Parkinson's Disease (PD) is a late-onset neurodegenerative disease characterized by progressive motor dysfunction caused by a loss of dopaminergic neurons for which there is no known cure. Among the most common genetic causes of PD are mutations in the leucine-rich repeat kinase 2 gene (LRRK2), encoding a multi-domain protein with kinase activity. The LRRK2 G2019S mutation causes hyperactivity of the kinase domain and is the most frequent LRRK2 mutation in patients with familial PD, though its role in PD pathology remains unclear. Preliminary data from the lab of our collaborator, Dr. David Park, demonstrated through a genetic screen in Drosophila melanogaster that the deletion of rbp9 encoding an RNA-binding protein prevented pathology induced by PD-relevant mutations in the LRRK2 kinase domain. The neuronal homolog of RBP9 in humans is HuD, a member of the Hu family of RNA-binding proteins that regulates the expression of many transcripts involved in neuronal development, plasticity, and survival. In addition, HuD has been shown to modify the age-at-onset or risk of developing PD. Here, we studied the effect of LRRK2 on the post-transcriptional regulation of mRNAs bound by HuD in the context of PD. Our findings showed that HuD is a substrate for LRRK2 phosphorylation in vitro, and that LRRK2 G2019S hyperphosphorylates HuD. We demonstrated that LRRK2 kinase activity is required for the binding of several transcripts by HuD that encode PD-relevant proteins such as α-synuclein and neuronal survival factor BDNF. Our findings in human neuroblastoma cells indicated that LRRK2 regulates the protein levels of HuD mRNA targets α-synuclein and BDNF in a mechanism that can by modified by HuD. Finally, we showed that the combination of HuD knockout with LRRK2 G2019S expression in mice rescues aberrant expression of HuD targets in mice with only the LRRK2 G2019S mutation or the knockout of HuD alone. Together, our findings demonstrate that LRRK2 affects the post-transcriptional regulation of HuD-bound mRNAs, and suggest the use of HuD as a potential therapeutic target in patients with PD caused by the LRRK2 G2019S mutation.

Submitted by DIEGO ORCIOLI DA SILVA null (diego_orcioli@hotmail.com) on 2016-01-26T20:23:30Z No. of bitstreams: 1 Dissertação_Orcioli-Silva.pdf: 2125935 bytes, checksum: 70f39e06a5152e7798496d596456cdd6 (MD5) / Approved for entry into archive by Sandra Manzano de Almeida (smanzano@marilia.unesp.br) on 2016-01-27T12:18:10Z (GMT) No. of bitstreams: 1 orciolisilva_d_me_rcla.pdf: 2125935 bytes, checksum: 70f39e06a5152e7798496d596456cdd6 (MD5) / Made available in DSpace on 2016-01-27T12:18:10Z (GMT). No. of bitstreams: 1 orciolisilva_d_me_rcla.pdf: 2125935 bytes, checksum: 70f39e06a5152e7798496d596456cdd6 (MD5) Previous issue date: 2015-12-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: A presente dissertação de mestrado é composta por dois estudos. O Estudo 1 analisou e comparou a influência do aumento da complexidade do ambiente nos parâmetros cinemáticos e cinéticos do andar de idosos com doença de Parkinson (DP) e idosos neurologicamente sadios. O Estudo 2 analisou e comparou a assimetria do andar de idosos com DP e idosos neurologicamente sadios em ambientes com múltiplos obstáculos. Materiais e método: A amostra do estudo foi composta por 38 idosos, sendo 19 idosos com DP e 19 idosos sadios. A tarefa experimental consistiu em andar em velocidade preferida nas seguintes condições: sem ultrapassagem de obstáculo; com ultrapassagem de um obstáculo; com ultrapassagem de dois obstáculos a 108cm de distância entre eles (Estudo 1), ainda, no Estudo 2 foi acrescentada a condição com ultrapassagem de dois obstáculos a 50cm de distância entre eles. No Estudo 1, a ultrapassagem foi realizada com o membro inferior direito e, no Estudo 2, com ambos os membros inferiores. Para o andar sem obstáculo, foi analisada a passada central. Nas condições com obstáculo(s) foram analisadas as fases de aproximação e ultrapassagem, sendo que, na condição com dois obstáculos, a análise foi realizada apenas para o primeiro obstáculo. No Estudo 1 foram analisados os parâmetros cinemáticos e cinéticos do andar e no Estudo 2 foi calculado o Índice de Assimetria para cada variável do andar. Resultados: Estudo 1: os idosos diminuíram o comprimento da passada nas condições com 1 e 2 obstáculos e, na condição com 2 obstáculos, aumentaram a duração da passada. Ainda, os idosos com DP diminuíram a porcentagem em suporte simples e aumentou o duplo suporte em ambas as condições com obstáculos. Na fase de ultrapassagem, a presença de 2 obstáculos no andar exigiu ajustes cinemáticos e cinéticos (menor comprimento e velocidade do passo, menor distância horizontal e vertical entre o pé e o obstáculo e menor impulso horizontal de frenagem) mais acentuados comparado às outras condições. Estudo 2: os idosos com DP aumentaram a assimetria na fase de aproximação, especialmente nas variáveis temporais do passo (duração e fase de balanço do passo), nas condições com múltiplos obstáculos. Na fase de ultrapassagem, os idosos com DP apresentaram maior assimetria na distância vertical do pé para o obstáculo. Conclusão: Os idosos