Treinamento de potência muscular na doença de Parkinson: um estudo prova de conceito

Abstract

Muscle power is reduced in individuals with Parkinson's disease (PD) and is associated with slower walking velocity and falls. Balance and gait disorders in the PD result in loss of independence and represent major therapeutic challenges in disease. It was suggested that muscle power training should be implemented in exercise programs in PD. There is still no evidence that this type of exercise is tolerated, safe and effective in improving muscle performance, functional and quality of life of individuals with PD. Proof of concept studies are phase I / II that generate information about the tolerance and side effects associated with treatment and motivate conducting studies demonstrating the efficacy of this treatment effect size. Therefore, this study investigated the feasibility, safety and effectiveness of training muscular power in muscle performance, functional and quality of life of individuals with PD. Thirteen individuals (Hoehn and Yahr II - III) performed training muscular power to the lower limbs, 3 times / week for 10 weeks. Data on the number of individuals recruited as well as the attendance at training sessions and the levels of adherence to the intervention were recorded. Safety was assessed bythe presence of adverse events, pain during activity, number of falls associated with treatment. Patients were assessed 2 baseline assessments and postintervention assessments occurred at the end of the intervention. Measurements of work and power were evaluated by isokinetic dynamometer, the balance was assessed by the Berg Balance Scale (BBS), bradykinesia was evaluated by summing of items 26, 27,29 and 31 of the Unified Parkinson's Disease Rate Scale, walking velocity, stride length and cadence of gait were evaluated by GAITRite ® and quality of life for the Parkinson's Disease Questionnaire (PDQ-39). Descriptive statistics such as mean (standard deviation), percentile and repeated measures ANOVA were used. Over eight months, 62 individuals were screened and only thirteen participated in the program until the end. The rates of attendance and adherence were 88% and 97%, respectively. There were no adverse effects during training. After treatment, there was an increase in measures of work (p = 0.001) and power (p= 0.0001). The BBS score increased 5 points (p = 0.001) and a significant improvement of bradykinesia (p = 0.01). Moreover, walking velocity increased after the intervention (0.22 m / s, p = 0.003), there was a gain of stride length(0.09m, p = 0.002) but this did not occur with the cadence (p = 0, 09). There was no significant difference in the total score of the PDQ-39 (p = 0.06). The training of muscle power was feasible, safe and had the potential to be effective in improving muscular and functional performance of individuals with PD.