Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.

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Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants’ weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.

Objectives: This study evaluated the capacity of cardiac risk stratification protocols on simple complications that occur during activities of a cardiovascular rehabilitation program. Design: Observational longitudinal cohort study. Setting: Outpatient clinic of cardiovascular rehabilitation. Subject: Patients diagnosed with cardiovascular disease and/or risk factors. Interventions: Not applicable. Main measures: The relationship between the cardiac risk classes of seven risk stratification protocols and the occurrence of simple complications (such angina, abnormal changes in blood pressure, arrhythmias, fatigue, muscle pain, pallor) was assessed using the chi-square test, and when statistical significance was observed, sensitivity, specificity and accuracy were determined. Results: About 76 patients were analyzed. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) protocol showed a statistically significant relationship between simple complications and cardiac risk classes ( P-value = 0.046), however the results of sensitivity (0.53), specificity (0.52), and accuracy (0.53) were not significant. The other protocols analyzed were not significant: American College of Sports Medicine ( P-value = 0.801), Brazilian Society of Cardiology ( P-value = 0.734), American Heart Association ( P-value = 0.957), Pashkow ( P-value = 0.790), Society French Cardiology ( P-value = 0.314), and Spanish Society of Cardiology ( P-value = 0.078). Conclusion: The AACVPR protocol showed a significant relationship between the risk classes and the occurrence of simple complications, however, the low values obtained for sensitivity, specificity and accuracy show that it is not useful for this purpose. Clinical trials registration: NCT03446742.

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Background The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. Objective To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. Methods A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. Results At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. Conclusion Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.

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A Doença de Parkinson (DP) é caracterizada pela degeneração progressiva de neurônios dopaminérgicos da substância negra, resultando em desordens não motoras e motoras que estão relacionadas com o aparecimento de tremor de repouso, bradicinesia, rigidez articular, instabilidade postural, alterações no padrão da marcha, declínio do equilíbrio. A Fisioterapia em Grupo no formato de Circuit Training (FGCT) é um modelo terapêutico baseado em estações de trabalho dispostos num formato de circuito dirigido que reproduzem atividades físicas. O objetivo foi avaliar a velocidade de marcha rápida, de indivíduos com DP submetidos a sessões de FGTC. Participaram deste estudo 13 voluntários com DP. A avaliação inicial (AV1) foi realizada utilizando o Time up and go (TUG) e o Teste de velocidade de marcha de 10 metros (TV10M). No TUG, a velocidade de execução média foi de 0,68 ± 0,19 m/seg na AV1 e 0,66 ± 0,14 m/seg na AV2 e no TV10M de 1,36 ± 0,26 m/seg na AV1 enquanto na AV2 foi 1,45 ± 0,32 m/seg, sem diferença significante entre os dois momentos de medida. Os parkinsonianos não apresentaram melhoras funcionais talvez porque a terapia não teve exercícios com enfoque na velocidade da marcha e o tempo de terapêutica pode não ter sido suficiente para ocorrer mudanças nesse aspecto. Porém, sabe-se que a reabilitação em grupo contribui na melhora do estado de saúde global do paciente, permitindo maior socialização entre os indivíduos. Pode-se concluir que o protocolo terapêutico utilizado não foi suficiente para alterar a velocidade da marcha dos pacientes. Palavras-chave: Doença de Parkinson, marcha, exercícios em circuito, Fisioterapia, reabilitação neurológica.