Parâmetros espaço-temporais do andar emcrianças obesas e com peso normalde acordo com o sexo

Características corporais interferem no desempenho motor. Para analisar os parâmetros espaço-temporais do andar em crianças obesas e de peso normal, por sexo, 23 crianças entre 7 e 10 anos de idade, foram intencionalmente selecionadas e distribuídas em dois grupos: obeso (OB, n=9) e normal (N, n=14). Marcadores reflexivos foram afixados em pontos anatómicos (quinto metatarso, maléolo lateral e calcando). Os participantes andaram sobre uma passarela de 8m de comprimento na velocidade preferida e foram filmados no plano sagital. As variaveis descritivas analisadas foram: comprimento da passada (CP), comprimento da passada normalizado pela estatura (CPN) duração da passada (DP), velocidade da passada (VP), duração da fase de balanço (DFB) e duração da fase de suporte (DFS). Os resultados revelaram que: grupo isoladamente interfere em CPN e DP; sexo isoladamente afeta CP, CPN, VP; grupo e sexo afetam CPN, DFB, DP. Assim, o aumento da massa corporal ocasiona mudanças nos parâmetros espaço- temporais do andar quando sexo é considerado.Considering that body features interfere in motor performance, the aim of this study was to analyze the changes in spatial and temporal parameters of gait in obese, and non-obese children according to the gender.23 children intentionally selected participated in this study and they were distributed between two experimental groups according to their body mass index:obese (OB, n=9) and normal (N, n=14). Ali the participants had written consent forms signed by their parents. Reflexive markers were attached on the following body landmarks of the rightfoot: fifth metatarsal, malleolus lateral and calcaneus. The participants were asked to walk on an 8m rubber pathway at a preferred pace while their locomotor behavior were recorded using a video camera Panasonic (model NV - M9OOOPN S-VHS) in a sagittal plane. Using a MatLab routine, the following variables were collected: stride length (SL), stride length normalized byheight (SLN), stride duration (SD), stride velocity (SV), swing phase duration (SPD), and support phase duration (SUD). Data was statically analyzed using ANOVA with groups and gender asfactors. Results revealed that: group alone interfere on SLN and SD; gender alone affects SL, SLN and SV; group and gender affects SLN, SPD and SD. These results allowed us to concludethat the increase in body weight can make changes in spatial and temporal parameters of children gait when gender is considered

Functional parameters indicative of mild cognitive impairment: a systematic review using instrumented kinematic assessment

Background: Patients with mild cognitive impairment (MCI) experience alterations of functional parameters, such as an impaired balance or gait. The current systematic review set out to investigate whether functional objective performance may predict a future risk of MCI; to compare functional objective parameters in patients with MCI and a control group; and to assess changes in these parameters after different physical activity interventions. Methods: Electronic databases, including PubMed, AMED, CINAHL, EMBASE, PEDro and Web of Science as well as grey literature databases, were searched from inception to February 2020. Cohort studies and Randomized Controlled Trials (RCTs) were included. The risk of bias of the included studies was assessed independently by reviewers using quality assessment checklists. The level of evidence per outcome was assessed using the GRADE criteria. Results: Seventeen studies met inclusion criteria including patients with MCI. Results from RCTs suggested that gait speed, gait variability and balance may be improved by different physical activity interventions. Cohort studies showed that slower gait speed, above all, under Dual Task (DT) conditions, was the main impaired parameter in patients with MCI in comparison with a Control Gorup. Furthermore, cohort studies suggested that gait variability could predict an incident MCI. Although most of included cohort studies reported low risk of bias, RCTs showed an unclear risk of bias. Conclusions: Studies suggest that gait variability may predict an incident MCI. Moreover, different gait parameters, above all under DT conditions, could be impaired in patients with MCI. These parameters could be improved by some physical activity interventions. Although cohort studies reported low risk of bias, RCTs showed an unclear risk of bias and GRADE criteria showed a low level of evidence per outcome, so further studies are required to refute our findings

Gait Spatial And Temporal Predictors For Functional Capacity Tests In Parkinson's Disease Patients