realizam ajustes nos parâmetros do andar em ambientes com obstáculos. Devido à maior exigência motora, atencional e sensorial do ambiente com múltiplos obstáculos, os idosos aumentaram a duração da passada na fase de aproximação, demonstrando a necessidade de mais tempo para processar as informações do ambiente. Contudo, devido aos déficits na integração sensório-motora e comprometimentos motores dos idosos com DP, o andar em ambientes mais complexos é mais prejudicial para essa população, exacerbando a bradicinesia e a hipometria. Por fim, os idosos com DP apresentam maior assimetria no andar quando comparados a idosos sadios em ambiente com múltiplos obstáculos, principalmente na fase de aproximação. / Introduction: This dissertation consists of two studies. Study 1 investigated the influence of environmental complexity on kinematic and kinetic parameters of gait in people with Parkinson's disease (PD) and healthy older adults. Study 2 compared gait asymmetry between people with (PD) and healthy older adults while walking on an environment with multiple obstacles. Materials and method: Thirty-eight older adults (19 patients with PD and 19 healthy individuals) participated in the study. The experimental task required participants to walk at preferred speed under the following conditions: free (regular) walking, avoiding one obstacle, avoiding two obstacles placed 108cm apart (Study 1); in the Study 2, another experimental condition was added: avoiding two obstacles placed 50cm apart. In the Study 1, obstacle avoidance was performed with the right limb as the leading limb, while both limbs were used as the leading limb for the Study 2. For free walking condition, the stride cycle performed in the central area of the pathway was considered for analysis. For conditions with two obstacles, outcome measures included calculations related to the first obstacle only, considering both approach and crossing phases. In the Study 1, we calculated kinematic and kinetic parameters of walking; in the Study 2, we calculated the asymmetry index for each outcome measure. Results: Study 1: both people with PD and healthy individuals decreased the stride length while approaching obstacles (one or two) and increased stride duration while approaching two obstacles. Also, people with PD decreased the percentage of time spent in single support and increased the time spent in double support in both condition with one and two obstacles. For the crossing phase, the presence of 2 obstacles in the pathway required more evident kinematic and kinetic adjustments (decreases were observed for step length, step velocity, horizontal and vertical distances from the feet to the obstacle, and horizontal braking impulse) in comparison to the other experimental conditions. Study 2: people with PD increased asymmetry of walking in the approach phase, especially for temporal outcomes (step duration and swing phase) in the conditions with multiple obstacles. For the crossing phase, people with PD demonstrated higher asymmetry values than healthy older adults for toe clearance. Conclusion: both people with PD and healthy individuals were able to adapt walking behavior when faced with environmental constraints induced by obstacles. Due to increased attentional and sensorimotor requirements to succeed while walking in environments with multiple obstacles, both people with PD and healthy participants increased stride duration in the approach phase, suggesting that additional time is necessary to process information from the environment in this situation. However, due to deficits in sensorimotor integration and motor impairments of PD, walking in more complex environments is more harmful to patients with PD, exacerbating bradykinesia and hypometria. Lastly, people with PD demonstrated higher asymmetry of walking than healthy individuals in environment with multiple obstacles, especially in the approach phase. / FAPESP: 2013/27032-0

abstract: Parkinson's disease is a neurodegenerative condition diagnosed on patients with clinical history and motor signs of tremor, rigidity and bradykinesia, and the estimated number of patients living with Parkinson's disease around the world is seven to ten million. Deep brain stimulation (DBS) provides substantial relief of the motor signs of Parkinson's disease patients. It is an advanced surgical technique that is used when drug therapy is no longer sufficient for Parkinson's disease patients. DBS alleviates the motor symptoms of Parkinson's disease by targeting the subthalamic nucleus using high-frequency electrical stimulation. This work proposes a behavior recognition model for patients with Parkinson's disease. In particular, an adaptive learning method is proposed to classify behavioral tasks of Parkinson's disease patients using local field potential and electrocorticography signals that are collected during DBS implantation surgeries. Unique patterns exhibited between these signals in a matched feature space would lead to distinction between motor and language behavioral tasks. Unique features are first extracted from deep brain signals in the time-frequency space using the matching pursuit decomposition algorithm. The Dirichlet process Gaussian mixture model uses the extracted features to cluster the different behavioral signal patterns, without training or any prior information. The performance of the method is then compared with other machine learning methods and the advantages of each method is discussed under different conditions. / Dissertation/Thesis / Masters Thesis Electrical Engineering 2015

