Comparing postural balance among older adults and Parkinson’s disease patients

The objective of this study was to compare postural balance among healthy older adults and Parkinson's disease (PD) patients during one-legged stance balance. We recruited 36 individuals of both sexes and divided them into two groups: healthy older adults (HG), and individuals with PD (PG). All the participants were assessed through a single-leg balance test, with eyes open, during 30 seconds (30 seconds of rest across trials) on a force platform. Balance parameters were computed from mean across trials to quantify postural control: center of pressure (COP) area and mean velocity in both directions of movement, anterior-posterior and medial-lateral. Significant differences between-group were reported for area of COP (P=0.002) and mean velocity in anterior-posterior direction (P=0.037), where poor postural control was related to PD patients rather than to healthy individuals. One-legged stance balance was a sensitive task used to discriminate poor postural control in Parkinson individuals

Impact of Parkinson’s disease in the performance of balance with different attentional demands

O objetivo deste estudo foi avaliar o equilíbrio de pacientes com doença de Parkinson (DP) na posição de tandem com os olhos abertos (OA), olhos fechados (OF) e em condição de dupla tarefa (DT). Trata-se de um estudo transversal composto por 19 indivíduos com DP nos estágios leve a moderado. Os pacientes foram avaliados em uma plataforma de força Biomec400. Os parâmetros analisados foram a área do centro de pressão dos pés (COP) e a amplitude e velocidade do COP nas direções anteroposterior (AP) e mediolateral (ML). Foram encontrados resultados estatisticamente significantes para amplitude AP e ML do COP e da área do COP, com valores maiores para as posições em tandem de OF e tandem com DT, quando comparados com a posição em tandem de OA. Os valores de velocidade média AP e ML foram maiores na posição em tandem de OF em comparação ao tandem de OA (p=0,009 e p=0), respectivamente. Concluiu-se que indivíduos com DP, quando submetidos a desafios cognitivos, comportam-se de forma semelhante à retirada do recurso visual no que diz respeito às alterações de equilíbrio. Isso reforça a necessidade de introduzir no plano terapêutico desses indivíduos atividades que requeiram o treino dessas habilidades.El propósito de este estudio fue evaluar el equilibrio de pacientes con enfermedad de Parkinson (DP) en la posición tándem con los ojos abiertos (OA), ojos cerrados (OC) y en condición de doble tarea (DT). Se trata de un estudio transversal, del cual participaron 19 personas con DP en etapas leve a moderada. Se evaluaron a los pacientes en una plataforma de fuerza Biomec400. Los parámetros evaluados fueron el área del centro de presión de los pies (COP) y la amplitud y velocidad del COP en las direcciones anteroposterior (AP) y mediolateral (ML). Se encontraron resultados estadísticamente significativos para la amplitud AP y ML del COP y del área del COP, con mayores valores para las posiciones tándem con OC y tándem en DT, en comparación a la posición tándem con OA. Los valores de la velocidad media AP y ML fueron mayores en la posición tándem de OC comparados a la tándem de OA (p=0,009 y p=0, respectivamente). Se concluye que los sujetos con DP, en el momento que se les sometieron a los desafíos cognitivos, se portaron de manera semejante cuando se les taparon los ojos en lo que se refiere a las alteraciones de equilibrio. Este resultado señala la necesidad de introducir en la fisioterapia de los pacientes con DP actividades que les exigen el entrenamiento de estas habilidades.This study aimed to evaluate the balance of Parkinson’s disease (PD) patients in Tandem stance with eyes open (EO), eyes closed (EC), and in dual task condition (DT). This is a cross-sectional study, composed of 19 individuals with mild to moderate PD. Patients were evaluated in a BIOMEC400 force platform. The parameters analyzed were: area of the foot center of pressure (COP), COP amplitude and speed, in the anteroposterior (AP) and mediolateral (ML) directions. We found statistically significant results for AP and ML amplitude of the COP and COP area, with higher values for the stances EC Tandem and DT Tandem, when compared with EO Tandem. The values of AP and ML average speed were higher in EC Tandem when compared with EO Tandem (P=0.009 and P=0.000), respectively. We concluded that, when individuals with PD undergo cognitive challenges, they behave as if they were with eyes closed regarding balance changes. This reinforces the need to introduce, in the therapeutic plan of these individuals, activities that require the practice of these skills

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

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

Comparing postural balance among older adults and Parkinson's disease patients

ABSTRACT The objective of this study was to compare postural balance among healthy older adults and Parkinson's disease (PD) patients during one-legged stance balance. We recruited 36 individuals of both sexes and divided them into two groups: healthy older adults (HG), and individuals with PD (PG). All the participants were assessed through a single-leg balance test, with eyes open, during 30 seconds (30 seconds of rest across trials) on a force platform. Balance parameters were computed from mean across trials to quantify postural control: center of pressure (COP) area and mean velocity in both directions of movement, anterior-posterior and medial-lateral. Significant differences between-group were reported for area of COP (P=0.002) and mean velocity in anterior-posterior direction (P=0.037), where poor postural control was related to PD patients rather than to healthy individuals. One-legged stance balance was a sensitive task used to discriminate poor postural control in Parkinson individuals