Abstract
A doença de Parkinson (DP) é uma doença degenerativa e progressiva do sistema nervoso central, e seus sintomas podem proporcionar um declínio da qualidade de vida (QV) dos pacientes, que pode ser influenciada positivamente pela fisioterapia aquática (FA). A FA é um recurso fisioterapêutico que utiliza os efeitos físicos, fisiológicos e cinesiológicos advindos da imersão do corpo em piscina aquecida. O questionário da doença de Parkinson 39 (PDQ-39) é o instrumento mais apropriado para a avaliação da QV do paciente com DP. O objetivo deste estudo foi avaliar os efeitos da FA na QV de pacientes com DP nos estágios de leve a moderado, utilizando-se do PDQ-39. Foram incluídos 13 pacientes com DP, com idade entre 45 e 74 anos, entre os estágios 1 a 3 da doença (Hoehn-Yahr). Os pacientes foram submetidos a 16 sessões de FA, duas vezes por semana, com duração de uma hora, em piscina terapêutica aquecida. A percepção da QV foi mensurada por meio do PDQ-39, antes e depois da FA. Depois da FA, ocorreu uma redução estatisticamente significativa (p<0,0001) tanto no escore total do PDQ-39 quanto em todos os seus domínios (p=0,032). A QV foi mais afetada em maiores estágios da doença. Antes da FA, a QV era pior no estágio mais avançado da doença, e apesar da melhora dos escores de QV depois da FA, o estágio mais avançado continuou apresentando pior percepção da QV. A FA proporcionou uma melhora na qualidade de vida dos pacientes com doença de Parkinson neste estudo.
Highlights
Parkinson’s Disease (PD) is a degenerative and progressive condition of the central nervous system (CNS) which is characterized by the neuronal loss of dopaminergic cells from the compact portion of the substantia nigra of the mesencephalon
The excluded patients were those with another neurological pathology, limiting orthopedic or heart associated conditions, as well as those who were submitted to another physical therapy resource or who needed to change the medication schedule
Before and after the Aquatic physical therapy (APT) treatment, answered the Parkinson’s Disease Questionnaire 39 (PDQ-39), which has 39 items distributed into eight dimensions: mobility, activities of daily life (ADL), emotional well-being, stigma, social support, cognition, communication and physical discomfort, in which higher scores indicate a poor perception of QOL18,19
Summary
Parkinson’s Disease (PD) is a degenerative and progressive condition of the central nervous system (CNS) which is characterized by the neuronal loss of dopaminergic cells from the compact portion of the substantia nigra of the mesencephalon. The PD diagnosis is established as the presence of two among the following cardinal signs: resting tremor, bradykinesia (akinesia or hypokinesia), plastic-type muscle rigidity and postural instability[2,3]. Associated with these changes, the physical, mental, emotional, social and economical compromise related to the signs and symptoms of PD interfere in the subject’s level of capacity and can negatively influence the his or her quality of life (QOL), leading to isolation and decreased participation in social life[4]. Knowing such aspects is essential to improve the planning of therapeutic interventions addressed to these patients, once the main focus of the treatment with subjects with chronic diseases, such as PD, should be the maintenance of QOL5
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