Background: Parkinson’s disease (PD) is a neurodegenerative disorder that causes distinct motor impairments (i.e., resting tremor, bradykinesia, rigidity, postural instability) and affects approximately one percent of the global population over the age of 60 years. Currently, there is no cure and diagnosis remain challenging due to the lack of well validated biomarkers. Prodromal PD is a phase that predates the onset of motor symptoms but includes brain changes and nonmotor symptoms, such as rapid eye movement sleep behaviour disorder (RBD) and hyposmia. Diffusion tensor imaging (DTI) provides non-invasively acquired metrics of microstructural changes in white matter and subcortical tissue and has potential as a biomarker for PD. To date, most DTI studies have focused on the clinical phase of PD. Investigating potential biomarkers in the prodromal phase of the disease is key for early diagnosis and treatment. This study had two primary objectives: (1) to investigate how white matter microstructure changes in different phases of PD progression, and (2) to investigate how sleep and motor symptoms relate to white matter microstructure in different phases of PD. Methods: All study data were downloaded from the Parkinson’s Progression Markers Initiative database. Subjects included 21 heathy controls (mean age=68.17±4.69; 6 female), 20 individuals with prodromal PD (14 with RBD and 6 with hyposmia) (mean age=67.95±5.90; 6 female), and 17 individuals with clinical PD (mean age=67.69±5.97; 6 female) (at baseline and one-year later). Tract based spatial statistics were used to determine between group differences in fractional anisotropy (FA) and mean diffusivity (MD) at the whole brain level and in a region of interest (ROI), the substantia nigra. The relationship between sleep or motor symptoms and DTI metrics were investigated within each group. Results: There were no differences between the groups in age, education level, or cognitive scores. Clinical PD had significantly higher motor symptoms than healthy controls or prodromal PD, and this significantly increased from baseline to one-year later. Between group comparisons showed increased MD (reflecting increased neurodegeneration) in prodromal PD relative to clinical PD (both at baseline and one-year later), while there were no group differences between either prodromal or clinical PD and healthy controls at the whole brain level or within the ROI. Increased motor symptoms were associated with neurodegeneration (i.e., decreased FA and increased MD) for healthy controls, while increased sleep symptoms were associated with decreased MD for clinical PD. Conclusion: This was the first to study of white matter microstructure differences in a mixed prodromal PD group relative to clinical PD. The detected early brain changes may support an RBD subtype of PD with overall different pattern of neurodegeneration. However, these results are preliminary and future studies must be conducted to clarify and expand upon the microstructural differences between prodromal and clinical PD, ideally with longitudinal follow-up. / Graduate / 2019-07-27

Orientador: Lilian Teresa Bucken Gobbi / Banca: Renato de Moraes / Banca: Luciane Aparecida Pascucci Sande de Souza / Resumo: Este estudo teve como objetivo analisar o comportamento locomotor de pacientes com DP na tarefa de subir e descer degraus. Para isso, dois estudos foram desenvolvidos. Estudo 1: objetivou verificar, por meio de análise qualitativa, a percepção subjetiva de facilidade/dificuldade para subir e descer degraus, a frequência de uso de escadas, o tipo de escadas utilizadas no dia a dia, a frequência de quedas neste ambiente e a relação entre a facilidade/dificuldade percebida para subir e descer degraus, o nível de atividade física, o estágio e comprometimento da DP. Participaram deste estudo 50 pacientes com DP, nos estágios leve e moderado da escala de Hohen e Yahr. Após avaliação clínica, foram aplicados 2 questionários: 1) questionário diagnóstico, com perguntas abertas e fechadas, que buscou investigar sobre o uso de escadas no dia a dia e o número de quedas (NQ) por pacientes com DP. 2). Questionário de Baecke Modificado para Idosos, para avaliar o nível de atividade física (NAF) dos pacientes. Os dados foram tratados através de porcentagem de ocorrência, teste de correlação de Spearman e regressão linear múltipla. Os resultados do Estudo 1 indicaram que pacientes com DP percebem a descida dos degraus como mais desafiadora e, que o nível de atividade física e a incidência de quedas influenciam a percepção de facilidade/dificuldade para subir (R2= 0,260; p=0,001; NAF/β= -0,313; p=0,016; NQ/β= 0,393; p=0,003) e para descer (R2= 0,233; p=0,002; NAF/β= -0,386; p=0,004; NQ/β= 0,279; p=0,034) degraus. Estudo 2: objetivou analisar o comportamento locomotor, por meio de análise cinemática e cinética, na tarefa de subir e descer degraus; indicar as principais diferenças no comportamento das forças externas de reação do solo, verticais e ântero-posteriores, entre as duas tarefas; identificar a estratégia de uso do corrimão... