RESUMO

BACKGROUND: National projections about the increase in the elderly population over 60 years bring with it an increase in the number of people affected by Parkinson's Disease (PD), making it an important public health problem. Therefore, the establishment of effective strategies for intervention in people with PD needs to be more clearly investigated. OBJECTIVE: The study aimed to report the effectiveness of exercise on functional capacity and neurobiological mechanisms in people with PD. METHODS: This study is a critical review of the literature. RESULTS: The progressive death of dopaminergic neurons in the substantia nigra is described as one of the main physiological mechanisms manifested before PD, directly interfering with motor behavior. However, PD is not only related to motor symptoms, but also to cognitive, autonomic, and mood impairments. Such effects may be attenuated by pharmacological influence, but also evidence suggests that the implementation of regular physical exercise programs may exhibit potential benefits over PD. The synthesis and expression of monoaminergic neurotransmitters can act positively on motor disorders, as well as directly or indirectly influence the neuronal plasticity of the brain, restoring neuronal pathways previously affected. CONCLUSION: Physical exercise contributes effectively to the treatment of PD, and can play a preventive and maintenance role of physical fitness and mental health.

RESUMO

INTRODUCTION: Physical rehabilitation is commonly used in patients with Parkinson's disease (PD) to improve their health and alleviate the symptoms. OBJECTIVE: We compared the effects of three programs, strength training (ST), aerobic training (AT), and physiotherapy, on motor symptoms, functional capacity, and electroencephalographic (EEG) activity in PD patients. METHODS: Twenty-two patients were recruited and randomized into three groups: AT (70% of maximum heart rate), ST (80% of one repetition maximum), and physiotherapy (in groups). Subjects participated in their respective interventions twice a week for 12 weeks. The assessments included measures of disease symptoms (Unified Parkinson's Disease Rating Scale [UPDRS]), functional capacity (Senior Fitness Test), and EEG before and after 12 weeks of intervention. RESULTS: The PD motor symptoms (UPDRS-III) in the group of patients who performed ST and AT improved by 27.5% (effect size [ES]=1.25, confidence interval [CI]=-0.11, 2.25) and 35% (ES=1.34, CI=-0.16, 2.58), respectively, in contrast to the physiotherapy group, which showed a 2.9% improvement (ES=0.07, CI=-0.85, 0.99). Furthermore, the functional capacity of all three groups improved after the intervention. The mean frequency of the EEG analysis mainly showed the effect of the interventions on the groups (F=11.50, P=0.0001). CONCLUSION: ST and AT in patients with PD are associated with improved outcomes in disease symptoms and functional capacity.

Assuntos

RESUMO

OBJECTIVE: To evaluate the relationship between the quantitative results of functional and cognitive performance of patients with Parkinson's disease (PD) and disease severity; and to study the relationship between patients' functional and cognitive capacity and motor impairment (Unified Parkinson's Disease Rating Scale - UPDRS III). METHOD: Twenty-nine subjects clinically diagnosed with PD were classified into three groups according to disease severity using the modified Hoehn and Yahr Scale (H&Y). They were submitted to functional (Senior Fitness Test) and neuropsychological tests. Stepwise regression analysis showed a significant association between H&Y and upper limb strength (r² =0.30; p=0.005) and executive function (r² =0.37; p=0.004). In relation to UPDRS III, there was a significant association between lower limb strength (r² =0.27; p=0.010) and global cognitive status (r² =0.24; p=0.024). CONCLUSION: The implementation of simple tests of functional capacity associated with neuropsychological testing can help to assess disease severity and motor impairment, and can be used to monitor the response to treatment in PD.

Assuntos

RESUMO

Objective To evaluate the relationship between the quantitative results of functional and cognitive performance of patients with Parkinson's disease (PD) and disease severity; and to study the relationship between patients' functional and cognitive capacity and motor impairment (Unified Parkinson's Disease Rating Scale - UPDRS III). Method Twenty-nine subjects clinically diagnosed with PD were classified into three groups according to disease severity using the modified Hoehn and Yahr Scale (H&Y). They were submitted to functional (Senior Fitness Test) and neuropsychological tests. Stepwise regression analysis showed a significant association between H&Y and upper limb strength (r 2 =0.30; p=0.005) and executive function (r 2 =0.37; p=0.004). In relation to UPDRS III, there was a significant association between lower limb strength (r 2 =0.27; p=0.010) and global cognitive status (r 2 =0.24; p=0.024). Conclusion The implementation of simple tests of functional capacity associated with neuropsychological testing can help to assess disease severity and motor impairment, and can be used to monitor the response to treatment in PD. .

