Movimentos da hesitação: deslizamentos do dizer em sujeitos com Doença de Parkinson

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Eletromiografia de superfície da musculatura supra-hióidea durante a deglutição de idosos sem doenças neurológicas e idosos com Parkinson

OBJETIVO: investigar as diferenças entre os achados eletromiográficos dos músculos supra-hióideos direito e esquerdo durante a deglutição de um líquido e um pastoso fino, em sujeitos idosos com doença de Parkinson e idosos sem doença neurológica. MÉTODOS: 30 sujeitos de ambos os sexos participaram deste estudo, 15 idosos sem doença neurológica e os demais com doença de Parkinson. Todos foram submetidos a um protocolo de avaliação clínica e avaliação eletromiográfica de superfície. RESULTADOS: foram constatadas diferenças significantes nos valores entre os sujeitos (f=14.4 e p= 0.000) e entre os lados (f=4.4 e p=0.0037). em relação ao tempo de duração da contração muscular durante a deglutição as diferenças foram significantes apenas entre as consistências (f=8.2 e p=0.005). CONCLUSÃO: a amplitude eletromiográfica foi menor nos sujeitos com doença de Parkinson e maior nos músculos supra-hiódeos do lado direito em ambos os grupos. A duração da contração muscular não diferiu significativamente entre os sujeitos com doença de Parkinson e idosos sem doença neurológica e foi menor para a consistência líquida.

Metabolic syndrome and dementia associated with Parkinson's disease: impact of age and hypertension

Objective: To determine correlations between age and metabolic disorders in Parkinson's disease (PD) patients. Methods: This observational cross-sectional study included brief tests for dementia and the Mattis test. Signals of metabolic syndrome were evaluated. Results: There was no significant effect from the presence of hypertension (OR=2.36 for patients under 65 years old and OR=0.64 for patients over 65), diabetes or hypercholesterolemia regarding occurrences of dementia associated with PD (24% of the patients). The study demonstrated that each year of age increased the estimated risk of dementia in PD patients by 9% (OR=1.09; 95%Cl: 1.01-1.17). Conclusion: There was no evidence to correlate the presence of metabolic syndrome with the risk of dementia that was associated with PD. The study confirmed that dementia in PD is age dependent and not related to disease duration.

Papel da visão no controle locomotor durante a ultrapassagem de obstáculos de diferentes alturas em idosos com doença de Parkinon e idosos sadios

Pós-graduação em Ciências da Motricidade - IBRC

Effect of different exercise programs on the psychological and cognitive functions of people with Parkinson's disease

The purpose of this study was to analyze the effect of different exercise programs on the psychological and cognitive functions in patients with Parkinson's disease (PD). Forty-five patients with PD participated in the study. The participants were randomized in three intervention programs: Group-1 (n=15, cognitive-activities), Group-2 (n=15, multimodal exercise) and Group-3 (n=15, exercises for posture and gait). The clinical, psychological and cognitive functions were assessed before and after 4 months of intervention. Univariate analysis did not reveal significant interactions between groups and time (p>0.05). However, univariate analysis for time revealed differences in stress level and memory. Participants showed less physical stress (p<0.01) and overall stress (p < 0.04) and higher performance in episodic declarative memory (p < 0.001) after exercise. These findings suggest that group work with motor or non-motor activities can improve cognitive and psychological functions of patients with PD.

Parkinson's disease severity and motor subtype influence physical capacity components

The severity of Parkinson's disease (PD) and PD's motor subtypes influence the components of physical capacity. The aim of this study was to investigate the impact of both PD severity and motor subtype in the performance of these components. Thirty-six PD patients were assigned into four groups: Tremor (TD) initial and TD mild, akinetic-rigid (AR) initial, and AR mild. Patients' strength, balance, coordination, mobility and aerobic capacity were evaluated and groups were compared using a two-way ANOVA (severity and subtype as factors). AR presents a poorer performance than TD in almost all tests. Also this performance was worsened with the advance of the disease in AR, contrary to TD. We conclude that AR and TD subgroups are different about their performance on physical capacity components, moreover, this performance worsens with the advance of the disease of the AR group, but not for TD.

