Equilíbrio dinâmico em idosos com doença de Parkinson
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Data
2008-12-13
Autores
Caetano, Maria Joana Duarte [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Andar é essencial para o desempenho das funções diárias. No entanto, as alterações morfofuncionais decorrentes do processo de envelhecimento podem comprometer o equilíbrio durante o andar e gerar instabilidade. Este comprometimento é ainda mais acentuado em idosos com doença de Parkinson devido aos distúrbios motores ocasionados pela doença. Neste contexto, os objetivos do presente estudo foram: 1) analisar as características espaço-temporais e os ângulos articulares de indivíduos idosos neurologicamente sadios e com doença de Parkinson idiopática andando livremente e em condições de restrição na largura e na altura da superfície de suporte; 2) relacionar estes parâmetros com as pontuações nas escalas de H&Y e UPDRS (apenas para os pacientes) e com a incidência de queda recente (1 ano) e pontuações na Escala de Equilíbrio Funcional de Berg (para ambos os grupos). Participaram 16 idosos distribuídos em dois grupos: oito idosos neurologicamente sadios e oito com doença de Parkinson idiopática. As características espaço-temporais e os ângulos articulares andando livremente e em condições de restrição na largura e na altura da superfície de suporte foram investigados por meio de ferramenta cinemática. Pacientes com doença de Parkinson apresentaram valores médios significativamente menores que os idosos neurologicamente sadios em relação à duração da fase de balanço e ao comprimento e velocidade da passada e maiores para a duração do duplo suporte devido à hipocinesia, à dificuldade no controle do equilíbrio e ao próprio relacionamento entre as variáveis. As restrições impostas pela superfície de suporte geraram alterações nas características espaço-temporais e angulares do andar dos idosos de ambos os grupos, devido à necessidade de adotar uma estratégia cautelosa que facilite o controle da locomoção, garantindo estabilidade, e ao medo de cair imposto pelas demandas da tarefa,...
Walking is crucial for the performance of daily living activities. However, morpho and functional changes due to the aging process can compromise the balance during walking and generate instability. It is more pronounced in elderly patients with Parkinson’s disease due to the motor signs/symptoms of the disease. In this context, the aims of this study were: 1) to analyze the spatial and temporal parameters and joint angles of healthy elderly and with Parkinson’s disease during free walking and under width and height constraints of the support surface; 2) to correlate these parameters with the scores in H&Y scale and UPDRS (only for patients) and with the occurrence of recent fall (1 year) and the scores in the Berg Functional Balance Scale (for both groups). Sixteen elderly were distributed in two groups: 8 healthy elderly and 8 idiopathic Parkinson’s disease patients. Both the spatial and temporal parameters of gait and joint angles were investigated by means of kinematics tools during free walking and under width and height constraints of the support surface. Parkinson’s disease patients showed significantly lower mean values than healthy elderly for swing phase duration, stride length and stride velocity, and higher double support duration due to the hipokinesia, the difficulty in balance control, and the relationship among the gait variables. The support surface constraints changed the gait spatial and temporal parameters and joint angles in both groups due to the necessity to perform a cautious walking strategy that can facilitate the locomotor control, preventing instability, and the fear of falling enforced by the task demands, specially when width and height constraints were associated. The scores in H&Y and UPDRS were not correlated to the gait parameters of the Parkinson’s disease patients probably because the scales did not reflect the gait performance of patients under medication. There were a relationship among the gait .
Walking is crucial for the performance of daily living activities. However, morpho and functional changes due to the aging process can compromise the balance during walking and generate instability. It is more pronounced in elderly patients with Parkinson’s disease due to the motor signs/symptoms of the disease. In this context, the aims of this study were: 1) to analyze the spatial and temporal parameters and joint angles of healthy elderly and with Parkinson’s disease during free walking and under width and height constraints of the support surface; 2) to correlate these parameters with the scores in H&Y scale and UPDRS (only for patients) and with the occurrence of recent fall (1 year) and the scores in the Berg Functional Balance Scale (for both groups). Sixteen elderly were distributed in two groups: 8 healthy elderly and 8 idiopathic Parkinson’s disease patients. Both the spatial and temporal parameters of gait and joint angles were investigated by means of kinematics tools during free walking and under width and height constraints of the support surface. Parkinson’s disease patients showed significantly lower mean values than healthy elderly for swing phase duration, stride length and stride velocity, and higher double support duration due to the hipokinesia, the difficulty in balance control, and the relationship among the gait variables. The support surface constraints changed the gait spatial and temporal parameters and joint angles in both groups due to the necessity to perform a cautious walking strategy that can facilitate the locomotor control, preventing instability, and the fear of falling enforced by the task demands, specially when width and height constraints were associated. The scores in H&Y and UPDRS were not correlated to the gait parameters of the Parkinson’s disease patients probably because the scales did not reflect the gait performance of patients under medication. There were a relationship among the gait .
Descrição
Palavras-chave
Educação fisica, Equilíbrio dinâmico, Restrições da tarefa, Andar, Cinematica, Parkinson, Doença de, Equilibrio (Fisiologia), Educação física adaptada, Dynamic balance, Parkinson’s disease, Task constraints, Walking, Kinematics
Como citar
CAETANO, Maria Joana Duarte. Equilíbrio dinâmico em idosos com doença de Parkinson. 2007. 82 f. Dissertação (mestrado) - Universidade Estadual Paulista, Instituto de Biociências de Rio Claro, 2007.