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of this study was to analyze the locomotor behavior of people with Parkinson's disease (PD) in the task of going up and down stairs. Two studies were conducted to achieve this purpose. Study 1 aimed to verify, through qualitative analysis, the subjective perception of facility/difficulty to go up and down stairs, the frequency of stairs utilization, the stairs features the patients used every day, the falls frequency in this environment and the relationship among the perceived facility/difficulty to go up and down stairs, the physical activity level and the PD stage and impairment. Fifty people with PD (mild and moderate levels in the Hohen and Yahr rating scale) participated in Study 1. After clinic assessment, participants answered two questionnaires: (1) An assessment questionnaire with open and closed questions to investigate the everyday stairs utilization and the falls incidence (FI), and (2) the modified Baecke questionnaire for older people to assess the physical activity level (PAL). The data were treated by the occurrence percentage, Spearman correlation test and multiple regression analyses. The results revealed that people with PD perceived more challenging going down stairs than up stairs and the physical activity level and the falls incidence affected the perception of facility/difficulty to go up (R2= 0.260; p=0.001; NAF/β= -0.313; p=0.016; NQ/β= 0.393; p=0.003) and down (R2= 0.233; p=0.002; NAF/β= -0.386; p=0.004; NQ/β= 0.279; p=0.034) stairs. Study 2 aimed to analyze the locomotor features using kinematic and kinetic tools while going up and down stairs, to indicate the major differences in the behavior of the ground reaction external forces, verticals and anterior-posteriors, between the two tasks; to identify the strategy of handrail use and the perceived facility/difficulty in going up and down stairs, and to observe the relationship... (Complete abstract click electronic access below) / Mestre

Orientador: Lourenço Chacon Jurado Filho / Banca: Clélia Cândida Abreu Spinardi Jubran / Banca: Leda Verdiani Tfouni / Resumo: Tendo como base as freqüentes hesitações nos enunciados falados de sujeitos afetados pela doença de Parkinson, predominantemente atribuídas pela literatura biomédica a limitações orgânicas impostas pela doença, nossa proposta foi investigar aspectos do funcionamento hesitativo de tais sujeitos. Extraímos os dados de uma sessão de conversação entre um sujeito parkinsoniano (NL) e um documentador (JN). Partindo da concepção de que as hesitações são marcas das negociações do sujeito com os outros constitutivos do (seu) discurso, detectamos 48 marcas hesitativas que apresentavam um aspecto peculiar: a tensão em um elemento fonético-fonológico. Pela análise dos 48 enunciados que continham as marcas, observamos, em primeiro lugar, a presença desse elemento fonético-fonológico tensionado em palavras presentes nos trechos que sucediam ou, simultaneamente, antecediam e sucediam as marcas hesitativas. Observamos, ainda, que a tensão provocada por essa repetição se mostrou fortemente vinculada a outros tipos de tensões - que remetiam tanto a elementos de outros planos da língua, além do fonético-fonológico, quanto a elementos do processo discursivo. Com relação aos planos da língua, sobretudo o semântico se mostrou vinculado com o fonético-fonológico. Já com relação ao processo discursivo, levantamos indícios de que o funcionamento hesitativo que denominamos deslizamentos em contexto fonético-fonológico recorrente escancara negociações relacionadas a diferentes elementos das condições de produção do discurso, tais como o das imagens que se fazem de si os protagonistas do processo e a dominância de objetos discursivos. Com relação aos objetos discursivos dominantes no processo analisado, identificamos: (a) doença; (b) família; (c) trabalho; e (d) estudo. Quando os dois primeiros objetos se mostravam em dominância, observamos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Considering the frequent hesitations on the utterance of individuals with Parkinson's disease, mainly related by the biomedical literature to organical impairment ruled by the disease, our purpose was to investigate the aspects of hesitative functioning of those individuals. Data were extracted of a conversation session between a parkinsonian individual (NL) and a documenter (JN). Thinking the hesitations as marks of the individual's negotiations with the constructing others of (his) discourse, 48 hesitating marks were found presenting a peculiar aspect: the stress in an phonetic-phonologic element. Through the analysis of the 48 utterances that contained the marks, we observed, on first place, the presence of this phoneticphonologic element that was in stress in words that succeeded or, simultaneously, preceded