Background: Idiopathic Parkinson’s disease (PD) is a progressive neurodegenerative disease that has a prevalence of 18–328 per 100,000 in habitants in developing countries, with an estimated 3.3% of the Brazilian elderly population affected by PD throughout life. The classic symptoms include a resting tremor, muscular rigidity, bradykinesia and postural instability, which are all motor symptoms. The mobility of the subjects is compromised early, thus impairing their balance and limiting their ability to perform simple tasks. The restricted movement prevents dissociation between the head and trunk during walking, and freezing occurs as advanced disease reduces the progression of movements during walking. Objective: To analyze mobility and functionality profiles in subjects with Parkinson’s disease and compare them with healthy subjects. Method: A sample was consisted of 10 subjects with PD and 10 healthy elderly subjects. Assessment tools were used to quantify the severity of PD the scale Hoehn and Yah (HY), for mobility were used the Dynamic Parkinson’s Gait Scale (DYPAGS) and Modified Parkinson Activity Scale (PAS modified), for functionality were used the Unified Parkinson’s Disease Rating Scale (UPDRS) and dual task (DT) performance. Results: The subjects with PD showed worse performance in mobility and DT as determined by the modified PAS (p=0.0001) and DYPAGS (p=0.0001). Correlations were found between the UPDRS, the Gait Freezing Questionnaire (FOG), the PAS modified score, left-hand grip strength and the HY values (p<0.05). There were no differences in prehensile muscle strength between PD and healthy subjects. Conclusions: Subjects with PD showed decreased mobility and functionality for activities related to ADLs, gait and DT compared to healthy elderly subjects. Disease severity, muscle strength and freezing were correlated with the mobility and DT performance in subjects with PD.

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Background: It is estimated that the prevalence of cerebrovascular accident (CVA) increases significantly as a result of the increase in the elderly population, leading to dependence and care. Interventions with physical exercises are essential for patients with chronic CVA and hemiparesis to contribute to functional motor recovery. The gait of the hemiparetic patients is very impaired, including decreased speed, unipodal support in the abbreviated paretic limb, increased step length, decreased hip flexion, increased knee flexion and plantar flexion and involves compensatory strategies to deal with deficits of the affected limb. Rehabilitation programs of patients with CVA should focus on the restoration of the individual's independence and ability to move. Objective: To analyze the effects of the addition of a load on a lower limb not affected in the discharge of weight and motor function of paretic lower limb. Method: Experimental, randomized, double-blind study conducted at the Physiotherapy and Occupational Therapy Outpatient Clinic of the Hospital das Clínicas (HC)-UNICAMP. Participants were assessed by the Confidence and Balance Scale, Fugl-Meyer Assessment of Physical Performance (FMA), Modified Ashworth Scale (MAS), Postural Stroke Scale for post-stroke patients (PSS), Time up and go test (TUG), 10-Meter gait test, Stroke Scale Barthel and weight transfer in the affected lower limb. Participants were treated in 12 walking training sessions on the treadmill with 1 kg added to the ankle of the lower limb. Results: There were variations between the 3 times for gait time (p= 0.005), FMA (p= 0.002), Activities-specific Balance Confidence Scale (ABC scale) (p= 0.007) and EAPA (p= 0.042). Conclusion: Treadmill therapy and weight addition in the healthy limb revealed improvement in motor function, balance in orthostatism and walking speed.

Objetivo: Descrever e analisar os ganhos funcionais e a saúde auto referida de idosos submetidos a terapia em grupo. Métodos: Os idosos foram submetidos as intervenções 2 vezes na semana durante 12 semanas, com duração de 50 min cada atendimento. Foi desenvolvido pela equipe de pesquisadores, um protocolo de atividades variadas envolvendo exercícios de mobilidade, equilíbrio, coordenação, cognição, fortalecimento muscular de membros inferiores e superiores, alongamentos e socialização. Foi utilizado: O Mini Exame do Estado Mental (MEEM), escala de Categoria de Deambulação Funcional (EDF), Prova Cognitiva de Leganés (PCL) e O Short Physical Performance Battery (SPPB). Resultados e conclusões: Nossos resultados mostram melhora na percepção de saúde e um impacto positivo sobre a cognição, socialização e no ganho de força muscular, refletidos nos instrumentos utilizados. Confirmamos ainda, a importância e incentivamos a participação de idosos em grupo de exercícios supervisionados.

