Postural adjustments and biomechanics during gait initiation and obstacle negotiation: a cmparison between akinetic-rigid and hyperkinetic Parkinson’s disease

Individuals with Parkinson’s disease (PD) exhibit different combinations of motor symptoms. The most frequent subtypes are akinetic-rigid (AK-R) and hyperkinetic (HYP). Motor symptoms, such as rigidity and bradykinesia, can directly affect postural adjustments and performance in daily tasks, like gait initiation and obstacles negotiation, increasing the risk of falls and functional dependence. Objective: To compare postural adjustments and biomechanical parameters during the gait initiation and obstacle negotiation of people with AK-R and HYP PD and correlate with functional mobility and risk of falls. Methods: Cross-sectional study. Thirty-three volunteers with PD were divided into two groups according to clinical motor manifestations: AK-R (n = 16) and HYP (n = 17). We assessed the anticipatory (APA), compensatory (CPA) postural adjustments analyzing kinematic, kinetic and, electromyographic parameters during the gait initiation and obstacle negotiation tests. We applied independent T-tests and Pearson correlation tests for comparisons and correlations, respectively (α = 0.05). Results: In the APA phase of the gait initiation test, compared to the functional HYP group, the AK-R group showed shorter time for single support (p = 0.01), longer time for double support (p = 0.01) accompanied by a smaller first step (size, p = 0.05; height, p = 0.04), and reduced muscle activation of obliquus internus (p = 0.02). Similarly, during the first step in the obstacle negotiation test, the AK-R group showed less step height (p = 0.01) and hip excursion (p = 0.02), accompanied by a reduced mediolateral displacement of the center of pressure (p = 0.02) during APA, and activation of the gluteus medius (p = 0.02) and the anterior tibialis (p = 0.04) during CPA in comparison with HYP group. The findings suggest that people with AK-R present impaired postural adjustments during gait initiation and obstacles negotiation compared to hyperkinetic PD. Based on defined motor symptoms, the proposition presented here revealed consistent postural adjustments during complex tasks and, therefore, may offer new insights onto PD motor evaluation and neurorehabilitation

Effects of nordic walking on gait symmetry in mild Parkinson’s Disease

Individuals with Parkinson’s disease (PD) have gait asymmetries, and exercise therapy may reduce the differences between more and less affected limbs. The Nordic walking (NW) training may contribute to reducing the asymmetry in upper and lower limb movements in people with PD. We compared the effects of 11 weeks of NW aerobic training on asymmetrical variables of gait in subjects with mild PD. Fourteen subjects with idiopathic PD, age: 66.8 ± 9.6 years, and Hoehn and Yard stage of 1.5 points were enrolled. The kinematic analysis was performed pre and post-intervention. Data were collected at two randomized walking speeds (0.28 m·s−1 and 0.83 m·s−1) during five minutes on the treadmill without poles. The more affected and less affected body side symmetries (threshold at 5% between sides) of angular kinematics and spatiotemporal gait parameters were calculated. We used Generalized Estimating Equations with Bonferroni post hoc (α = 0.05). Maximal flexion of the knee (p = 0.007) and maximal abduction of the hip (p = 0.041) were asymmetrical pre and became symmetrical post NW intervention. The differences occurred in the knee was less affected and the hip was more affected. We concluded that 11 weeks of NW training promoted similarities in gait parameters and improved knee and hip angular parameters for PD subjects

Aquatic exercise associated or not with grape juice consumption-modulated oxidative parameters in Parkinson disease patients : a randomized intervention study

Parkinson's disease (PD) is a neurodegenerative disorder with significant motor disabilities and cognitive decline. Importantly, the imbalance of oxidative stress is related to PD physiopathology and progression. This study aimed to evaluate the impact of grape juice consumption associated with an aquatic exercise protocol on oxidative stress parameters and cognitive function in individuals with PD. The participants were randomized into two groups: grape juice group (GJG) and control group (CG) and were submitted to 4 weeks of an aquatic intervention (twice a week, approximately 60 minutes/session). The GJG also consumed 400 ml of grape juice per day (integral and conventional) during this period. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCa) questionnaire. For the analysis of oxidative stress markers, specifically lipid oxidative damage (TBARS), proteins (Carbonil), acid uric and the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase), blood collection were done before and after intervention. No changes were observed in cognitive function after intervention in both groups. Regarding biomarkers, a reduction of antioxidant enzymes, thiobarbituric acid reactive substances (TBARS) and uric acid was observed in both groups. However, only the GJG showed a significant reduction on protein oxidation levels after intervention. In conclusion, the consumption of grape juice associated with an aquatic exercise protocol might be consider an effective alternative to reduce the oxidative damage in PD, reinforcing the importance of this intervention in promoting beneficial impact in this population

Effect of Nordic Walking on anthropometric profile and body composition of subjects with Parkinson’s disease: randomized clinical trialen

Introdução: A doença de Parkinson (DP) é caracterizada por distúrbios motores, aumentando risco de quedas e inatividade física. Objetivo:Analisar perfil antropométrico e composição corporal, antes e após um programa de treinamento de caminhada nórdica (CN) e caminhada livre (CL). Métodos: Os 33 sujeitos foram randomizados em dois grupos experimentais: CL (n = 16) e CN (n = 17) para realização das 12 sessões de treinamento. Resultados: Relação cintura/quadril reduziu (2,2%, p = 0,022) para o CL. O somatório total das dobras cutâneas reduziu em 4,3% no grupo CN (p = 0,012), e 4,7% no grupo CL (p = 0,012), sem diferença entre os grupos. O período de treinamento não promoveu alterações significativas na massa corporal (p = 0,808), IMC (p = 0,392), nas massas magra (p = 0,834), gorda (p = 0,721) e óssea (p = 0,348), bem como nos percentuais de gordura (p = 0,887). Conclusão: O treinamento promoveu melhora antropométrica efetiva para ambos os grupos.Introduction: Parkinson’s disease (DP) is characterized by motor disorders, increasing risk of falls and physical inactivity. Objective: To analyze the anthropometric profile and body composition of subjects before and after participating in a Nordic Walking (NW) or Free Walking (FW) training program. Methods: A total of 33 patients were randomized into two experimental groups, NW (n = 16) and FW (n = 17), to perform the 12 training sessions. Results: Waist-hip ratio was reduced (2.2%, p = 0.022) for FW. The total number of skinfolds was reduced by 4.3% in the NW group (p = 0.012) and 4.7% in the FW group (p = 0.012). However, the training period did not promote significant changes in body mass (p = 0.808), in IMC (p = 0.392), lean mass (p = 0.834), adipose mass (p = 0.721) and bone mass (p = 0.348), nor in the percentages of adipose mass (p = 0.887) in any of the groups. Conclusion: The training promoted an effective anthropometric improvement for both groups

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements