Fatores associados à realização de atividades de vida diária em indivíduos com doença de parkinson

Abstract

Bradykinesia, rest tremor, rigidity and postural instability are the cardinal signs of Parkinson’s Disease (PD). These signs, in addition to axial postural deformities and gait disorders, cause difficulties in perform activities of daily living (ADLs). Additionally, non-motor symptoms, such as neuropsychiatric and sleep disorders, are identified as factors associated with greater disability and worsening quality of life. However, there are no studies that investigate the factors associated with performing ADL, using na instrument that assesses the individual’s perception of their performance in real-life context. Thirty individuals with PD, mean age of 64.3 (±10.5) years and disease duration of 7.9 (±3.9) years, participated in this study. The participants were recruited from Ambulatório de Distúrbios do Movimento Humano do Anexo Bias Fortes, Hospital das Clínicas, Universidade Federal de Minas Gerais and Ambulatório de Neurologia, Centro de Especialidades Médicas, Santa Casa, Belo Horizonte. Cognitive function (Mini Mental State Examination, MMSE) and severity of PD signs and symptoms (Unified Parkinson’s Disease Rating Scale, UPDRS) were evaluated to characterize the sample. Balance (MINIBESTest), mobility (Timed Up and Go, TUG), digital dexterity (Nine Hole Peg Test, 9-HPT), depression (Beck Depression Inventory, BDI) and fatigue (Fatigue Severity Scale, FSS) were the independent variables. UPDRS scores were used to determine the clinical phenotype. Individuals were classified as fallers and non-fallers from the cutoff point ≥11.5 sec on the TUG. Activities of Daily Living (ADLQ-Brazil) was the dependent variable, wich assess the ADLs. There was no difference among the clinical phenotype different groups (p = 0.519) and between fallers and non-fallers individuals (p = 0.555). There was a statistically significant correlation between the ADLQ-Brazil and 9-HPT scores 9-HPT scores (right: rs = 0.421, p = 0.029; left: rs = 0.547, p = 0.003), MINIBESTest (rs = 0.653, p <0.001), BDI (rs = 0.404, p = 0.027) e FSS (rs = 0.379, p = 0.039). There was no correlation with the total TUG score. The results showed that there was no difference between the groups when considering the clinical phenotype and risk of falls, as well as a low to moderate correlation between digital dexterity, balance, depressive symptoms and fatigue, and the perception of the performance of ADL. These findings are relevant because they point out which factors are associated with the limitation to perform ADL in individuals with PD and can be used to guide clinical decision-making and the choice of rehabilitation strategies in this population.