and succeeded the hesitating marks. We observed, yet, that the stress caused by this repetition showed itself strongly linked to other kinds of stress - that referred to both elements of other plans of language, besides phonetic-phonologic, and to elements of the discoursive process. Regarding other plans of language, mainly the semantic one showed itself linked to the phonetic-phonologic one. But, regarding the discoursive process, we observed that the hesitative functioning we called repeteadly phonetic-phonologic context slidings highlights negotiations related to different elements of the discourse production conditions, such as the images that the protagonists of the process make of themselves and the dominance of discoursive objects. In relation to objects in the dominant discourse analysis, we identified: (a) disease, (b) family, (c) work and (d) study. When the first two objects were in dominance, it was observed that NL was predominantly through by the image of ill subject, whereas, when the objects "work" and "study" predominated, emerged... (Complete abstract click electronic access below) / Mestre

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-10-06T18:37:17Z No. of bitstreams: 1 TeseCRP.pdf: 16817329 bytes, checksum: caeccc84696f23e07efee854d9bff6f5 (MD5) / Approved for entry into archive by Ronildo Prado (bco.producao.intelectual@gmail.com) on 2018-01-25T16:33:17Z (GMT) No. of bitstreams: 1 TeseCRP.pdf: 16817329 bytes, checksum: caeccc84696f23e07efee854d9bff6f5 (MD5) / Approved for entry into archive by Ronildo Prado (bco.producao.intelectual@gmail.com) on 2018-01-25T16:33:26Z (GMT) No. of bitstreams: 1 TeseCRP.pdf: 16817329 bytes, checksum: caeccc84696f23e07efee854d9bff6f5 (MD5) / Made available in DSpace on 2018-01-25T16:41:48Z (GMT). No. of bitstreams: 1 TeseCRP.pdf: 16817329 bytes, checksum: caeccc84696f23e07efee854d9bff6f5 (MD5) Previous issue date: 2017-07-26 / Não recebi financiamento / Currently, it is not a trivial task to point out a test that can diagnose accurately enough a patient with Parkinson’s Disease, as well as it is quit difficult to assess the level of the disease. Experts recommend the application of different types of tests, many of them based on signs and biomedical imaging, such as electroencephalogram, computed tomography and magnetic resonance to aid the detection of the disease process, since as the age ranges, symptoms such as fatigue and weakness can hide diagnosis. In order to provide a more effective clinical information to doctors aiming at diagnosis with greater confidence, methodologies to perform the fusion of different imaging modalities have become increasingly popular and promising. Recently, the use of forms containing some activities using a biometric pen with multi-sensors have been applied for the detection of Parkinson’s Disease by means of handwriting analysis. However, information derived from the scanned image of the form itself, and the one obtained by same pen have not been used together for this purpose. Thus, this proposal aims using pattern recognition techniques and image processing aimed at using the information from the form together with data from the pen. We believe a possible improvement in the medical diagnosis of Parkinson’s Disease can be archived. Another contribution of this proposal, is the design of a multimodal database to aid in the diagnosis of Parkinson’s Disease. / Atualmente, não é uma tarefa trivial apontar um exame que possa diagnosticar com precisão suficiente um paciente com mal de Parkinson, tendo como ponto importante também, após a constatação da enfermidade, a análise do nível da mesma. Especialistas recomendam a aplicação de diferentes tipos de exames, muitos deles baseados em sinais e imagens biomédicas, tais como eletroencefalograma, tomografia computadorizada e ressonância magnética para auxiliar no processo de detecção da doença, já que a faixa etária elevada e sintomas como cansaço e fraqueza podem ocultar o diagnóstico. Com o intuito de prover informações mais eficazes propiciando aos médicos um diagnóstico com maior confiança, metodologias para realizar a fusão entre diferentes modalidades de imagens tem se tornado cada vez mais populares e promissoras. Recentemente, a utilização de formulários contendo algumas atividades utilizando como ferramenta para o seu preenchimento uma caneta biométrica com multi-sensores tem sido aplicada para detecção do mal de Parkinson, efetuando o registro adquirido para análise da escrita. Entretanto, as informações oriundas da própria imagem digitalizada do formulário, bem como as mesmas obtidas pela caneta, ainda não foram utilizadas em conjunto para este fim. Desta forma, a presente proposta de tese de doutorado objetiva a utilização de técnicas de reconhecimento de padrões e processamento de imagens visando utilizar as diferentes informações provenientes do preenchimento do formulário em conjunto com dados provenientes da caneta, visando uma possível melhora no processo de auxílio ao diagnóstico médico do mal de Parkinson. Uma outra contribuição do trabalho é a criação de uma base de dados multimodal para o auxílio ao diagnóstico do mal de Parkinson.

