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Previous issue date: 2017-03-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Importance: The efficacy of combined body suspension with tilting exercises (Chordata Method) in Parkinson?s disease (PD) is unclear.
Objective: Design a clinical study to assess the efficacy of body suspension with tilting exercises on functional and quality of life outcomes in PD.
Design, Setting, and Participants: This is an assessor-blinded, randomized and controlled clinical trial. A total of 48 subjects with moderate PD were recruited from the Neurological Service of S?o Lucas Hospital, PUCRS, Brazil. Recruitment took place between September 2015 and May 2016. The entire protocol study lasted 16 weeks, with 8 weeks of exercise protocol and 8 weeks of follow-up.
Interventions: Subjects were randomly assigned to either body suspension with tilting exercises (intervention group) or stretching exercises (control group).
Main Outcomes and Measures: The primary outcome was the Timed Up and Go test at the 8th week. Secondary outcomes were Berg Balance Scale (BBS); Functional Reach Test (FRT); Unified Parkinson?s Disease Rating Scale (UPDRS) and Parkinson?s Disease Questionnaire (PDQ-39). These measures were assessed at baseline (before trial entry) and then at the 8th (end of exercise protocols) and 16th weeks (8 weeks of follow-up) after randomization.
Results: Of the 48 subjects randomized in the study 20 received the intervention (71.3?6.3 years old) and 20 were controls (66.7?6.4 years old). Eight of them were lost during the trial (four per group). Analysis of co-variance, with adjustment for baseline measurement, revealed a between-group difference in the Timed Up and Go test at 8th week [CI95% difference of -4.90 (-5.80 a -4.00), p<0.0001] and in the follow-up [CI95% difference of -4.94 sec (-5.82 to -4.06), p<0.0001], which was our primary outcome. Significant between-groups differences were also found for all secondary outcomes (BBS, UPDRS-III, FRT, and PDQ-39) at 8th week and follow-up (16th week) assessments.
Conclusions and relevance: We suggest the body suspension with tilting exercises protocol (the Chordata Method) improves functionality and quality of life in subjects with moderate PD. This evidence supports the Chordata method appears to be a new
effective therapeutic option to treat Parkinson-related mobility and balance dysfunctions. / Import?ncia: A efic?cia da utiliza??o de exerc?cios de suspens?o e pendula??o corporal (m?todo Chordata) para o tratamento de sujeitos com a Doen?a de Parkinson ainda n?o foi testada.
Objetivo: Realizar um estudo cl?nico para avaliar a efic?cia de um programa de exerc?cios de suspens?o e pendula??o corporal sobre a funcionalidade e qualidade de vida de sujeitos portadores da doen?a de Parkinson.
Delineamento, M?todo e Participantes: Trata-se de um ensaio cl?nico, controlado e randomizado, com avaliador de desfecho alheio aos grupos experimentais. Um total de 48 sujeitos com diagn?stico m?dico de doen?a de Parkinson, de est?gio leve ? moderado, foram recrutados a partir do Servi?o de Neurologia do Hospital S?o Lucas da PUCRS, Brasil. O recrutamento ocorreu entre Setembro de 2015 e Maio de 2016. O protocol do estudo teve a dura??o de 16 semanas, sendo 8 semanas de pr?tica dos exerc?cios propostos, com iguais 8 semanas de seguimento (follow-up).
Interven??o: Os sujeitos foram randomizados nos grupos interven??o (suspens?o e pendula??o corporal) e controle (alongamentos de grandes grupos musculares).
Desfechos principais e medidas: O desfecho prim?rio do presente estudo foi o teste do Timed Up and Go ao final do protocolo de treinamento (8 semanas). Os desfechos secund?rios foram a Escala de Equil?brio de Berg (EEB); o teste do Alcance Funcional (TAF); a Escala Unificada da Doen?a de Parkinson, sess?o III (UPDRS-III) e o Question?rio de Qualidade de Vida na Doen?a de Parkinson (PDQ-39). Estes desfechos foram avalaidos nos momentos pr?-interven??o, ap?s, ao t?rmino do protocol de exerc?cios (8 semanas) e no per?odo de seguimento (16 semanas ap?s a randomiza??o).
Resultados: De um total de 48 sujeitos randomizados, 20 participaram do grupo interven??o (71,3?6,3 anos de idade) e 20 do grupo controle (66,7?6,4 anos de idade). Oito sujeitos foram perdidos durante a execu??o do estudo (quarto em cada um dos grupos). A An?lise de co-vari?ncia, com ajuste para os dados basais, revelou uma diferen?a entre-grupos no teste do Timed Up and Go ao t?rmino do protocolo de exerc?cios (8 semanas) [diferen?a IC95%: -4,90 (-5,80 a -4,00), p<0,0001] e na avalia??o de seguimento [diferen?a IC95%: -4.94 sec (-5,82 to -4,06), p<0.0001],
teste este estabelecido como o desfecho prim?rio. Diferen?as significativas tamb?m foram encontradas para todos os desfechos secund?rios (EEB, UPDRS-III, TAF e PDQ-39) em ambas as avalia??es p?s-interven??o (8 e 16 semanas ap?s a randimiza??o).
Conclus?es e relev?ncia: Nossos resultados sugerem que os exerc?cios de suspens?o e pendula??o corporal s?o capazes de melhorar a funcionalidade e a qualidade de vida de sujeitos com a doen?a de Parkinson, em est?gio moderado. Esta evid?ncia suporta que o m?todo Chordata parece ser uma nova e efetiva interven??o terap?utica para o tratamento das desordens de mobilidade e equil?brio associadas ? doen?a de Parkinson.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7708 |
| Date | 03 March 2017 |
| Creators | Oliveira, Charlene Brito de |
| Contributors | Mestriner, Regis Gemerasca |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 500, 500, 600, 2296420844541114010, -969369452308786627, 2075167498588264571 |
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