Objetivo Avaliar a relação entre resultados quantitativos do desempenho funcional e cognitivo de pacientes com doença de Parkinson (DP) e a gravidade da doença; estudar a relação entre a capacidade funcional e cognitiva dos pacientes e o comprometimento motor (Unified Parkinson's Disease Rating Scale - UPDRS III). Método Vinte e nove sujeitos diagnosticados clinicamente com DP foram classificados em três grupos de acordo com a gravidade da doença através da Escala de Hoehn & Yahr (H&Y) modificada, e submetidos a testes funcionais (Senior Fitness Test) e neuropsicológicos. As análises de regressão Stepwise mostraram associação significativa entre a gravidade da doença e a força de membros superiores (r 2 =0,30; p=0,005) e a função executiva (r 2 =0,37; p=0,004). Em relação ao comprometimento motor, houve associação significativa com a força de membros inferiores (r 2 =0,27; p=0,010) e com o estado cognitivo global (r 2 =0,24; p=0,024). Conclusão Testes simples de capacidade funcional associados a testes neuropsicológicos podem contribuir para a avaliação da gravidade e do comprometimento motor e podem ser utilizados para o acompanhamento da resposta ao tratamento da DP. .

Assuntos

RESUMO

CONTEXTO: Evidências demonstram benefícios para a saúde mental com o treinamento aeróbico orientado em percentuais do VO2max, indicando a importância dessa variável para a prática clínica. OBJETIVO: Validar um método para estimar o VO2max por meio de um protocolo submáximo em idosos com diagnóstico clínico de transtorno depressivo maior (DM) e doença de Parkinson (DP). MÉTODOS: A amostra foi composta por 18 pacientes (64,22 ± 9,92 anos; sete pacientes com DM e 11 com DP). Foram realizadas três avaliações: I) estadiamento da doença, II) mensuração direta de VO2max e III) teste de esforço submáximo. Foi realizada regressão linear para verificar a precisão de estimativa do VO2max estabelecido na ergoespirometria pelo VO2max predito no teste submáximo. Também foi analisada a concordância de Bland-Altman entre os procedimentos. RESULTADOS: A análise de regressão mostrou que os valores de VO2max estimados pelo protocolo submáximo associam-se com o VO2max medido, tanto no valor absoluto (R2 = 0,65; EPE = 0,26 ; p < 0,001) quanto no relativo (R2 = 0,56; EPE = 3,70; p < 0,001). A análise de concordância de Bland-Altman mostrou boa associação entre as duas medidas. CONCLUSÃO: O VO2max predito por meio do protocolo submáximo demonstrou satisfatória validade de critério e simples execução comparado à ergoespirometria.

BACKGROUND: Evidence has shown benefits for mental health through aerobic training oriented in percentage of VO2max, indicating the importance of this variable for clinical practice. OBJECTIVE: To validate a method for estimating VO2max using a submaximal protocol in elderly patients with clinically diagnosis as major depressive disorder (MDD) and Parkinson's disease (PD). METHODS: The sample comprised 18 patients (64.22 ± 9.92 years) with MDD (n = 7) and with PD (n = 11). Three evaluations were performed: I) disease staging, II) direct measurement of VO2max and III) submaximal exercise test. Linear regression was performed to verify the accuracy of estimation in VO2max established in ergospirometry and the predicted VO2max from the submaximal test measurement. We also analyzed the correlation between the Bland-Altman procedures. RESULTS: The regression analysis showed that VO2max values estimated by submaximal protocol associated with the VO2max measured, both in absolute values (R2 = 0.65; SEE = 0.26; p < 0.001) and the relative (R2 = 0.56; SEE = 3.70; p < 0.001). The Bland-Altman plots for analysis of agreement of showed a good correlation between the two measures. DISCUSSION: The VO2max predicted by submaximal protocol demonstrated satisfactory criterion validity and simple execution compared to ergospirometry.

Assuntos

RESUMO

BACKGROUND: Over the last 30 years, frontal EEG asymmetry has been investigated with regards to the study of emotion, motivation, and psychopathology. METHOD: We analyzed the frontal alpha asymmetry, depressive symptoms with a Beck Depression Inventory (BDI) and quality of life with a Short Form Health Survey-36® (SF-36®) in depressed (n=12), remitted (n=8) and non-depressed (n=7) elderly subjects. We also evaluated the correlation between the frontal EEG asymmetry and physical and mental aspects of SF-36®. RESULTS: The groups showed no difference regarding the frontal alpha asymmetry (F=0.37; p=0.69). Moreover, there was no significant correlation between frontal asymmetry and quality of life (mental and physical aspects). CONCLUSION: The results showed no evidence of a relationship between frontal asymmetry, quality of life and depression in the elderly. Future studies on frontal asymmetry should carefully consider the effects of age.

Assuntos