Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

Abstract

Abstract-The purpose of this study was to investigate the effects of a multimodal exercise program (MEP) on the functional capacity of patients with Parkinson's disease (PD) according to disease severity and gender. Fourteen patients with PD participated in the study and were distributed into groups according to 1) stage of disease and 2) gender. Functional capacity was evaluated before and after 6 months of intervention. The overall PD patient group improved their coordination and strength. Men and women improved in strength performance after exercise. Men also improved on coordination. For severity of disease, the unilateral group improved in strength, while the bilateral group improved in strength, balance, coordination and the UPDRS-functional score. In conclusion, a MEP is efficient in improving components of functional capacity in patients with PD, especially in strength. Gender may be considered in the exercise program. Individuals in the bilateral disease group appeared to benefit more from exercise. Keywords: multimodal exercise program, functional capacity, Parkinson's diseaseResumo-"Efeitos de um programa de exercícios multimodal na capacidade funcional de pacientes com doença de Parkinson considerando a gravidade da doença e sexo". O objetivo deste estudo foi investigar o efeito de um programa de exercício multimodal (PEM) na capacidade funcional de pacientes com doença de Parkinson (DP), de acordo com a severidade da doença e gênero. Catorze pacientes com DP participaram do estudo, distribuídos em dois grupos: 1) severidade da doença, 2) gênero. A capacidade funcional foi avaliada antes e após 6 meses de intervenção. Em geral, os pacientes melhoraram a coordenação e força. Homens e mulheres melhoraram o desempenho da força após o exercício. Os homens também melhoraram a coordenação. Para a severidade da doença, o grupo unilateral melhorou a força, enquanto o grupo bilateral melhorou força, equilíbrio, coordenação e UPDRS funcional. Portanto, o PEM é eficiente na melhoria dos componentes da capacidade funcional de pacientes com DP, especialmente a força. O gênero deve ser considerado no programa de exercício. Pacientes no estágio bilateral parecem ter mais benefícios do exercício. Palavras-chave: programa de exercício multimodal, capacidade funcional, doença de ParkinsonResumen-"Efectos de un programa de ejercicio multimodal en la capacidad funcional de los pacientes con enfermedad de Parkinson teniendo en cuenta la gravedad de la enfermedad y el sexo". Esto estudio investigó el efecto de un programa de ejercicio multimodal (PEM) en la capacidad funcional de pacientes con enfermedad de Parkinson (EP), considerando la severidad de la enfermedad y el género. Catorce pacientes con EP participaron del estudio, distribuidos en grupos: 1) severidad de la enfermedad, 2) género. La capacidad funcional fue avaluada antes y después de 6-meses de intervención. En general, los pacientes mejoraron coordinación y fuerza. Hombres y mujeres mejoraron el desempeño de la fuerza después del ejercicio. Todavía, los homb...

Effects of physical exercise on articular range of motion of the lower limb in the Parkinson's disease individuals

“…The widespread nature of the exercise seems to benefit men and women similarly, and patients in both early and moderate stages of PD. This result contradicts the findings in the literature 11 which indicate that the benefits of physical exercise occur according to gender and the severity of the PD. One possible explanation for the independence of the benefits in relation to gender and the severity of the PD is the relationship between arcitular range movement and the signs/symptoms of the PD, especially muscle rigidity and hypokinesia 19 , since all the PD patients exhibit these motor symptoms in some degree.…”

“…In general, the results confirmed the hypothesis of the study, indicating that after eight months of physical exercises there is an improvement in the articular range of motion in patients with PD. This finding corroborates studies which verified the effect of long-term physical exercises 6,8,11 , indicating that the physical exercise is important in controlling the progression of PD. However, the effect of physical exercises on articular range of motion seems not to be influenced by gender and by the severity of the PD, indicating that the effects are independent from these aspects.…”

“…• emphasis on improving functional capacity, especially muscle strength 11 , facilitating an increase in range of motion due to improved neuromuscular control;…”

“…Studies of short and long duration have shown benefits of exercise in PD functional capacity [8][9][10][11] , locomotion 5,6 , postural control 12,13 and cognitive functions 14,15 . However, little is known about the effects of exercise on the articular range of motion in patients with PD.…”

“…The study hypothesis is that after eight months of exercises it would occur an improvement in the articular range of motion of the lower limbs. Specifically to the gender matter, it is expected that the benefits are similar for men and women, due to higher benefits that men presented for functional capacity 11 and the higher bioavailability of levodopa presented by women 19 . As for severity of the PD, it is expected that patients in more advanced stages have more benefits out of the exercise, due to the higher stiffness symptoms presented by this group 20 .…”