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Previous issue date: 2011-12-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Introduction: The intrinsic gait disorders in individuals with Parkinson's disease (PD) are one of the most disabling motor symptoms. Among the therapeutic approaches used in attempts to improve the motor function, especially the gait pattern of individuals, stands out the treadmill gait training associated with the addition of load. However, there are few findings that elucidate the benefits arising from such practice. Objective: To assess the effects of adding load on the treadmill gait training in individuals with PD. Material and Methods: A controlled, randomized and blinded clinical trial, was performed with a sample of 27 individuals (18 men and 9 women) with PD, randomly assigned to three experimental conditions, namely: treadmill gait training (n=9), treadmill gait training associated with addition of 5% load (n=9) and treadmill gait training associated with addition of 10% load (n=9). All volunteers were assessed, during phase on of Parkinson's medication, regarding to demographic, clinical and anthropometric (identification form) data, level of disability (Hoehn and Yahr Modified Scale), cognitive function (Mini Mental State Examination), clinical functional - in those areas activity of daily living and motor examination (Unified Parkinson's Disease Rating Scale - UPDRS) and gait cinematic analysis was performed through Qualisys Motion Capture System?. The intervention protocol consisted of gait training in a period of 4 consecutive weeks, with three weekly sessions, lasting 30 minutes each. The post-intervention assessment occurred the next day after the last training session, which was performed cinematic analysis of gait and the UPDRS. Data analysis was performed using the software Statistical Package for Social Sciences? (SPSS) 17.0. Results: The age of volunteers ranged from 41 to 75 years old (62,26 ? 9,07) and the time of clinical diagnosis of PD between 2 to 9 years (4,56 ? 2,42). There was a reduction regarding the score from motor exam domain (p=0,005), only when training with the addition of a 5% load. As for the space-time variables there was no significant difference between groups (p>0,120); however, the training with addition of 5% load presented the following changes: increase in stride length (p=0,028), in step length (p=0,006), in time balance of the most affected member (p=0,006) and reduction in support time of the referred member (p=0,007). Regarding angular variables significant differences between groups submitted to treadmill gait training without addition load and with 5% of load were observed in angle of the ankle at initial contact (p=0,019), in plantar flexion at toe-off (p=0,003) and in the maximum dorsiflexion in swing (p=0,005). While within groups, there was a reduction in amplitude of motion of the ankle (p=0,048), the only workout on the treadmill. Conclusion: The treadmill gait training with addition of 5% load proved to be a better experimental condition than the others because it provided greater gains in a number of variables (space-time and angular gait) and in the motion function, becoming a therapy capable of effectively improving the progress of individuals with PD / Introdu??o: As desordens da marcha em indiv?duos com doen?a de Parkinson (DP) representa um dos sintomas motores mais incapacitantes. Dentre as abordagens terap?uticas empregadas, na tentativa de aperfei?oar a fun??o motora, principalmente o padr?o de marcha, destaca-se o treino de marcha na esteira associado ? adi??o de carga. Todavia, poucos s?o os achados que elucidam os benef?cios oriundos de tal pr?tica. Objetivo: Verificar os efeitos da adi??o de carga no treino de marcha na esteira em indiv?duos com DP. Materiais e M?todos: Trata-se de um ensaio cl?nico, controlado, randomizado e cego, realizado com uma amostra de 27 indiv?duos com DP (18 homens e 9 mulheres), distribu?dos aleatoriamente, em tr?s condi??es: treino de marcha na esteira (n=9), treino de marcha na esteira com adi??o de 5% de carga (n=9) e treino de marcha na esteira com adi??o de 10% de carga (n=9). Todos os volunt?rios foram avaliados, estando na fase on do medicamento antiparkinsoniano, quanto aos dados demogr?ficos, cl?nicos e antropom?tricos (formul?rio de identifica??o), n?vel de incapacidade f?sica (escala de Hoehn e Yahr modificada), fun??o cognitiva (mini-exame do estado mental), estado cl?nico-funcional em rela??o aos dom?nios atividade de vida di?ria e exame motor (Unified Parkinson s Disease Rating Scale UPDRS) e a an?lise cinem?tica da marcha foi realizada por meio do sistema Qualisys Motion Capture System?. O protocolo de interven??o consistiu num per?odo de 4 semanas consecutivas de treino, sendo 3 sess?es semanais, com dura??o de 30 minutos cada. A an?lise dos dados foi realizada por meio do software Statistical Package for Social Sciences? (SPSS) 17.0, adotando-se n?vel de signific?ncia de 5%. Resultados: A idade dos volunt?rios variou entre 41 e 75 anos (62,26 ? 9,07) e o tempo de diagn?stico cl?nico da DP entre 2 e 9 anos (4,56 ? 2,42). Houve diminui??o do escore quanto ao dom?nio exame motor (p=0,005), apenas no treino com adi??o de 5% de carga. Quanto ?s vari?veis espa?o-temporais n?o foram encontradas diferen?as significativas entre os grupos (p>0,120); entretanto, o treino com adi??o de 5% de carga apresentou as seguintes altera??es: aumento no comprimento da passada (p=0,028), no comprimento do passo (p=0,006), no tempo de balan?o do membro mais afetado (p=0,006) e redu??o no tempo de apoio, do membro referido (p=0,007). Em rela??o ?s vari?veis angulares foram verificadas diferen?as significativas, entre os grupos submetidos ao treino apenas na esteira e com adi??o de 5% de carga, no ?ngulo do tornozelo no contato inicial (p=0,019), na flex?o plantar no toe-off (p=0,003) e na m?xima dorsiflex?o no balan?o (p=0,005). Enquanto que, dentro dos grupos, houve redu??o na amplitude de movimento do tornozelo (p=0,048), no treino apenas na esteira. Conclus?o: O treino de marcha na esteira com adi??o de 5% de carga demonstrou ser uma condi??o experimental superior ?s demais, por ter proporcionado ganhos em uma maior quantidade de vari?veis (espa?o-temporais e angulares da marcha) e na fun??o motora, tornando-se uma terapia capaz de beneficiar efetivamente a marcha de indiv?duos com DP
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/16712 |
| Date | 16 December 2011 |
| Creators | Trigueiro, Larissa Coutinho de Lucena |
| Contributors | CPF:84091193404, http://lattes.cnpq.br/6535678775361874, Godeiro J?nior, Clecio de Oliveira, CPF:00931137497, http://lattes.cnpq.br/6861574542099266, Paula, F?tima Val?ria Rodrigues de, CPF:45637121672, Lindquist, Ana Raquel Rodrigues |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Fisioterapia, UFRN, BR, Movimento e Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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