11 research outputs found
Falls and mobility in Parkinson's disease: protocol for a randomised controlled clinical trial
Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson\u27s disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group). Methods/Design People with idiopathic Parkinson\u27s disease who live at home will be recruited and randomly allocated to one of three groups. Each person shall receive therapy in an out-patient setting in groups of 3-4. Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks. All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase. Assessments will occur before therapy, after the 8 week therapy program, and at 3 and 12 months after the intervention. A falls calendar will be kept by each participant for 12 months after outpatient therapy. Consistent with the recommendations of the Prevention of Falls Network Europe group, three falls variables will be used as the primary outcome measures: the number of fallers, the number of multiple fallers and the falls rate. In addition to quantifying falls, we shall measure mobility, activity limitations and quality of life as secondary outcomes. Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson\u27s disease who live at home
Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinsonâs disease
Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined. Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD
InfluĂȘncia do fortalecimento muscular no equilĂbrio e qualidade de vida em indivĂduos com doença de Parkinson
This study aimed to evaluate the effect of muscle strengthening in the balance, mobility and quality of life (QoL) in individuals with Parkinson's disease (PD), and to check the correlation between muscle strengthening and QoL. Nine subjects belonging to both sexes, diagnosed with PD, participated in this study. Initially, they went through an evaluation of their balance and functional mobility through the Berg Balance Scale (BBS), the ÂTimed Up and Go (TUG) test, and a QoL test through the Parkinson's Disease Questionnaire (PDQ-39). The subjects also performed a test for determining the maximum load (one-repetition maximum) for the muscle groups trained. After the normality and homogeneity of the data were verified, the Student's t-test and Spearman correlation test were carried out. A significance level of p<0.05 was considered. We verified an improvement in balance (p=0.008) and QoL (p=0.013), and a negative correlation between balance and QoL (evaluation: r=-0.65 and p=0.05, revaluation: r=-0.82 and p=0.005). It was concluded that muscle strengthening was efficient in the improvement of balance and QoL in individuals with PD.Esse estudo teve como objetivo avaliar o Âefeito do fortalecimento muscular no equilĂbrio, mobilidade e na qualidade de vida (QV) de indivĂduos com doença de Parkinson (DP), e verificar a correlação entre fortalecimento muscular e qualidade de vida. Participaram do estudo nove sujeitos, de ambos os sexos, com diagnĂłstico mĂ©dico de DP. Eles, inicialmente, passaram por Âavaliação do equilĂbrio e da mobilidade funcional por meio da Escala de EquilĂbrio de Berg (EEB) e teste Timed Up and Go (TUG) e da QV pelo questionĂĄrio Parkinson's Disease Questionnaire (PDQ-39). Os sujeitos realizaram ainda o teste de determinação de carga mĂĄxima (1 RM) para os grupos musculares treinados. Depois de verificadas a normalidade e homogeneidade dos dados, foram realizados o teste t de Student e o teste de correlação de Spearman. Foi considerado nĂvel de significĂąncia de p<0,05. Foi verificada melhora no equilĂbrio (p=0,008) e na QV (p=0,013), e correlação negativa entre equilĂbrio e QV (avaliação r=-0,65 e p=0,05; e na reavaliação r=-0,82 e p=0,005). O Âfortalecimento muscular foi eficaz na melhora no equilĂbrio e na qualidade de vida de indivĂduos com doença de Parkinson.Este estudio tiene como objetivo evaluar el efecto del fortalecimiento muscular en el equilibrio, movilidad y en la calidad de vida (CV) de individuos con Enfermedad de Parkinson (EP), y verificar la correlaciĂłn entre el fortalecimiento muscular y calidad de vida. Participaron del estudio nueve sujetos, de ambos sexos, con diagnĂłstico mĂ©dico de EP. Inicialmente los sujetos pasaron por una evaluaciĂłn del equilibrio y la movilidad funcional por medio de la Escala de Equilibrio de Berg (EEB) y el test Timed Up and Go (TUG), y de la CV por el cuestionario Parkinson's Disease Questionnaire (PDQ-39). Los sujetos realizaron tambiĂ©n el test de determinaciĂłn de carga mĂĄxima (1 RM) para los grupos musculares entrenados. DespuĂ©s de verificar la normalidad y homogeneidad de los datos fue realizado el Test t de student y el test de correlaciĂłn de Spearman. Fue considerado nivel de significancia de p<0,05. Fue verificada una mejora en el Equilibrio (p=0,008) y en la CV (p=0,013), y correlaciĂłn negativa entre el equilibrio y CV (evaluaciĂłn r= -0,65 y p=0,05; y en la reevaluaciĂłn r=-0,82 p=0,005). El fortalecimiento muscular fue eficaz en la mejora del equilibrio y en la calidad de vida de individuos con enfermedad de Parkinson