Effects of physical exercise on articular range of motion of the lower limb in the Parkinson's disease individuals

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influência do tratamento fisioterapêutico em grupo no equilíbrio, na mobilidade funcional e na qualidade de vida de pacientes com Parkinson

Introduction: Parkinson’s disease (PD) is a chronic disease of the nervous system, characterized by degeneration of neurons in the mesencephalic substantia nigra, leading to a clinical state of rest tremor, bradykinesia, muscular rigidity and postural instability. Physical therapy seeks to act by slowing the progression of the disease and when done in a group and maintain and / or improving the motor skills of the individual, can provide psychosocial benefi ts. Objective: examine the infl uence of the physical therapy group in balance, functional mobility and quality of life of individuals with PD. Method: participated in this study 04 subjects were female, mean age 67.75 (± 9.5) years, with medical diagnosis of PD, stages 1 to 3 of the Hoehn & Yahr. Before starting treatment, subjects underwent an assessment of the balance (BBS), functional mobility (TUG) and the quality of life (PDQ-39).The treatment was performed in groups, for a period of 10 weeks, lasting 60 minutes each session twice a week, totaling 20 sessions of physiotherapy. Upon completion of the treatment period the subjects were again assessed for balance, functional mobility and quality of life. The data were analyzed using the Student t-test, with signifi cance level of 5% (p ≤ 0.05). Results: statistical analysis showed signifi cant differences in three variables: equilibrium (p = 0.010), functional mobility (p = 0.029) and quality of life (p = 0.004), after physiotherapy intervention. Conclusion: physiotherapy treatment was group provides better balance, functional mobility and quality of life of patients with PD.

Positive effects of auditory cue in locomotor pattern of people with Parkinson's disease (off and on medication)

Gait disorders are identified in people with Parkinson’s disease. The aim of this study was to investigate the effect of auditory cues and medication on kinematic, kinetic and EMG parameters, during different gait phases of people with PD and healthy elderly. Thirty subjects distributed in two groups (Group 1, PD patients off and on medication; Group 2, healthy elderly) participated in this study and were instructed to walk in two experimental conditions: non-cued and cued. Therefore, kinematic, kinetic and electromyography analyses were utilized to investigate the locomotor pattern. Changes in locomotor pattern (greater muscular activity) with auditory cue were observed for PD patients. Regarding the medication, locomotor parameter improvement was observed after levodopa intake in association with the auditory cue. These results confirm the hypothesis about the external cues therapy that could be used as a complement to drug therapy to achieve improvement in the locomotor pattern of PD patients.

Dysarthria and quality of life in neurologically healthy elderly and patients with Parkinson's disease

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Assimetria no controle postural em idosos caidores e não caidores neurologicamente sadios e com doenã de Parkinson em diferentes posições estáticas

Individuals with Parkinson's disease (PD) seem to present asymmetric postural control, and the commitment to postural control that is a big factor of falls in this population. However, the asymmetry in the postural control of fallers and non fallers with PD and neurologically healthy elderly is not too much studied. The objective of the study is to analyze the asymmetry in postural control in different static positions of elderly patients with PD and healthy elderly fallers and non fallers. The study included 70 older adults with PD and 70 neurologically healthy (CG). The groups were matched for age, gender, height, weight and cognitive condition. It was evaluated the clinical, cognitive status and incidence of falls among its participants through weekly prospective follow-up of 4 months. Then, for each group, CG and PD, it was selected 12 elderly fallers and 12 elderly non fallers to evaluate postural control. Participants were evaluated through two force platforms in conditions of bipedal support, unipedal and tandem position. It was realized 3 attempts of 30s for each condition. For unipedal and tandem condition it was made 3 attempts for each lower limb. The parameters of interest of the center of pressure (CoP), were analyzed for each condition and compared by MANOVAs with factor group, fall and asymmetry. Post hoc Tukey tests were used to determine the relationships between them. The results show that CG individuals showed greater velocity and CoP area in relation to PD. It was verified that at the control group that non fallers individuals (CGN) had more displacement and RMS in the average lateral direction in the dominant limb when compared to the less affected limb of non fallers with PD (PDN). Faller individuals in the control group (CGF) had larger area in the non dominant limb when compared to the most affected leg of fallers individuals with PD (PDF). Still, the PDF individuals had higher RMS in anteroposterior feeling....

Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Case for diagnosis

Descreve-se caso clínico de paciente feminina adulta, portadora de doença de Parkinson em uso de amantadina que desenvolveu extenso quadro de livedo reticular nos membros e abdome após o início do medicamento. Discutem-se a semiotécnica diagnóstica do livedo reticular e seus diferenciais. Os autores salientam que a etiologia medicamentosa deva ser considerada no diagnóstico dos livedos reticulares.

Hesitações em deslizamentos do dizer de sujeitos parkinsonianos e não-parkinsonianos: um estudo comparativo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)