Made available in DSpace on 2014-06-11T19:22:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-12-09Bitstream added on 2014-06-13T19:28:18Z : No. of bitstreams: 1 teixeiraarroyo_c_me_rcla.pdf: 2571699 bytes, checksum: 30bfe0b8c13e9a64db4ab400e27f7271 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Este estudo teve como objetivo analisar o comportamento locomotor de pacientes com DP na tarefa de subir e descer degraus. Para isso, dois estudos foram desenvolvidos. Estudo 1: objetivou verificar, por meio de análise qualitativa, a percepção subjetiva de facilidade/dificuldade para subir e descer degraus, a frequência de uso de escadas, o tipo de escadas utilizadas no dia a dia, a frequência de quedas neste ambiente e a relação entre a facilidade/dificuldade percebida para subir e descer degraus, o nível de atividade física, o estágio e comprometimento da DP. Participaram deste estudo 50 pacientes com DP, nos estágios leve e moderado da escala de Hohen e Yahr. Após avaliação clínica, foram aplicados 2 questionários: 1) questionário diagnóstico, com perguntas abertas e fechadas, que buscou investigar sobre o uso de escadas no dia a dia e o número de quedas (NQ) por pacientes com DP. 2). Questionário de Baecke Modificado para Idosos, para avaliar o nível de atividade física (NAF) dos pacientes. Os dados foram tratados através de porcentagem de ocorrência, teste de correlação de Spearman e regressão linear múltipla. Os resultados do Estudo 1 indicaram que pacientes com DP percebem a descida dos degraus como mais desafiadora e, que o nível de atividade física e a incidência de quedas influenciam a percepção de facilidade/dificuldade para subir (R2= 0,260; p=0,001; NAF/β= -0,313; p=0,016; NQ/β= 0,393; p=0,003) e para descer (R2= 0,233; p=0,002; NAF/β= -0,386; p=0,004; NQ/β= 0,279; p=0,034) degraus. Estudo 2: objetivou analisar o comportamento locomotor, por meio de análise cinemática e cinética, na tarefa de subir e descer degraus; indicar as principais diferenças no comportamento das forças externas de reação do solo, verticais e ântero-posteriores, entre as duas tarefas; identificar a estratégia de uso do corrimão... / The aim of this study was to analyze the locomotor behavior of people with Parkinson’s disease (PD) in the task of going up and down stairs. Two studies were conducted to achieve this purpose. Study 1 aimed to verify, through qualitative analysis, the subjective perception of facility/difficulty to go up and down stairs, the frequency of stairs utilization, the stairs features the patients used every day, the falls frequency in this environment and the relationship among the perceived facility/difficulty to go up and down stairs, the physical activity level and the PD stage and impairment. Fifty people with PD (mild and moderate levels in the Hohen and Yahr rating scale) participated in Study 1. After clinic assessment, participants answered two questionnaires: (1) An assessment questionnaire with open and closed questions to investigate the everyday stairs utilization and the falls incidence (FI), and (2) the modified Baecke questionnaire for older people to assess the physical activity level (PAL). The data were treated by the occurrence percentage, Spearman correlation test and multiple regression analyses. The results revealed that people with PD perceived more challenging going down stairs than up stairs and the physical activity level and the falls incidence affected the perception of facility/difficulty to go up (R2= 0.260; p=0.001; NAF/β= -0.313; p=0.016; NQ/β= 0.393; p=0.003) and down (R2= 0.233; p=0.002; NAF/β= -0.386; p=0.004; NQ/β= 0.279; p=0.034) stairs. Study 2 aimed to analyze the locomotor features using kinematic and kinetic tools while going up and down stairs, to indicate the major differences in the behavior of the ground reaction external forces, verticals and anterior-posteriors, between the two tasks; to identify the strategy of handrail use and the perceived facility/difficulty in going up and down stairs, and to observe the relationship... (Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:22:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-09Bitstream added on 2014-06-13T20:49:31Z : No. of bitstreams: 1 vitorio_r_me_rcla.pdf: 738679 bytes, checksum: f6658463b86c0d4b2c523cc21a93e6bb (MD5) / Pouco é conhecido sobre o andar de pacientes com doença de Parkinson (DP) em terrenos irregulares. Ainda, nenhum estudo abordou o controle visual na tarefa de ultrapassar obstáculo em pacientes com DP. Assim, o objetivo do estudo foi analisar o papel da