Efeitos do treino em esteira na marcha com dupla tarefa de indivíduos com doença de Parkinson: ensaio clínico controlado randomizado

Background: The gait automaticity loss difficults realization of concurrent activities - Dual Task (DT). In these situations, individuals with Parkinson`s disease (PD) show a significant reduction in gait velocity and stride length, as strides variability and asymmetry increased, factors predisposing to falls. However, recent studies have shown that training involving DT may cause subsequent improvements in gait variables with DT in individuals with PD. The treadmill use was adopted by this study, by promoting greater regularity in step and enhance training. Objective:To investigate immediate effects of gait training associated with cognitive tasks on gait in individuals with PD. Methods: Twenty-two volunteers were randomly divided into two groups: control group (n = 11), who performed gait training on a treadmill for 20 minutes, and the experimental group (n = 11), who performed treadmill gait training for 20 minutes associated with cognitive tasks of verbal fluency, memory, and spatial planning. Participants were evaluated in phase on of antiparkinsonian medication as the demographic, clinical and anthropometric (identification form), cognitive status (Montreal Cognitive Assessment - MoCA), executive function (Frontal Assessment Battery), level of physical disability (Hoehn and Yahr Modified), motor and functional status (Unified Rating Scale for Parkinson`s Disease - UPDRS), and kinematics (Qualisys Motion Capture System). Results: There were not differences between groups, but both showed improvement after the intervention. The control group had an increase in velocity (p = 0.008), stride length (p = 0.04), step length (p = 0.02) and decreased double support time(p = 0.03). The experimental group showed an increase in speed (p = 0.002), stride length (p = 0.008), step length (p = 0.02) and cadence (p = 0.01), as well as a decrease in the width stride (p = 0.001) and total support time (p = 0.02). As the angular variables, the experimental group had a significant increase in the initial contact angle of ankle (p = 0.01). Conclusion: The gait training combined with cognitive activities didn`t provide significant improvements in gait variables with DT, but this study was the first to demonstrate that gait training on treadmill as simple task minimized the negative interference of DT in PD

Balance, executive functions and falls in elderly with Alzheimer's disease (AD): A longitudinal study

Elderly individuals with AD are more susceptible to falls, which might be associated with decrements in their executive functions and balance, among other things. We aimed to analyze the effects of a program of dual task physical activity on falls, executive functions and balance of elderly individuals with AD. We studied 21 elderly with probable AD, allocated to two groups: the training group (TG), with 10 elderly who participated in a program of dual task physical activity; and the control group (CG), with 11 elderly who were not engaged in regular practice of physical activity. The Clock Drawing Test (CDT) and the Frontal Assessment Battery (FAB) were used in the assessment of the executive functions, while the Berg Balance Scale (BBS) and the Timed Up-and-Go (TUG)-test evaluated balance. The number of falls was obtained by means of a questionnaire. We observed a better performance of the TG as regards balance and executive functions. Moreover, the lower the number of steps in the TUG scale, the higher the scores in the CDT, and in the FAB. The practice of regular physical activity with dual task seems to have contributed to the maintenance and improvement of the motor and cognitive functions of the elderly with AD. (C) 2011 Elsevier B.V. All rights reserved.

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.

Apatia, funções cognitivas e funcionalidade motora em idosos com doença de Alzheimer

The aims of this study were to characterize the presence of apathy in patients with AD, determine the relationship between apathy, motor function and cognitive function, and to verify differences among patients stratified by level of apathy in relation to cognitive and motor abilities. Methods: A cross-sectional study was conducted of 37 patients with AD. The following tests were used: MoCA, the Frontal Assessment Battery, Verbal Fluency, Clock Drawing Test, Andreotti & Okuma Battery Tests, Sit and Reach, Resistance of Upper Limbs - AAHPERD Battery Test, Sit and Lift Chair and the Apathy domain of the Neuropsychiatric Inventory. After verifying the normality of the data distribution, comparisons were made using Student's t-test and the U Mann Whitney test; relationships were also assessed using Pearson's and Spearman's correlation coefficients. All analyses were considered to be statistically significant at a p-value of 0.05. Results: 46% of participants in this study showed mild symptoms of apathy. Significant and weak associations were found (p=0.04) between apathy and the attention domain on the MoCA and between apathy and the Walk Test. Analysis of differences in cognitive and motor functions according to participants' level of apathy revealed no significant differences for any of the variables. Conclusion: Apathy was reflected in attention and the Walk Test, suggesting these variables may be related to cognitive and functional decline in AD patients.

Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: A controlled trial

Aim: The objective of the present study was to investigate the effect of a multimodal exercise intervention on frontal cognitive functions and kinematic gait parameters in patients with Alzheimer's disease. Methods: A sample of elderly patients with Alzheimer's disease (n=27) were assigned to a training group (n=14; aged 78.0±7.3years) and a control group (n=13; aged 77.1±7.4years). Multimodal exercise intervention includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week for 16weeks, and the control participants maintained their regular daily activities during the same period. The frontal cognitive functions were evaluated using the Frontal Assessment Battery, the Clock Drawing Test and the Symbol Search Subtest. The kinematic parameters of gait-cadence, stride length and stride speed were analyzed under two conditions: (i) free gait (single task); and (ii) gait with frontal cognitive task (walking and counting down from 20 - dual task). Results and discussion: The patients in the intervention group significantly increased the scores in frontal cognitive variables, Frontal Assessment Battery (P<0.001) and Symbol Search Subtest (P<0.001) after the 16-week period. The control group decreased the scores in the Clock Drawing Test (P=0.001) and increased the number of counting errors during the dual task (P=0.008) after the same period. Conclusion: The multimodal exercise intervention improved the frontal cognitive functions in patients with Alzheimer's disease. © 2012 Japan Geriatrics Society.

