Banca de DEFESA: LILIANE SANTOS DE VASCONCELLOS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : LILIANE SANTOS DE VASCONCELLOS
DATE: 28/02/2020
TIME: 14:30
LOCAL: AUDITÓRIO DO DEPTO DE FISIOTERAPIA
TITLE:

EEffects of a home-based exercise program on motor and non-motor symptoms of individuals with Parkinson's disease: a randomized clinical trial

KEY WORDS:

Rehabilitation, Movement Disorders, Strengthening program, Patient-Centered Care.

PAGES: 102
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Alterations present in trunk region seem to be related to symptoms of motor and non-motor nature, such as postural balance, gait and intestinal constipation (IC) in individuals with Parkinson's disease (PD); however, few studies have used physical exercises directed at this region. Objective: To evaluate the effects of a home-based exercise program on motor and non-motor symptoms of individuals with PD. Methodology: randomized controlled clinical trial, with a sample of 28 individuals with PD who presented symptoms of IC, deficits in postural balance and gait. Sample was randomly distributed into Experimental Group (EG, n = 14) and Control Group (CG, n = 14). Participants were assessed for outcome measures: bowel function - The Bowel Function in the Community and Bristol Scale; gait variables - Qualisys Motion Capture System®; variables of postural balance, through a force platform, and quality of life - Parkinson Disease Questionnaire-39 - PDQ-39. The protocol was carried out daily for three consecutive weeks. Control group performed simple activities: diaphragmatic breathing; stretching of the main muscle groups of the upper and lower limbs; myolymphokinetic exercises on the feet; and active exercises free of upper limbs. The EG performed the exercise protocol focused on the trunk region: abdominal strengthening; strengthening of the erector muscles of the spine; pelvic tilt exercises; and contraction of the pelvic floor muscles. Data analysis was performed using Analysis of Variance (ANOVA) mixed with repeated measures to compare outcome measures between groups and between initial assessment, reassessment and follow-up. Correlation tests were applied between the non-motor variable “IC” and motor variables “postural balance” and “gait”. The level of significance adopted was 5%. Results: Article 1 - Data from the The Bowel Function in the Community questionnaire did not show significant interaction time * group (F = 0.235; P = 0.746), with a difference in the outcome over time (F = 6.576; P = 0.005), with reduced scores in both groups, indicating improvement in the IC outcome. For the General Intestinal Habit, there was no time * group interaction (F = 0.396; P = 0.688), and the data showed no change in the outcome over time (F = 0.526; P = 0.588). In the Bristol Scale, there was no time * group interaction (F = 0.611; P = 0.538), with no change in the outcome over time (F = 0.440; P = 0.635), demonstrating the maintenance of the feces consistency. In PDQ-39, there was no time * group interaction for this outcome (F = 0.452; P = 0.621), and there was no change in quality of life over time (F = 0.376; P = 0.699). There was a moderate correlation between the questionnaire The Bowel Function in the Community and self-reported mobility (P = 0.032, r = 0.407). Article 2 - For gait speed, data showed that there was no significant interaction between time and group (F = 1.820; P = 0.179), with no change in the outcome over time (F = 0.207; P = 0.778). The same occurred for the outcomes: stride length (time * group: F = 0.179; P = 0.799; time: F = 0.694; P = 0.482); double support time (time * group: F = 2.483; P = 0.120; time: F = 0.612; P = 0.468); hip extension (time * group: F = 0.207; P = 0.800; time: F = 0.527; P = 0.583); knee range of motion (time * group: F = 1.810; P = 0.183; time: F = 2.243; P = 0.130); ankle range of motion (time * group: F = 4.153; P = 0.045; time: F =0.037; P = 0.880). Balance data could not be finalized, and therefore will not be presented. Conclusion: It can be inferred that the exercise protocol composed of stretches, myolymphokinetic exercises, and free active exercises (control group) has a similar influence to the protocol of exercises to strengthen the trunk and pelvic floor (experimental group) on the outcome of IC. And, although the kinematic gait variables did not show significant differences, the correlation found between the IC and the patients' self-reported mobility demonstrates the existing interaction between the motor and non-motor symptoms of these individuals.

BANKING MEMBERS:
Interna - 2212151 - ELIZABEL DE SOUZA RAMALHO VIANA
Externa à Instituição - LARISSA COUTINHO DE LUCENA - FACENE
Presidente - 2319151 - TATIANA SOUZA RIBEIRO