Objective: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. Methods: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The dependent variables selected were the time taken in the agility and endurance tests and the kinematic variables: stride length (SL), cadence (CAD), stride time (ST), double support time (DS), single support time (SS), swing time (SW) and stride velocity (SV). Results: For agility, Pearson's test showed statistically significant correlations with SL (r=-0.70; p≤0.05), CAD (r=-0.72; p≤0.01), SV (r=-0.83; p≤0.01), ST (r=0.71; p≤0.01) and DS (r=0.90; p≤0.01). For endurance, there were correlations with SL (r=-0.67; p≤0.05), CAD (r=-0.72; p≤0.01), SV (r=-0.82; p≤0.01), ST (r=0.71; p≤0.01), and DS (r=0.90; p≤0.01). Multiple regression analysis revealed that DS was the only variable that predicted performance in both the agility (R2=0.82; p≤0.01) and the endurance (R2=0.81; p≤0.01) tests. Conclusions: It was observed that DS measure has a potential use as a kinematic parameter of gait that predicts the performance in agility and aerobic endurance tests in patients with idiopathic Parkinson's disease.125359365Christofoletti, G., Oliani, M.M., Gobbi, L.T.B., Gobbi, S., Stella, F., Risco de quedas em idosos com doença de Parkinson e demência de Alzheimer: Um estudo transversal. (2006) Rev Bras Fisioter, 10 (4), pp. 429-433Morris, M.E., Iansek, R., Matyas, T.A., Summers, J.J., Stride length regulation in Parkinson's disease: Normalization strategies and underlying mechanisms (1996) Brain, 119 (PART 2), pp. 551-568Morris, M.E., Huxham, F., Mcginley, J., Dodd, K., Iansek, R., The biomechanics and motor control of gait in Parkinson disease (2001) Clin Biomech, 16 (6), pp. 459-470Pieruccini-Faria, F., Menuchi, M.R.T.P., Vitório, R., Gobbi, L.T.B., Stella, F., Gobbi 4. S. Parâmetros cinemáticos da marcha com obstáculos em idosos com doença de Parkinson, com e sem efeito da Levodopa: Um estudo piloto. (2006) Rev Bras Fisioter, 10 (2), pp. 233-239Hirsch, M.A., Toole, T., Maitland, C.G., Rider, R.A., The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease (2003) Arch Phys Med Rehabil, 84 (8), pp. 1109-1117Herlofson, K., Larsen, J.P., The influence of fatigue on health-related quality of life in patients with Parkinson's disease (2003) Acta Neurol Scand, 107 (1), pp. 1-6Canning, C.G., Alison, J.A., Allen, N.E., Groeller, H., Parkinson's disease: An investigation of exercise capacity, respiratory function, and gait (1997) Arch Phys Med Rehabil, 78 (2), pp. 199-207Chien, S.L., Lin, S.Z., Liang, C.C., Soong, Y.S., Lin, S.H., Hsin, Y.L., The efficacy of quantitative gait analysis by the GAITRite system in evaluation of parkinsonian bradykinesia (2006) Parkinsonism Relat Disord, 12 (7), pp. 438-442Osness, W.H., Adrian, M., Clark, B., Hoeger, W., Raab, D., Wiswell, R., Functional fitness assessment for adults over 60 years: A field based assessment (1990) Reston: The American Alliance for Health, Physical Education, Recreation and Dance, pp. 5-18Zago, A.S., Gobbi, S., Valores normativos da aptidão funcional de mulheres de 60 a 70 anos. (2003) R Bras Ci Mov, 11 (2), pp. 77-86Lopes AG, Gurjão ALD, Oliani MM, Ferreira L, Corazza DI. Relação entre os níveis de capacidade funcional de idosos portadores de doença de parkinson e idosos saudáveis. IV congresso internacional de educação física e motricidade humana. Motriz. 2005;11(Supl 1): S7-S200Lopes, A.G., (2006) Efeitos do treinamento físico sobre o nível de atividade física e a capacidade funcional na doen&a de Parkinson, , dissertação, Rio Claro: Universidade Estadual Paulista;Fahn, S., Elton, R., Unified Parkinson's disease rating scale (1987) Recent developments in Parkinson's disease. Florham Park, pp. 153-164. , Fahn S, Marsden CD, Goldstein M, Calne DB Eds, NJ: Macmillan;Hoehn, M.M., Yahr, M.D., Parkinsonism: Onset, progression and mortality (1967) Neurology, 17 (5), pp. 427-442Figueroa, P.J., Leite, N.J., Barros, R.M.L., A flexible software for tracking of markers used in human motion analysis (2003) Comput Methods Programs Biomed, 72 (2), pp. 155-165Winter, D.A., (1991) The biomechanics and motor control of human gait: Elderly and pathological, , 2nd ed. Waterloo: University of Waterloo Press;Blin, O., Ferrandez, A.M., Serratrice, G., Quantitative analysis of gait in Parkinson's patients: Increased variability in stride length (1990) J Neurol Sci, 98 (1), pp. 91-97Morris, M.E., Matyas, T.A., Iansek, R., Summers, J.J., Temporal stability of gait in Parkinson's disease (1996) Phys Ther, 76 (7), pp. 763-780Phillips, J.G., Martin, K.E., Bradshaw, J.L., Iansek, R., Could bradyikinesia in Parkinson's disease simply be compensation? (1994) J Neurol, 241 (7), pp. 439-447Morris, M.E., Iansek, R., Matyas, T.A., Summers, J.J., The pathogenesis of gait hypokinesia in Parkinson's disease (1994) Brain, 117 (PART 5), pp. 1169-1181Silveira, C.R.A., (2007) Adaptação voluntária do andar em idosos com doença de Parkinson sob dica visual dinâmica, , dissertação, Rio Claro: Universidade Estadual Paulista;Demirci, M., Grill, S., McShane, L., Hallet, M., A mismatch between kinesthetic and visual perception in Parkinson's disease (1997) Ann Neurol, 41 (6), pp. 781-788Côté, L., Crutcher, M.D., (1991) The basal ganglia, , Kandel ER, Schwartz SH, Jessel TM. Principles of neural science. Norwalk, Connecticut: Apleton & Lange;Giladi, N., Shabtai, H., Rozenberg, E., Shabtai, E., Gait festination in Parkinson's disease (2001) Parkinsonism Relat Disord, 7 (2), pp. 135-138Berardelli, A., Rothwell, J.C., Thompson, P.D., Hallet, M., Pathophysiology of bradykinesia in Parkinson's disease (2001) Brain, 124 (PART 11), pp. 2131-2146Grillner, S., Hellgren, J., Ménard, A., Saitoh, K., Wikström, M.A., Mechanisms for selection of basic motor programs - roles for the striatum and pallidum (2005) Trends Neurosci, 28 (7), pp. 364-370Brown, L.A., Cooper, S.A., Doan, J.B., Dickin, D.C., Whishaw, I.Q., Pellis, S.M., Parkinsonian deficits in sensory integration for postural control: Temporal response to changes in visual input (2006) Parkinsonism Relat Disord, 12 (6), pp. 376-381Qutubuddin, A.A., Pegg, P.O., Cifu, D.X., Brown, R., McNamee, S., Carne, W., Validating the Berg Balance Scale for patients with Parkinson's disease: A key to rehabilitation evaluation (2005) Arch Phys Med Rehabil, 86 (4), pp. 789-792Franchignoni, F., Martignoni, E., Ferriero, G., Pasetti, C., Balance and fear of falling in Parkinson's disease (2005) Parkinsonism Relat Disord, 11 (7), pp. 427-433Zijlstra, W., Rutgers, A.W., Van Weerden, T.W., Voluntary and involuntary adaptation of gait in Parkinson's disease (1998) Gait Posture, 7 (1), pp. 53-63Schubert, M., Prokop, T., Brocke, F., Berger, W., Visual kinesthesia and locomotion in Parkinson's disease (2005) Mov Disord, 20 (2), pp. 141-15

