Influência da dupla tarefa cotidiana sobre variáveis biomecânicas da marcha de idosos com doença de Parkinson
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2016-12-14
Autores
Yamada, Patrícia de Aguiar [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A marcha durante a maioria das atividades diárias é realizada concomitante à outra tarefa, denominada dupla tarefa. Indivíduos com doença de Parkinson (DP) tendem a apresentar alterações na marcha quando expostos à condição de dupla tarefa, entretanto, situações de risco parecem ser mais bem identificadas durante condições que melhor representam as atividades diárias do indivíduo. Objetivo: Verificar a influência da dupla tarefa cotidiana sobre variáveis biomecânicas da marcha de idosos com DP. Métodos: Participaram do estudo voluntários idosos, os quais foram divididos em grupo de idosos sem DP e grupo de idosos com DP. Foi realizada avaliação cinética da marcha através da plataforma de força AMTI® e da cinemática através do sistema GAITRite®, durante três diferentes condições: marcha sem dupla tarefa (C1), marcha carregando sacolas com peso (C2) e marcha falando ao celular (C3). Foi aplicado o teste estatístico ANOVA Medidas Repetidas Two Way com post Hoc de Bonferroni no software PASW statistics 18.0® (SPSS), adotando o nível de significância de p<0.05. Resultados: Para as variáveis cinéticas, observou-se menor pico de força de reação do solo (PFRS) vertical durante a propulsão, além de menor taxas de aceitação e propulsão em idosos com DP. Ambos os grupos apresentaram maior PFRS vertical durante a aceitação do peso e a propulsão na C2 e menores valores de velocidade na C3. Para as variáveis cinemáticas, idosos com DP apresentaram menor velocidade, cadência e comprimento de passo em relação aos idosos sem DP durante a marcha sem dupla tarefa e, quando expostos à dupla tarefa, idosos com DP obtiveram menor comprimento de passo, largura de passo e tempo de balanço, além de maior tempo de duplo apoio e apoio durante a C2. Quando submetidos à C3, observou-se redução da velocidade, cadência, comprimento de passo e tempo de balanço, e aumento da largura de passo, tempo de duplo apoio e apoio. Conclusão: A dupla tarefa cotidiana influenciou as variáveis cinemáticas de idosos com DP, entretanto, em relação às variáveis cinéticas, o impacto da dupla tarefa cotidiana foi similar em ambos os grupos.
Introduction: The gait during most daily activities is carried out concomitantly with other task, called dual task. Individuals with Parkinson's disease (PD) tend to have gait changes when exposed to dual task condition, however, risk situations seems to be better identified during conditions that best represent the individual's daily activities. Objective: To verify the influence of the daily dual task on gait biomechanical variables of elderly with PD. Methods: Elderly volunteers participated in the study, which were divided into a group of elderly without PD and a group of elderly with PD. Gait kinetic evaluation was performed through the AMTI® power platform and kinematics through the GAITRite® system, during three different conditions: gait without dual task (C1), gait carrying bags with weight (C2) and gait talking on the cell phone (C3). Two-way ANOVA repeated measures with Post Hoc of Bonferroni were applied in the software PASW statistics 18.0® (SPSS), adopting the level of significance of p<0.05. Results: For the kinetic variables, there was lower vertical ground reaction force peak (GRFP) during propulsion, as well as lower acceptance and propulsion rates in elderly with PD. Both groups presented higher vertical GRFP during weight acceptance and propulsion in C2 and lower velocity values in C3. For the kinematic variables, the elderly with PD had lower speed, cadence and step length than elderly without PD during the gait without dual task and, when exposed to the dual task, elderly with PD had shorter step length, step width and balance time, as well as a longer time of double support and support during C2. When submitted to C3, it was observed a reduction of speed, cadence, step length and balance time, and increased step width, double support time and support. Conclusion: The daily dual task influenced the kinematic variables of the elderly with PD, however, in relation to the kinetic variables, the impact of the daily dual task was similar in both groups.
Introduction: The gait during most daily activities is carried out concomitantly with other task, called dual task. Individuals with Parkinson's disease (PD) tend to have gait changes when exposed to dual task condition, however, risk situations seems to be better identified during conditions that best represent the individual's daily activities. Objective: To verify the influence of the daily dual task on gait biomechanical variables of elderly with PD. Methods: Elderly volunteers participated in the study, which were divided into a group of elderly without PD and a group of elderly with PD. Gait kinetic evaluation was performed through the AMTI® power platform and kinematics through the GAITRite® system, during three different conditions: gait without dual task (C1), gait carrying bags with weight (C2) and gait talking on the cell phone (C3). Two-way ANOVA repeated measures with Post Hoc of Bonferroni were applied in the software PASW statistics 18.0® (SPSS), adopting the level of significance of p<0.05. Results: For the kinetic variables, there was lower vertical ground reaction force peak (GRFP) during propulsion, as well as lower acceptance and propulsion rates in elderly with PD. Both groups presented higher vertical GRFP during weight acceptance and propulsion in C2 and lower velocity values in C3. For the kinematic variables, the elderly with PD had lower speed, cadence and step length than elderly without PD during the gait without dual task and, when exposed to the dual task, elderly with PD had shorter step length, step width and balance time, as well as a longer time of double support and support during C2. When submitted to C3, it was observed a reduction of speed, cadence, step length and balance time, and increased step width, double support time and support. Conclusion: The daily dual task influenced the kinematic variables of the elderly with PD, however, in relation to the kinetic variables, the impact of the daily dual task was similar in both groups.
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Palavras-chave
Doença de Parkinson, Tarefa dupla, Atividade diária