupos e análise da normalidade dos dados utilizando o teste de Shapiro- Wilk. A análise inferencial foi feita para comparar as medidas de equilíbrio e marcha entre os fenótipos PIGD e TD/ indeterminado, com significância de 5%. Resultados: De acordo com a classificação utilizada, 2 pacientes foram classificados no fenótipo TD, 28 no fenótipo PIGD, 8 como indeterminado. Considerando os grupos analisados (PIGD, n=28 e TD/indeterminado, n=10), a análise das variáveis de equilibro postural e marcha não demonstrou diferenças estatísticas significativas entre os grupos (P>0,05), exceto para a variável de ADM de tornozelo. Conclusão: Os resultados reforçam a heterogeneidade das manifestações clínicas da DP, porém, o maior comprometimento do equilíbrio e marcha na amostra estudada fez com que não houvesse diferenças entre os fenótipos quando analisados por instrumentos específicos. Ainda assim, sugere-se o desenvolvimento de trabalhos que usem a categorização em fenótipos motores com base em Stebbins (2013) – a qual parece permitir uma melhor previsão de progressão clínica, bem como, o planejamento de estratégias de tratamento durante a progressão da DP. 2021-09-23T13:29:08Z 2021-09-23T13:29:08Z 2021-09-10 bachelorThesis SILVA, Raquel Souza. Classificação e análise de indivíduos com Doença de Parkinson nos fenótipos motores. 2021. 72f. Trabalho de Conclusão de Curso (Graduação em Fisioterapia), Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, 2021. https://repositorio.ufrn.br/handle/123456789/37975 pt_BR Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN Graduação em Fisioterapia Departamento de Fisioterapia |