visão no controle locomotor durante a ultrapassagem de obstáculos de diferentes alturas em idosos com DP e idosos sadios. Participaram 12 idosos com DP, classificados entre os estágios 1 e 2,5 da escala de Hoehn & Yahr, e 12 idosos sadios com idade, gênero e características antropométricas semelhantes. Os participantes foram convidados a percorrer andando, em velocidade preferida, uma distância de 8 metros, em condições sem obstáculo (SO) e com obstáculo baixo (OB) ou alto (OA). As tentativas foram apresentadas combinando condições de visão (informação visual dinâmica, estática e autosselecionada) e de obstáculo (SO, OB e OA), em 3 tentativas por condição, totalizando 27 tentativas; realizadas em 3 blocos. A amostragem visual foi manipulada através do uso de óculos de lentes de cristal líquido. A análise cinemática foi realizada tridimensionalmente e a análise cinética através de duas plataformas de força. As variáveis dependentes selecionadas incluíram a quantidade e duração das amostragens visuais autosselecionadas, o número de contatos, os parâmetros espaciais e temporais e variáveis extraídas a partir das curvas força-tempo normalizadas nas fases de aproximação e ultrapassagem do obstáculo. O tratamento estatístico das variáveis incluiu a estatística descritiva, uma ANOVA e oito MANOVAs. Os resultados revelaram que as manipulações experimentais, do terreno e da amostragem visual, provocaram modificações no comportamento motor dos participantes, tanto nos parâmetros cinemáticos como nos cinéticos. As condições de obstáculo alto e de informação visual estática foram as que mais... / The Parkinson's disease (PD) patients' behavior during walking on uneven terrain is less known. Furthermore, we didn't find any paper that studied the visual control during obstacle avoidance task in people with PD. The aim of this study was to analyze the role of vision in locomotor control during obstacle avoidance of different heights in people with PD and healthy elderly. It has been collected data of 12 PD patients (from 1 to 2.5 stages in the Hoehn & Yahr Scale) and 12 healthy elderly matched by age, gender and anthropometric characteristics. Participants were invited to walk, at preferred velocity, on an 8m long pathway, under conditions without obstacle (WO), ankle height obstacle (AO) and mid shank height obstacle (MSO). Trials combined conditions of visual information (DVI = dynamic visual information; SVI = static visual information; SSVI = self-selected visual information) and obstacle (WO, AO, MSO); twenty-seven trials were realized; which were distributed into 3 blocks. The visual sample was manipulated by the use of liquid crystal display goggles. Kinematics and kinetic analysis were realized by digital camcorders and two force plates, respectively. The selected dependent variables refer to amount of self-selected visual information, obstacle contacts, spatial and temporal parameters during the approaching and crossing phases and variables extracted from normalized force-time curves. Variables were statistically treated in a descriptive way and by one ANOVA e eight MANOVAs. Results showed that experimental manipulations, terrain and visual sample, modified motor behavior of participants. Gait control was more disturbed by MSO and SVI conditions. The higher number of obstacle contacts was observed in PD patients at SVI condition. PD influenced, in approach phase, spatial kinematics variables and stride velocity and, in crossing phase, leading limb propulsion for gait... (Complete abstract click electronic access below)

Submitted by Vinicius Alota Ignacio Pereira null (viniciusalota_dm@hotmail.com) on 2018-02-06T23:55:47Z No. of bitstreams: 1 Dissertação Vinícius Alota Ignácio Pereira.pdf: 2317305 bytes, checksum: 591ed98421ed584fd9d5fa8feebf7b9a (MD5) / Rejected by Maria Marlene Zaniboni null (zaniboni@bauru.unesp.br), reason: Solicitamos que realize correções na submissão seguindo as orientações abaixo: 1) Falta ficha catalográfica - A ficha deve ser inserida após folha de rosto do trabalho. 