Evaluating the Acute Contributions of Dopaminergic Replacement to Gait With Obstacles in Parkinson's Disease

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The influence of dopaminergic replacement (DR) on gait in people with Parkinson's disease (PD) is well documented. However, little is known about the acute effects of dopamine on more complex locomotor tasks that require visual guidance to avoid obstacles during gait. The authors investigated the influence of DR on locomotor behavior in a task where movement planning and control might be challenged by the height of the obstacle. The PD group included patients diagnosed with idiopathic PD (n = 12), as well as healthy controls (n = 12). Patients walked and stepped over obstacles of different heights before (OFF) and after (ON) levodopa intake. Spatial adjustments were not modulated by DR, but the step time to perform these anticipatory gait adjustments was longer only in PD-OFF (compared with healthy controls) when approaching the highest obstacle, but not PD-ON. During the crossing phase, trail limb toe clearance of PD patients was shorter than healthy controls only during the OFF state. ON-OFF comparisons were significantly different only for the time to reach the lead foot clearance over the highest obstacle. In summary, DR partially improved movement slowness but did not directly affect movement amplitude of lower limb regulation in this gait task.455369380Fundação para o Desenvolvimento da UNESP (FUNDUNESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2005/00775-6

Preditores espaço-temporais do andar para testes de capacidade funcional em pacientes com doença de Parkinson

