FISIOTERAPIA BASEADA NO TREINAMENTO DE DUPLA TAREFA NO EQUILÍBRIO DE INDIVÍDUOS COM DOENÇA DE PARKINSON

Objetive: This study was designed to investigate the effectiveness of a physical therapy treatment protocol based in dual task training in balance in individuals with Parkinson's disease. Méthods: Nine patients were evaluated before and after a physical therapy program based on an exercise protocol dual task, with 60 minutes, 2x/week. The following variables were investigated: Unified Parkinson’s Disease Rating Scale (UPDRS), Balance Evaluation Systems Test (BESTest) and measurements of the Balance Protocol. Results: Significant differences were found in the motor domain values and the total score of UPDRS, in two sections and the total score values of BESTest, and two postures of Balance Assessment Protocol. Conclusion: The intervention was effective in balance, motor scores and total scores of the UPDRS, suggesting be an appropriate treatment for balance and evolution of the disease in the studied group.   Descriptors: Parkinson Disease; Postural Balance; Physical Therapy Modalities; Rehabilitation.Objetivo: Investigar a efetividade de um protocolo de tratamento fisioterápico baseado no treino de duplas tarefas no equilíbrio de indivíduos com doença de Parkinson. Métodos: Nove indivíduos foram avaliados antes e após um programa fisioterápico baseado em um protocolo de exercícios de dupla tarefa, com terapia de 60 minutos, 2x/semana. Os seguintes instrumentos foram utilizados para avaliação: Escala Unificada para Avaliação da doença de Parkinson (UPDRS), Balance Evaluation Systems Test (BESTest) e Protocolo de avaliação do Balance. Resultados: Foram encontradas diferença significantes nos valores do domínio motor e na pontuação total da UPDRS, nos valores referentes ao BESTest em duas seções e escore total, além de duas posturas do Protocolo de avaliação do Balance. Conclusão: A intervenção foi eficaz no desfecho equilíbrio, escores motor e escore total da UPDRS, o que sugere ser um tratamento adequado sobre o equilíbrio e evolução da doença no grupo estudado. Descritores: Doença de Parkinson; Equilíbrio Postural; Modalidades de Fisioterapia; Reabilitação

Comparison of three physical therapy interventions with an emphasis on the gait of individuals with Parkinson’s disease

Abstract Introduction: Gait impairments are one of the earliest signs reported by patients with Parkinson’s disease (PD) and cause an increased number of falls and decreased quality of life among these patients. Objective: To compare the effectiveness of three physical therapy interventions using Rhythmic Cues (RC), Swiss Ball (SB) and Dual Task (DT), with an emphasis on gait treatment (step and stride length, duration and velocity), in individuals with PD. Methods: Quasi-randomized clinical trial addressing a sample composed of 45 individuals assigned to three groups. The individuals were assessed before and after the intervention protocol using the following: Modified Hoehn and Yahr Scale (HY), Unified Parkinson’s Disease Rating Scale (UPDRS), Footprint analysis, Video Gait analysis, and Timed Up and Go Test (TUG). The groups were homogeneous concerning age, HY and UPDRS. Statistical analysis was performed using SPSS, version 20.0. Results: Statistically significant differences were found in all the variables analyzed in the RC and SB groups when compared in the pre- and post-intervention. With the exception of the TUG variable, the DT group presented statistically significant differences in all the remaining variables. Conclusion: The three interventions were effective for the outcomes under study, but the SB group presented the greatest magnitude of change (effect size), while the RC group presented the greatest improvement in the temporal gait variables (duration and velocity) and TUG