Relação entre nível de atividade física, cognição, processamento da informação e funcionalidade motora de idosos no estágio leve da doença de Alzheimer

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A preparação e a execução de tarefa de alcance ao alvo em crianças com transtornos do desenvolvimento da coordenação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Atividade física e funções cognitivas frontais associadas aos parâmetros cinemáticos da marcha em pacientes com demência de Alzheimer

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Funções cognitivas frontais e controle postural na doença de Alzheimer: efeitos do programa de intervenção motora com tarefa dupla

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Práticas educativas de genitores e professoras e repertório comportamental de crianças do ensino fundamental: estudos de caso

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do treinamento aeróbio nos níveis plasmáticos do fator neurotrófico derivado do cérebro, variáveis metabólicas e funções cognitivas em idosos com a doença de Alzheimer

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

Benefits of Multimodal Exercise Intervention for Postural Control and Frontal Cognitive Functions in Individuals with Alzheimer's Disease: A Controlled Trial

Objective To verify the effects of a systematized multimodal exercise intervention program on frontal cognitive function, postural control, and functional capacity components of individuals with Alzheimer's disease (AD).DesignNonrandomized controlled trial with pre- and posttraining tests in a training group and a control group.SettingKinesiotherapy program for seniors with AD, SAo Paulo State University.ParticipantsConvenience sample of older adults with AD (n=30) were assigned to a training (n=14; aged 78.67.1) and a control (n=16; aged 77.06.3) group.InterventionThe intervention program was structured with the aim of simultaneously promoting better balance and frontal cognitive capacity. The participants attended a 1-hour session three times a week for 16weeks, whereas the control group did not participate in any activity during the same period.MeasurementsFrontal cognitive function was evaluated using the Montreal Cognitive Assessment, the Clock Drawing Test, the Frontal Assessment Battery, and the Symbol Search Subtest. Postural control (center of pressure area) was analyzed under four dual-task conditions. Functional capacity components were analyzed using the Timed Up and Go Test, the 30-second sit-to-stand test, the sit-and-reach test, and the Berg Functional Balance Scale.ResultsIntervention group participants showed a significant increase in frontal cognitive function (P<.001, partial (2)=0.838), with less body sway (P=.04, partial (2)=0.04) during the dual tasks, and greater functional capacity (P=.001, partial (2)=0.676) after the 16-week period.ConclusionIntervention participants performed better on dual-task activities and had better postural balance and greater functional capacity than controls.

Equilíbrio, funções executivas e quedas de idosos com demência de Alzheimer: um estudo longitudinal

Falls among older people is a major clinical problem due to its high incidence, with consequent implications for the health and care costs. Elderly patients with dementia of Alzheimer type (AD) are more susceptible to falls due to the impairment of executive functions and gait, with the risk of falls 3 times higher than non-demented elderly. This study used a longitudinal design and aimed to analyze the effects of a regular and systematized physical activity program on the frequency of falls in patients with AD. Additionally, we aimed to correlate the frequency of falls with the executive functions and equilibrium, after and before the physical activity program. The study included 21 patients with clinical diagnosis of AD, divided into two groups: control group (CG), composed of 11 subjects not engaged in any systematized physical activity and training group (TG): 10 seniors who participated in the Cinesioterapia Functional and Cognitive in Elderly with Alzheimer's disease program (PRO-CDA). The physical activity program lasted four months, with weekly frequency of three times, with each session lasting 60 minutes. Were administered the Mini-Mental State Examination (MMSE) to assess cognitive functioning and global score of the Clinical Dementia Rating (CDR) to classify the severity of dementia. For the evaluation of executive functions were used the Clock Drawing Test (TDR) and Frontal Assessment Battery (FAB). In addition, we used the Functional Balance Scale, Berg test (EEFB) and Timed Up-and-Go (TUG) to assess the equilibrium and risk of falls. Falls were recorded by means of a questionnaire, which included the number of falls in the last four months. Analyzing the results, it was observed that TG obtained significant improvements in equilibrium and in executive functions, highlighting the beneficial effects of physical activity in these variables... (Complete abstract click electronic access below)

Estudo normativo do R-2: teste não verbal de inteligência para crianças

This study presents the standardization of the R-2 Non Verbal Intelligence Test for Children conducted at the city of Assis – SP, Brazil, and compares it with the São Paulo city standardization. The sample was composed by 559 children, between 5 and 11 years old, half of each sex, students from Assis city, randomly selected according to their proportion in private and public schools. Results indicate differences between ages and school types, but not between sexes. Percentile norms were established for the total sample at each age. The comparison of Assis and São Paulo city children reveals significant differences and Assis' results slightly higher. The conclusion is that R-2 Test is appropriate to cognitive assessment of Assis children, suggesting the use of new norms for this region.

Indirectly measuring evaluations of several attitude objects in relation to a neutral reference point

This article presents a new response time measure of evaluations, the Evaluative Movement Assessment (EMA). Two properties are verified for the first time in a response time measure: (a) mapping of multiple attitude objects to a single scale, and (b) centering that scale around a neutral point. Property (a) has implications when self-report and response time measures of attitudes have a low correlation. A study using EMA as an indirect measure revealed a low correlation with self-reported attitudes when the correlation reflected between-subjects differences in preferences for one attitude object to a second. Previously this result may have been interpreted as dissociation between two measures. However, when correlations from the same data reflected within-subject preference rank orders between multiple attitude objects, they were substantial (average r = .64). This result suggests that the presence of low correlations between self-report and response time measures in previous studies may be a reflection of methodological aspects of the response time measurement techniques. Property (b) has implications for exploring theoretical questions that require assessment of whether an evaluation is positive or negative (e.g., prejudice), because it allows such classifications in response time measurement to be made for the first time.