2) Falta Ata de Defesa - Inserir após ficha catalográfica. Agradecemos a compreensão. on 2018-02-07T13:09:17Z (GMT) / Submitted by Vinicius Alota Ignacio Pereira null (viniciusalota_dm@hotmail.com) on 2018-02-07T15:04:18Z No. of bitstreams: 1 Dissertação Vinícius Alota Ignácio Pereira.pdf: 3066161 bytes, checksum: 9eaea7d0b949ff79a544da07118f6821 (MD5) / Approved for entry into archive by Maria Marlene Zaniboni null (zaniboni@bauru.unesp.br) on 2018-02-07T16:00:07Z (GMT) No. of bitstreams: 1 pereira_vai_me_bauru.pdf: 2541554 bytes, checksum: 4ed0c4407bec93ca8aa5076b4cb48bf1 (MD5) / Made available in DSpace on 2018-02-07T16:00:07Z (GMT). No. of bitstreams: 1 pereira_vai_me_bauru.pdf: 2541554 bytes, checksum: 4ed0c4407bec93ca8aa5076b4cb48bf1 (MD5) Previous issue date: 2017-12-19 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Idosos com doença de Parkinson (DP) apresentam déficits nas áreas corticais e subcorticais que prejudicam o planejamento e a execução das ações motoras. São afetados, principalmente, movimentos repetitivos, simultâneos e sequenciais, especialmente quando uma tarefa cognitiva concomitante é realizada durante a ação motora. Tarefas locomotoras mais complexas, como desviar de um obstáculo durante o andar, parecem evidenciar ainda mais estes déficits, podendo aumentar a assimetria presente nesta população. Assim, os objetivos deste estudo foram: a) analisar a estratégia motora e visual de idosos com DP e idosos neurologicamente sadios na tarefa de desviar de um obstáculo durante o andar com a presença de uma tarefa concomitante cognitiva; b) verificar o efeito da tarefa concomitante cognitiva na assimetria/simetria do desvio de um obstáculo durante o andar em idosos com DP. Foram desenvolvidos dois estudos para responder os questionamentos deste projeto. Participaram dos estudos 15 idosos com DP e 15 idosos neurologicamente sadios. Os participantes realizaram a tarefa de andarem na velocidade preferida, com desvio de um obstáculo posicionado na metade da distância a ser percorrida (10 m). Foram realizadas, para ambos os lados, tentativas do andar com desvio do obstáculo com tarefa concomitante cognitiva e sem a tarefa concomitante. Os parâmetros motores (Vicon Motion System) e visuais (ASL,EyeTracking Mobile System) das condições de interesse, foram comparados por meio de ANOVAs, utilizando fatores de acordo com as variáveis independentes dos estudos. Os principais achados deste projeto foram que idosos com DP foram mais conservadores do que idosos neurologicamente sadios durante o andar com desvio de um obstáculo com tarefa cognitiva concomitante, buscando maior segurança e estabilidade que seus pares saudáveis. Ainda, a tarefa dupla concomitante aumentou a assimetria de parâmetros espaço-temporais durante o desvio para ambos os grupos de maneira semelhante para os dois grupos e diminuiu a assimetria dos parâmetros do movimento dos olhos. Por fim, idosos com DP foram capazes de realizar ambas as tarefas (motora e cognitiva) com êxito. / Older people with Parkinson's disease (PD) show deficits in cortical and subcortical areas, which to impair the planning and execution of motor actions. Repetitive, simultaneous and sequential movements are mainly affected, especially when concomitant cognitive task is performed during motor action. More complex locomotor tasks, such as obstacle circumvention during walking, seem to evidence these deficits and increase the asymmetry this population. Therefore, the aims of this study were: a) to analyze the motor and visual strategy on obstacle circumvention during walking with concomitant cognitive task in older people with DP and neurologically healthy individuals; b) to verify the effect of concomitant cognitive task on asymmetry/symmetry of the obstacle circumvention during walking in older people with DP. Two studies was developed to answer the questions of this project. Fifteen individuals with DP and 15 neurologically healthy individuals participated in the study. Participants performed the task to walk, in self-selected speed, with obstacle circumvention, which was positioned at half distance that the participant will cover (10 m). On both sides, attempts were made to walk with obstacle deviation with concomitant cognitive task and without a concomitant task. The motor (Vicon Motion System) and visual parameters (ASL, Eye Tracking Mobile System) of the conditions of interest, were compared through ANOVAs according to the independent variables of the each study. The main findings of this project were that elderly with PD were more conservative than neurologically healthy elderly during walking with an obstacle bypass with a concomitant cognitive task, seeking greater safety and stability than their healthy counterparts. Furthermore, the concomitant double task increased the asymmetry of spatiotemporal parameters during deviation for both groups similarly for both groups and decreased asymmetry of the parameters of eye movement. Finally, elderly people with PD were able to perform both tasks (motor and cognitive) successfully. / 15/15928-4