Abstract
RESUMO O objetivo deste estudo foi avaliar o equilíbrio de pacientes com doença de Parkinson (DP) na posição de tandem com os olhos abertos (OA), olhos fechados (OF) e em condição de dupla tarefa (DT). Trata-se de um estudo transversal composto por 19 indivíduos com DP nos estágios leve a moderado. Os pacientes foram avaliados em uma plataforma de força Biomec400. Os parâmetros analisados foram a área do centro de pressão dos pés (COP) e a amplitude e velocidade do COP nas direções anteroposterior (AP) e mediolateral (ML). Foram encontrados resultados estatisticamente significantes para amplitude AP e ML do COP e da área do COP, com valores maiores para as posições em tandem de OF e tandem com DT, quando comparados com a posição em tandem de OA. Os valores de velocidade média AP e ML foram maiores na posição em tandem de OF em comparação ao tandem de OA (p=0,009 e p=0), respectivamente. Concluiu-se que indivíduos com DP, quando submetidos a desafios cognitivos, comportam-se de forma semelhante à retirada do recurso visual no que diz respeito às alterações de equilíbrio. Isso reforça a necessidade de introduzir no plano terapêutico desses indivíduos atividades que requeiram o treino dessas habilidades.
Highlights
Balance disorders in individuals with Parkinson’s disease (PD) can occur at different stages of the disease, increasing their physical disability[1]
This was a cross-sectional study, in which we included individuals of both sexes, aged above 50 years, and with diagnosis of idiopathic PD according to the criteria of the London Brain Bank[13], from the neurology outpatient clinic of the Clinical Hospital of Londrina State University – in partnership with the Laboratory of Functional Evaluation and Human Motor Performance of Norte do Paraná University, in Londrina, Paraná, in mild to moderate stage according to the modified Hoehn & Yahr scale (HY)[14], able to walk by themselves, and not enrolled in other therapeutic programs besides the drug treatment.We excluded from the study patients with other neurological, musculoskeletal, and associated disorders and cognitive changes that could interfere in the evaluation process
The main results of this study showed a significant increase in the area of center of pressure (COP) displacement in Tandem stance performed with eyes closed (EC) and dual tasks (DT) when compared with Tandem stance with eyes open (EO)
Summary
Balance disorders in individuals with Parkinson’s disease (PD) can occur at different stages of the disease, increasing their physical disability[1]. This can be justified by the impairment of the central nervous system’s ability to process vestibular, visual, and proprioceptive afferences, which normally interprets them to generate the appropriate muscle responses that are responsible for the maintenance of body balance[2,3]. To obtain a good postural control, it is necessary to maintain the center of mass within the limits of stability in static or dynamic condition, as well as to control the position of the body in space[8]. There is the interaction of multiple systems, which comprise biomechanical components, sensory strategies, anticipatory and reactive mechanisms, stability limits, and perceptual and cognitive system[9,10]
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