Objective: The aim of this study was to evaluate the effects on static and dynamic balance after the use of textured insoles. Method: Fifteen subjects with multiple sclerosis were evaluated before using the insoles, after using them for 1 month, and after 2 months without using, them using the following measuring instruments: the Berg Balance Scale, Dynamic Gait Index, and 10-meter Walk Test, a means of functional gait assessment. Results: Improvement was observed in the Berg Balance Scale and Dynamic Gait Index scores, walking time, number of steps and step length after using the insoles for 1 month. The improvement in Berg Balance Scale score remained after two months without the insoles and there were no changes in gait speed. Conclusion: The use of textured insoles was effective as an intervention to improve static and dynamic balance in patients with multiple sclerosis.

Background: Parkinson’s disease (PD) was initially described as a movement disorder, however there is now recognition that its clinical features also include non-motor symptoms such as cognitive impairment and dementia, which are frequent even in the early stages of the disease and, especially in the advanced stages. Cognitive deficits in PD include impairments in executive functions, attention, memory, and visuospatial skills. Cognitive impairment may manifest as mild cognitive impairment (MCI) or dementia, in which MCI refers to the stage between normal cognitive functioning and dementia. Factors associated with cognitive dysfunction in PD include advanced age, low schooling, worse motor scores, stiffness, postural instability and increased daytime sleepiness. Objective: To track cognitive decline and to correlate measurement instruments in subjects with PD by comparing them to healthy subjects. Methods: Study conducted at the Faculty of Health Sciences of Trairi / UFRN. The sample consisted of 20 old people (10 healthy elderlies and 10 elderlies with PD). It was applied the socio-demographic record, Unified Parkinson’s Disease Rating Scale (UPDRS II and III), Hoehn & Yahr Scale, Mini Mental State Examination, Leganés Cognitive Test (LCT) and Montreal Cognitive Assessment (MoCA). Results: It was observed cognitive decline in both groups by MoCA (90% of the PD group and 80% of the healthy group), with no statistically significant difference (p=0.10). It was also verified association between UPDRS II and LCT (r= -0.69, p=0.03) and between UPDRS III and LCT (r=-0.66, p=0.04). Conclusion: We found a cognitive deficit in the elderly group with PD, with no significant difference when compared to the healthy elderly. There was an association between motor and cognitive function in subjects with PD. MoCA was more sensitive in the screening of cognitive deficit in subjects with PD.

Background: Several attempts to reduce spasticity have been directed to stroke sufferers based on the historical view that spasticity is the major determinant of motor dysfunction and that its reduction results in improved function of the affected limb. Paresis is also recognized as a limiting factor in hemiparetic rehabilitation and has a negative impact on self-care, mobility, or up and down stairs due to slow activation of motor units and difficulty in producing adequate amount of muscle strength. In the treatment of spasticity, many therapeutic procedures have been used. Resisted exercises occur when there is load on the body segment distal to the muscle that develops muscle tension, occurs muscle shortening and an external force is overcome. Objective: The aim of this study was to analyze the results of isometric and isotonic strengthen program in the quadriceps muscles of the affected limb of patients with chronic hemiparesis secondary to stroke and to evaluate its effects on spasticity, motor function of the lower limb, balance and mobility. Methods: The participants were divided into three groups: isotonic strengthening, isometric strengthening and control group. It was applied the Ashworth scale, Fugl-Meyer Protocol, Time Up and Go test and Berg Balance Scale. Results: The isometric and isotonic strengthening program presented post-treatment variations, whereby only the isometry group showed improvement in balance. The control group did not show a significant improvement. There was no increase in the muscular tonus of the quadriceps or hamstrings immediately after the treatment. Conclusion: The selective muscle strengthening of the quadriceps resulted in an increase of the motor function, balance and mobility followed by a decrease or maintenance of the muscular tonus of the patients.