Telehealth For Individuals with Parkinson’s Disease During Covid-19 In Brazil: A Prospective Case Series

Objective: To implement a telerehabilitation prevention, treatment, and follow-up physical therapy protocol for monitoring individuals with Parkinson´s disease (PD) and to verify its effectiveness in minimizing the deleterious effects of the COVID-19 pandemic. Design: Prospective case series, involving 40 participants with mild to moderate PD recruited from a specialized neurorehabilitation group. The study was divided into four parts: (1) Phone calls to assess the feasibility of participating in remote physical therapy. (2) Social media training. (3) Baseline and post-intervention assessment for functional lower extremity strength, fear of falling, quality of life, depression, anxiety, activities of daily living, verbal fluency. (4) Intervention protocol consisting of 20 remote weekly physical therapy sessions, graphic material for physical and cognitive training, social activities, and education. Conclusion: The telerehabilitation protocol was viable and effective for patients with PD as an alternative to in-person treatment during the COVID-19 pandemic

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

Efficacy of neurofunctional versus resistance training in improving gait and quality of life among patients with Parkinson’s disease: a randomized clinical trial

Abstract AIMS to compare the efficacy of neurofunctional training versus resistance training in improving gait and quality of life among patients with PD METHODS This randomized controlled trial included 40 participants randomly assigned to two groups through random number table generator: resistance training (RT) (n=19) and neurofunctional training (NT) (n=21). The RT group performed resistance exercises emphasizing the lower limbs and trunk, while the NT group sessions were focused on gait, functional independence and balance training. Trained physical therapists supervised both groups. The training sessions lasted 60 minutes in each group and were performed twice a week, totalizing 24 sessions. The outcomes, gait and quality of life, were measured using video gait analysis and footprint analysis; and PDQL and PDQ-39 questionnaires, respectively RESULTS intra-group comparison revealed all gait variables (stride length, step length, number of steps, time of distance walked, gait speed and cadence) improved after the NT intervention with large effect size, while only stride length improved in the RT group with moderate effect size. The between group analyses means (Δ) shows that all the variables presented statistically significant differences in the NT group. Additionally, both groups showed significant improvements in quality of life. CONCLUSIONS The application of specific neurofunctional training, directed and enriched with sensorial resources, resulted in superior gait performance among individuals with PD when compared to those in the resistance training group; both treatments were efficacious in improving quality of life

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