Efeitos de 30 minutos de caminhada nórdica sobre a postura e a marcha de idosos com e sem a doença de Parkinson
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2020-08-26
Autores
Mascari, Amanda Persson
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Universidade Estadual Paulista (Unesp)
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Introdução: Em todas as alterações motoras oriundas da Doença de Parkinson (DP), como a bradicinesia, alterações posturais, tremor de repouso, rigidez muscular e distúrbios de marcha, vê-se a importância fisioterapêutica para a melhora sintomatológica e aumento da independência funcional dos indivíduos. A Caminhada Nórdica (CN) pode ser uma das ferramentas úteis a esta população pois propicia, entre outros fatores, aumento do comprimento de passo e do controle postural durante sua execução. Objetivo: O objetivo deste estudo é analisar ângulos posturais e variáveis cinemáticas da marcha durante 30 minutos de CN e compará-los com os valores obtidos durante a marcha convencional e durante a fotogrametria postural estática, realizadas antes e depois da CN, em idosos com e sem a DP. Método: 15 idosos com a DP (GDP) e 12 idosos sem a mesma (GC) foram avaliados quanto a angulações posturais e quanto à parâmetros cinemáticos da marcha. Os indivíduos foram filmados realizando sua marcha convencional, e realizaram fotogrametria postural estática, antes e depois de executarem 30 minutos de CN. Durante a CN, marcha e postura foram avaliadas através das filmagens. O software Corel Draw foi utilizado para análise da fotogrametria estática, e o Kinovea para análise das filmagens. Resultados: Na fotogrametria estática, o ângulo da protusão de cabeça (PC) demonstrou-se maior no grupo GDP (p=0,001) e neste grupo, maior na reavaliação do que na avaliação inicial (p=0,007). A lordose lombar (LL) em ambos os grupos, foi também estatisticamente maior na reavaliação (p=0,03). Observou-se ainda na análise dinâmica, PC e Lordose Cervical (LC) maiores no grupo GDP, do que em GC (p=0,015 e p=0,004 respectivamente). O ângulo tíbio-társico (ATT) foi maior no grupo GC do que em GDP independente da avaliação (p=0,03). Tais resultados corroboram com o que a literatura descreve a respeito das alterações posturais e de marcha na DP, e demonstram que em nosso estudo a CN não provocou alterações significativas nas variáveis posturais e de marcha analisadas em ambas as populações.
Introduction: In all motor disorders resulting from Parkinson’s Disease (PD), such as bradykinesia, postural changes, rest tremor, muscle stiffness and gait disfunction, there is a physiotherapeutic importance to get improvements on the symptoms and bigger functional independence of individuals. Nordic Walking (NW) may be one of the useful therapeutic tools for this population because it provides according to the literature, increased step length and postural control during its execution. Objective: To analyze postural angles and kinematic gait variables during 30 minutes of NW and compare them with the values obtained during conventional gait and during static postural photogrammetry, performed before and after NW in ederly people with and without PD. Method: 15 elderly people with PD (GDP) and 12 elderly people without it (GC) were evaluated for some postural angulations and for kinematic parameters of gait. The circuit was about 120 meters. The participants were filmed performing their usual gait and performed static photogrammetry to obtain data of their posture. During NW, postural and kinematic variables were also evaluated by the recording of the cameras. Corel Draw software was used to analyze static photogrammetry, and Kinovea to analyse the footage. Results: In static photogrammetry, the angle of head protusion (HP) was shown to be greater in the GDP group (p=0,001) and in this group, greater in the reassessment than in the initial evaluation (p=0,007). Lumbar lordosis (LL) in both groups was also statistically higher in the reassessment (p=0,03). It was also observed in the dynamic analysis, CP and Cervical Lordosis (CL) were higher in the GDP group, than in GC (p=0,015 and p=0,004 respectively). The tibio-tarsal angle (TTA) was greater in the GC group than in GDP despite of the assessment (p=0,03). Such results corroborate with what literature describes regarding postural and gait changes from PD, and demonstrate that in our study, the NW did not cause significant changes in postural and gait variables analyzed in both populations.
Introduction: In all motor disorders resulting from Parkinson’s Disease (PD), such as bradykinesia, postural changes, rest tremor, muscle stiffness and gait disfunction, there is a physiotherapeutic importance to get improvements on the symptoms and bigger functional independence of individuals. Nordic Walking (NW) may be one of the useful therapeutic tools for this population because it provides according to the literature, increased step length and postural control during its execution. Objective: To analyze postural angles and kinematic gait variables during 30 minutes of NW and compare them with the values obtained during conventional gait and during static postural photogrammetry, performed before and after NW in ederly people with and without PD. Method: 15 elderly people with PD (GDP) and 12 elderly people without it (GC) were evaluated for some postural angulations and for kinematic parameters of gait. The circuit was about 120 meters. The participants were filmed performing their usual gait and performed static photogrammetry to obtain data of their posture. During NW, postural and kinematic variables were also evaluated by the recording of the cameras. Corel Draw software was used to analyze static photogrammetry, and Kinovea to analyse the footage. Results: In static photogrammetry, the angle of head protusion (HP) was shown to be greater in the GDP group (p=0,001) and in this group, greater in the reassessment than in the initial evaluation (p=0,007). Lumbar lordosis (LL) in both groups was also statistically higher in the reassessment (p=0,03). It was also observed in the dynamic analysis, CP and Cervical Lordosis (CL) were higher in the GDP group, than in GC (p=0,015 and p=0,004 respectively). The tibio-tarsal angle (TTA) was greater in the GC group than in GDP despite of the assessment (p=0,03). Such results corroborate with what literature describes regarding postural and gait changes from PD, and demonstrate that in our study, the NW did not cause significant changes in postural and gait variables analyzed in both populations.
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Palavras-chave
Doença de Parkinson, Marcha humana, Postura, Idosos, Fisioterapia, Parkinson's disease, Human gait, Posture, Elderly, Physical Therapy