Objective
The aim of the study was to verify the effectiveness of physiotherapy associated with cognitive training to improve cognition and quality of life in individuals with Parkinson disease.
Design
This is a randomized clinical trial involving 58 individuals with mild to moderate Parkinson disease, randomly distributed into two groups: motor group and cognitive-motor group. Both groups were assessed for cognition and quality of life at the beginning of the study, at the end of the intervention protocols, and 3 mos after the end of the intervention. The following instruments were used to assess cognition and quality of life: Mini-Mental State Examination, Montreal Cognitive Assessment, Verbal fluency test, Rey Auditory Verbal Learning Test, Cognitive and perceptual assessment by pictures, Trail Making Test, Clock Drawing Executive Test, and Parkinson Disease Quality of Life Questionnaire. The motor group engaged in motor physiotherapy, whereas the cognitive-motor group underwent combined motor physiotherapy with cognitive training.
Results
The intragroup analysis revealed that both groups presented improved cognition (memory and visuospatial function domains) and quality of life after execution of the protocols, but without statistically significant intergroup differences.
Conclusions
When comparing the intervention moments, the two treatment approaches used were effective for the outcomes: memory, visuospatial function, and quality of life in both groups.
We confirmed that balance based on COP measures was reliable in individuals with Parkinson's disease, especially during the Romberg condition with closed eyes.
Introduction: Gait impairments are one of the earliest signs reported by patients with Parkinson's disease (PD) and cause an increased number of falls and decreased quality of life among these patients. Objective: To compare the effectiveness of three physical therapy interventions using Rhythmic Cues (RC), Swiss Ball (SB) and Dual Task (DT), with an emphasis on gait treatment (step and stride length, duration and velocity), in individuals with PD. Methods: Quasi-randomized clinical trial addressing a sample composed of 45 individuals assigned to three groups. The individuals were assessed before and after the intervention protocol using the following: Modified Hoehn and Yahr Scale (HY), Unified Parkinson's Disease Rating Scale (UPDRS), Footprint analysis, Video Gait analysis, and Timed Up and Go Test (TUG). The groups were homogeneous concerning age, HY and UPDRS. Statistical analysis was performed using SPSS, version 20.0. Results: Statistically significant differences were found in all the variables analyzed in the RC and SB groups when compared in the pre-and post-intervention. With the exception of the TUG variable, the DT group presented statistically significant differences in all the remaining variables. Conclusion: The three interventions were effective for the outcomes under study, but the SB group presented the greatest magnitude of
Objetivo: Verificar a efetividade da fisioterapia no sistema cognitivo-perceptual de indivíduos com doença de Parkinson (DP). Métodos: Trata-se de série de casos prospectiva, composta por 16 indivíduos com DP, entre os estágios 1,5 a 3 na escala de Hoehn e Yahr modificada (HY), avaliados antes, ao final e três meses pós-intervenção (follow up) utilizando-se os seguintes instrumentos: Escala Unificada para Avaliação da DP, Escala de Estadiamento HY modificada, Escala de Depressão Geriátrica (GDS), Mini-exame do estado mental (MEEM), Índice de Katz e duas ilustrações visomotoras. Receberam intervenção fisioterapêutica totalizando 20 sessões visando a melhora do sistema cognitivo-perceptual. Resultados: Foram encontradas diferenças estatisticamente significantes entre os valores pré e pós (P=0,03) e entre o pós e o follow up (P=0,03) para a execução das duas ilustrações visomotoras. Quanto aos demais desfechos não foram encontradas diferenças significantes. Conclusão: A intervenção realizada foi efetiva para o sistema perceptual em indivíduos com DP. Entretanto, não foram observadas diferenças estatisticamente significantes entre os valores dos três momentos de avaliação nas escalas MEEM, GDS e Índice de Katz.
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