Efeitos de diferentes tipos de exercício nos parâmetros do andar de idosas

O tipo de exercício, a intensidade e a frequência são fatores importantes para produzir mudanças na velocidade de andar. O objetivo do estudo foi comparar os efeitos de diferentes tipos de exercício nos parâmetros cinemáticos do andar de idosas, considerando as características antropométricas, a capacidade funcional e o nível de atividade física. Participaram do estudo 56 idosas que foram agrupadas de acordo com o envolvimento, a mais de seis meses, na prática específica de uma atividade: dança (n = 10), musculação (n = 10), hidroginástica (n = 12) e caminhada (n = 11). Além disso, um grupo de idosas inativas (n = 13), sem envolvimento em atividade física regular por pelo menos dois meses, também participou do estudo. Foram mensurados o nível de atividade física (Questionário de Baecke), a capacidade funcional (Bateria da AAHPERD) e os parâmetros cinemáticos do andar (comprimento da passada e do passo, duração e velocidade da passada, cadência e duração das fases de suporte simples, balanço e duplo suporte). Os resultados revelaram que o nível de atividade física do grupo Controle foi diferente dos demais grupos que praticam atividades físicas. em relação à capacidade funcional, apenas o componente força apresentou diferenças entre os grupos, indicando que o grupo Controle difere do grupo musculação. Quanto às variáveis do andar, o grupo Controle foi estatisticamente diferente apenas do grupo dança, tanto no comprimento do passo como no comprimento da passada. Pode-se concluir que a capacidade funcional e os parâmetros do andar dos idosos ativos e sedentários apresentam poucas diferenças

Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia

INTRODUCTION: A significant benefit from physical activity has recently been described in some patients who suffer from neurodegenerative diseases. OBJECTIVE: To assess the effects of physical activity on neuropsychiatric disturbances in demented patients and on the mental burden of their caregivers. METHODS: Assisted by a public geriatric psychiatry clinical unit, we studied 59 patients with dementia. Patients were divided into three groups according to their diagnosis and level of physical activity. Data were assessed through a semi-structured interview. Patients were evaluated with the Neuropsychiatric Inventory, the Mini-Sleep Questionnaire and the Baecke Questionnaire. The data were statistically analyzed using the Mann-Whitney U test and linear regression, with the level of significance set at 5%. RESULTS: Patients with Alzheimer's or vascular dementia who engaged in physical activity had fewer neuropsychiatric symptoms than those who did not. When compared to the control group, the caregivers of patients with vascular dementia who engaged in physical activity had a reduced burden. CONCLUSION: The regular practice of physical activity seems to contribute to a reduction in neuropsychiatric symptoms in dementia patients and to attenuate the burden of the caregivers of those patients.

Effects of Exercise Training on Hippocampus Concentrations of Insulin and IGF-1 in Diabetic Rats

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

An explanatory mechanism for the different decline in limb strength in older women

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

OBSTACLE STEPPING and BODY SCALE MODULATING PARAMETERS

The purpose of this study was to investigate gait spatial parameters at the point of departure, with obstacle heights adjusted to individual body scale. Undergraduate student volunteers (M age=22.4 yr., SD=2.1; 6 women, 1 man) were asked to step once, then cross over an obstacle and stop. This behavior was video recorded to extract kinematic data. The obstacle heights corresponded to high (knee-height) and low obstacles (half the knee-height). Points of departure corresponded to far (length of the lower limb) and close (half the length of the lower limb). The close point of departure influenced the trailing foot's placement ahead of the obstacle as well as step length. The high obstacle influenced the trailing foot's toe clearance. An interaction between factors was observed for leading foot toe clearance. Results indicate that body scale affected the participants' locomotor behavior during the obstacle-avoidance task.

Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia

Purpose: To analyse the effects of two interventions on the cognition and balance of institutionalized elderly people with mixed dementia.Methods: Fifty-four participants were allocated into three groups. Group 1 was assisted by an interdisciplinary programme comprising physiotherapy, occupational therapy and physical education. A physiotherapist alone carried out the intervention in group 2. Group 3 was considered as control. Assessors were blinded to guarantee the absence of bias. Cognitive functions were analysed with the Mini-Mental State Examination and the Brief Cognitive Screening Battery. Balance was assessed with the Berg Balance Scale and the Timed Get-Up-and-Go Test. Multiple analysis of variance (MANOVA) was used to test possible main effects of the interventions.Results: The results showed benefits on the balance of subjects in both groups 1 (F=3.9, P < 0.05) and 2 (F= 3.1, P < 0.05), compared with group 3. MANOVA did not indicate benefits on the cognitive functions between groups 1 and 3 (F= 1.1, P > 0.05) and groups 2 and 3 (F= 1.6, P > 0.05). However, univariate analysis indicated some benefits of the interdisciplinary intervention on two specific domains measured by the Brief Cognitive Screening Battery (F=26.5, P < 0.05; F= 4.4, P < 0.05).Conclusion: Six months of multidisciplinary or physiotherapeutic intervention were able to improve a person's balance. Although global cognition did not improve through treatment, when the intervention was carried out on a multidisciplinary basis we observed an attenuation in the decline of global cognition on two specific cognitive domains. Exercises applied in different contexts may have positive outcomes for people with dementia.

Quality of life (QoL) in relation to disease severity in Brazilian Parkinson's patients as measured using the WHOQOL-BREF

This study aimed at evaluating and describing the QoL and its association with the severity of disease among Brazilian Parkinson's disease (PD) patients. In this cross-sectional study 68 PD patients were interviewed using the World Health Organization Quality of Life instrument Short Form (WHOQOL-BREF) and the Hoehn-Yahr (HY) scale. Analysis of variance, chi(2), Kruskal-Wallis and Mann-Whitney U-tests, Spearman and Cronbach reliability coefficients were used to analyze the data. The results indicate: (1) physical capacity was the domain that showed the most deterioration; (2) severity of PD is associated with QoL measured by WHOQOL-BREF; (3) overall QoL, working capacity, activities of daily living (ADL) and self-esteem are affected in both transitional periods in the progression of PD (mild to moderate and moderate to advanced). Satisfaction with general health, pain, energy, positive feelings, personal relationship and satisfaction with home are affected in the first period of transition while mobility, body image, sexual activity and access to information are affected in the second. This study mainly shows specific facets that are affected depending on the specific periods of PD progression, which can help to understand the impact of the disease, the effectiveness of care, and the demand for health care resources. (C) 2007 Elsevier B.V. All rights reserved.

Effects of obstacle height on obstacle crossing in mild Parkinson's disease

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

The role of vision in Parkinson's disease locomotion control: Free walking task

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

Effect of Strength Training on Rate of Force Development in Older Women

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Functional capacity of Brazilian patients with Parkinson's disease (PD): Relationship between clinical characteristics and disease severity

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of postural threat on walking features of Parkinson's disease patients

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

Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention

Background: Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden. Methods: The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre- and post-intervention) and the motor intervention program. Results: While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P= 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P= 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P= 0.01; Zarit: F: 11.28; P= 0.01). Conclusion: Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden.

Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.