OBJETIVOS: Determinar quais parâmetros espaço-temporais são preditores do andar de indivíduos com doença de Parkinson idiopática para os testes de resistência aeróbia e agilidade, propostos pela bateria de testes da American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD). MATERIAIS E MÉTODOS: Foram selecionados seis homens e seis mulheres com comprometimento e estágio da doença em níveis leve e moderado, que realizaram os testes de agilidade e resistência aeróbia, conforme o protocolo da AAHPERD, e andaram 8m sobre uma passarela. Uma câmera digital registrou uma passada central. Marcadores foram fixados no quinto metatarso e na face lateral do calcâneo do membro inferior direito e no primeiro metatarso e na face medial do calcâneo do membro inferior esquerdo. As variáveis dependentes selecionadas foram: tempo nos testes de agilidade e resistência e as variáveis cinemáticas (comprimento da passada - CP, cadência - CAD, duração da passada - DP, duração da fase de duplo suporte - DDS, duração do suporte simples - SS, duração da fase de balanço - DB e velocidade da passada - VP). RESULTADOS: Para agilidade, o teste de Pearson apontou correlação estatisticamente significativa entre as variáveis CP (r=-0,70; p<0,05), CAD (r=-0,72; p<0,01), VP (r=-0,83; p<0,01), DP (r=0,71; p<0,01) e DDS (r=0,90; p<0,01). Para resistência, houve correlação com as variáveis CP (r=-0,67; p<0,05), CAD (r=-0,72; p<0,01), VP (r=-0,82; p<0,01), DP (r=0,71; p<0,01) e DDS (r=0,90; p<0,01). A análise de regressão múltipla revelou que a DDS foi a única variável preditora dos testes de agilidade (R²=0,82; p<0,01) e resistência (R²=0,81; p<0,01). CONCLUSÕES: Observou-se o uso potencial da DDS como parâmetro espaço-temporal do andar preditor do desempenho dos testes de resistência aeróbia e agilidade em pacientes com doença de Parkinson idiopática.OBJECTIVE: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. METHODS: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test in accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The dependent variables selected were the time taken in the agility and endurance tests and the kinematic variables: stride length (SL), cadence (CAD), stride time (ST), double support time (DS), single support time (SS), swing time (SW) and stride velocity (SV). RESULTS: For agility, Pearson's test showed statistically significant correlations with SL (r=-0.70; p<0.05), CAD (r=-0.72; p<0.01), SV (r=-0.83; p<0.01), ST (r=0.71; p<0.01) and DS (r=0.90; p<0.01). For endurance, there were correlations with SL (r=-0.67; p<0.05), CAD (r=-0.72; p<0.01), SV (r=-0.82; p<0.01), ST (r=0.71; p<0.01), and DS (r=0.90; p<0.01). Multiple regression analysis revealed that DS was the only variable that predicted performance in both the agility (R²=0.82; p<0.01) and the endurance (R²=0.81; p<0.01) tests. CONCLUSIONS: It was observed that DS measure has a potential use as a kinematic parameter of gait that predicts the performance in agility and aerobic endurance tests in patients with idiopathic Parkinson's disease.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Visual cues and gait improvement in Parkinson's disease: which piece of information is really important?

Visual exproprioception refers to information of the body relative to the environment and may be the critical piece of sensory information that explains why gait improvements can be achieved with visual step cues in people with Parkinson's disease (PD). The primary aim of current study was to investigate the role of visual exproprioception in the positive effect of visual cues on gait in patients with PD. Nineteen individuals with PD and 15 healthy subjects participated in this study. Four conditions of self-paced gait were tested: normal walking, without exproprioception (exproprioceptive information of lower limbs removed), visual step length cues, and visual step length cues but without exproprioception. Gaze behavior, gait parameters and the accuracy and precision of foot placement on the visual cues were recorded. Individuals with PD improved step length in both cued conditions. Both groups fixated close to 46% on visual cues necessary to accomplish the next step (ongoing step), while 54% of fixations were focused on visual cues one or more steps ahead. Also, both groups increased absolute error and error variability of the foot placement around the visual cues without vision of their feet. These results suggest that exproprioceptive information is not critical to achieve step length and overall gait benefits with visual cues in PD, but is critical for the accuracy and precision of foot placement on targets. People with PD and healthy individuals use visual information from visual cues in both on-line and feedforward fashions. In conclusion, patients with PD likely focus attention on the discrete goal of each foot hitting a visual cue placed on the floor and then use the exteroceptive information (i.e. position of next foot placement location) to plan each step individually at a cortical level. (C) 2014 IBRO. Published by Elsevier Ltd. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

The motor deficits caused by Parkinson's disease are not able to block adjustments for a safe strategy during obstacle crossing in individuals with moderate disease

Abstract The aim of this study was to verify whether patients with Parkinson's disease (PD) are able to adjust their motor behavior according to restrictions imposed by the task instruction during walking with obstacle crossing. Eighteen elderly people (moderate motor compromise) with a diagnosis of PD walked on a pathway and cross an obstacle according to the following conditions: walking at preferred velocity; walking at maximum vertical elevation of the feet to cross the obstacle; walking at maximum step length to cross the obstacle; walking at maximum velocity. The modulations were directly related to the instructions provided to patients with PD before performing each task, which seems to indicate that attentional cues can influence and benefit strategies during obstacle crossing. In conclusion, patients with PD are able to adjust walking during obstacle crossing according to instructions given to them, which increases their safety