Associação do pico de força e taxa de desenvolvimento de força com a função física e equilíbrio de idosos com e sem a doença de Parkinson
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2021-12-01
Autores
Yamada, Patrícia de Aguiar
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Universidade Estadual Paulista (Unesp)
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Introdução: Prejuízos na taxa de desenvolvimento de força (TDF) e na capacidade de gerar força máxima estão associados à incapacidade funcional e à maior incidência de quedas em idosos e em indivíduos com doença de Parkinson (DP), acarretando um desafio para o sistema de saúde e sociedade. Avaliar a função muscular e verificar a relação entre a força e a TDF com as alterações de função física e equilíbrio em idosos com e sem DP podem auxiliar a prática clínica, contribuindo para a realização de condutas efetivas para a manutenção e melhora da função física e equilíbrio dessa população. Objetivo: Avaliar a força e a TDF dos extensores de quadril e joelho de idosos com e sem DP e sua relação com a função física e equilíbrio. Material e métodos: 20 idosos com DP (estágio I a III da escala de Hoehn e Yahr) (GDP) e 20 idosos neurologicamente saudáveis (GC) foram submetidos à avaliação do pico de força e TDF; da função física através dos testes SPPB, TUG e velocidade de marcha; do equilíbrio estático e dinâmico em uma plataforma de força; sendo avaliadas ainda no GDP variáveis clínicas como comprometimento motor, estágio da doença e tempo de doença. Resultados: Houve diferença entre os grupos para TDF 200 (p=0,022), função física (SPPB (p=0,004); TUG (p=0,002), velocidade de marcha (p=0,001)) e equilíbrio estático (deslocamento médio-lateral (p=0,001); deslocamento ântero-posterior (p=0,023); área da elipse de confiança (p=0,005)). Durante o equilíbrio estático, houve relação positiva do deslocamento médio-lateral com a TDF 50 e negativa com a TDF 200. Durante o equilíbrio dinâmico, no levantar houve relação positiva da TDF 200 com o deslocamento ântero-posterior; no sentar, houve relações positivas da TDF 200 com a velocidade média de deslocamento e área da elipse de confiança, e da TDF 50 com o deslocamento médio-lateral. O pico de força relacionou-se negativamente com os comprometimentos motores da DP, enquanto o tempo de doença e estágio da doença relacionaram-se negativamente com a TDF 50. Conclusão: Idosos com DP apresentam menor TDF 200, maior limitação na função física e equilíbrio estático, entretanto, em relação ao pico de força, TDF 50 e equilíbrio dinâmico, não foi observada diferenças entre os grupos. Não houve relação da força e TDF com a função física e quando relacionadas a força e TDF com o equilíbrio, houve associação do equilíbrio estático e dinâmico apenas com a TDF. O pico de força relacionou-se apenas com os comprometimentos motores da DP, enquanto o estágio da doença e tempo de doença relacionaram-se com a TDF 50.
Introduction: Impairments in the rate of torque development (RTD) and in the ability to generate maximum strength are associated with functional incapacity and a higher incidence of falls in elderly and individuals with Parkinson's disease (PD), causing a challenge to the health system and society. Assessing muscle function and verifying the relationship between strength and RTD with changes in physical function and balance in elderly with and without PD can help clinical practice, contributing to the realization of effective approaches to the maintenance and improvement of physical function and balance of this population. Objective: Evaluate the strength and RTD of hip and knee extensors in elderly with and without PD and their relationship with physical function and balance. Material and methods: 20 elderly with PD (stage I to III of Hoehn and Yahr scale) (PDG) and 20 neurologically healthy elderly (CG) were submitted to peak torque and RTD evaluation; physical function through SPPB, TUG and gait speed test; static and dynamic balance on a force platform; clinical variables such as motor impairment, disease stage and disease duration were also evaluated in the PDG. Results: There was a difference between the groups for RTD 200 (p=0,022), physical function (SPPB (p=0,004); TUG (p=0,002), gait speed (p=0,001)) and static balance (mediolateral displacement (p=0,001); anteroposterior displacement (p=0,023); area of the confidence ellipse (p=0,005)). During static balance, there was a positive relationship of mediolateral displacement with RTD 50 and negative with the RTD 200. During dynamic balance, when standing up there was a positive relationship of RTD 200 with anteroposterior displacement; in sitting, there were positive relationships of RTD 200 with the average velocity and area of the confidence ellipse, and of RTD 50 with the mediolateral displacement. Peak torque was negatively related to PD motor impairments, while disease duration and disease stage were negatively related to RTD 50. Conclusion: Elderly with PD have lower RTD 200, major limitation in physical function and static balance, however, in relation to peak torque, RTD 50 and dynamic balance, no differences were observed between groups. There was no relationship between strength and RTD with physical function and when strength and RTD were related to balance, there was an association of static and dynamic balance only with RTD. Peak torque was related only to PD motor impairments, while disease stage and disease duration were related to RTD 50.
Introduction: Impairments in the rate of torque development (RTD) and in the ability to generate maximum strength are associated with functional incapacity and a higher incidence of falls in elderly and individuals with Parkinson's disease (PD), causing a challenge to the health system and society. Assessing muscle function and verifying the relationship between strength and RTD with changes in physical function and balance in elderly with and without PD can help clinical practice, contributing to the realization of effective approaches to the maintenance and improvement of physical function and balance of this population. Objective: Evaluate the strength and RTD of hip and knee extensors in elderly with and without PD and their relationship with physical function and balance. Material and methods: 20 elderly with PD (stage I to III of Hoehn and Yahr scale) (PDG) and 20 neurologically healthy elderly (CG) were submitted to peak torque and RTD evaluation; physical function through SPPB, TUG and gait speed test; static and dynamic balance on a force platform; clinical variables such as motor impairment, disease stage and disease duration were also evaluated in the PDG. Results: There was a difference between the groups for RTD 200 (p=0,022), physical function (SPPB (p=0,004); TUG (p=0,002), gait speed (p=0,001)) and static balance (mediolateral displacement (p=0,001); anteroposterior displacement (p=0,023); area of the confidence ellipse (p=0,005)). During static balance, there was a positive relationship of mediolateral displacement with RTD 50 and negative with the RTD 200. During dynamic balance, when standing up there was a positive relationship of RTD 200 with anteroposterior displacement; in sitting, there were positive relationships of RTD 200 with the average velocity and area of the confidence ellipse, and of RTD 50 with the mediolateral displacement. Peak torque was negatively related to PD motor impairments, while disease duration and disease stage were negatively related to RTD 50. Conclusion: Elderly with PD have lower RTD 200, major limitation in physical function and static balance, however, in relation to peak torque, RTD 50 and dynamic balance, no differences were observed between groups. There was no relationship between strength and RTD with physical function and when strength and RTD were related to balance, there was an association of static and dynamic balance only with RTD. Peak torque was related only to PD motor impairments, while disease stage and disease duration were related to RTD 50.
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Fisioterapia, Doença de Parkinson, Idosos Doenças, Parkinson's disease