Effect of Global Postural Rehabilitation program on spatiotemporal gait parameters of parkinsonian patients: a three-dimensional motion analysis study
The aim of the present study was to evaluate
the effects of a Global Postural Rehabilitation (GPR) program
on motor symptoms and gait parameters of patients
with Parkinsonâs disease (PD) by means of three-dimensional
motion analysis study. Ten subjects with clinical
diagnosis of PD were enrolled (study group). Age-, sexand
disease duration-matched PD patients were recruited as
a control group (no treatment). Three-dimensional motion
analysis was conducted by means of a stereophotogrammetric
system. After basal evaluation, the study group
underwent a specific rehabilitation program consisting of
individual 40 min GPR daily sessions, 3 days a week for 4
consecutive weeks. Neurological status and spatiotemporalgait parameters of the two groups were evaluated at study
entry (t0), at 4 weeks (t1, end of rehabilitation protocol) and
at 8 and 12 weeks (t2 and t3, follow-up evaluation). At
baseline evaluation, the two groups did not differ in clinical
features and gait parameters. At the end of rehabilitation
protocol (t1) and at follow-up evaluation (t2 and t3), a
significant improvement in temporal gait parameters and
UPDRS scores was observed in all treated patients as
compared to baseline and controls. Our preliminary findings
showed that significant improvements in mobility and
gait parameters of PD patients can be obtained through
GPR treatment, with a parallel improvement in clinical
status. Quantitative analysis of gait pattern can be considered
a useful tool to assess the efficacy of rehabilitation
interventions in patients affected by PD
Efeitos do exercĂcio fĂsico sobre o estado redox cerebral Effects of physical exercise over the redox brain state
A atividade fĂsica Ă© conhecida por promover saĂșde e bem-estar. O exercĂcio tambĂ©m Ă© responsĂĄvel por aumentar a produção de EspĂ©cies Reativas de OxigĂȘnio (ERO) pelo acrĂ©scimo do consumo de oxigĂȘnio mitocondrial nos tecidos. O desequilĂbrio entre a produção de EROs e as defesas oxidantes dos tecidos pode provocar danos oxidativos a proteĂnas, lipĂdios e DNA. O dano oxidativo cerebral Ă© um mecanismo etiopatolĂłgico comum da apoptose e da neurodegeneração. O fator de crescimento cĂ©rebro-derivado desempenha um importante papel neste contexto. Nesta revisĂŁo, apresentamos os resultados de diferentes modelos de exercĂcio fĂsico no metabolismo oxidativo e neurotrĂłfico do Sistema Nervoso Central (SNC). TambĂ©m revisamos estudos que utilizaram suplementação antioxidante para prevenir danos oxidativos exercĂcio-induzido ao SNC. Os modelos de exercĂcio fĂsico mais comuns foram as rodas de correr, a natação e a esteira com configuraçÔes de treinamento muito diferentes como a duração e a intensidade. Os resultados do treinamento fĂsico no tecido cerebral sĂŁo muito controversos, mas geralmente demonstram ganhos na plasticidade sinĂĄptica e na função cognitiva com exercĂcios de intensidade moderada e baixa.<br>Physical activity is known for promoting health and well-being. Exercise is also responsible for increasing the production of Oxygen Reactive Species (ORS) by increasing mitochondrial oxygen consumption causing tissue oxidative stress. The imbalance between ORS production and tissue antioxidant defenses can cause oxidative damage to proteins, lipids and DNA. Brain oxidative damage is a common etiopathology mechanism of apoptosis and neurodegeneration. The brain-derived neurotrophic factor plays an important role in this context. In this review, we showed the results of different models and configurations of physical exercise in oxidative and neurotrophic metabolism of the Central Nervous System (CNS). We also reviewed studies that utilized antioxidant supplementation to prevent exercise-induced oxidative damage to CNS. The commonest physical exercise models were running wheels, swimming and treadmill with very different configurations of physical training such as duration and intensity. The results of physical training on brain tissues are very controversial, but generally show improvement in synaptic plasticity and cognition function with low and moderate intensity exercises