Determinants of the use of physiotherapy services among individuals with Parkinson's disease living in Brazil

Abstract

To identify the factors affecting the use of physiotherapy services among individuals with Parkinson's disease (PD) living in Brazil. Methods: Overall, 479 individuals with idiopathic PD, of both sexes, at any stage of the Hoehn & Yahr (HY) scale, and from seven capital cities in Brazil were recruited from 2014 to 2016. Multivariate logistic regression was the main statistical tool. For the construction of the logistic model, the association of the dependent variable “physiotherapy” with the independent sociodemographic/economic and clinical variables: age, education, family income, time of PD since onset, HY, the activities of daily living and motor subscales of the Unified Parkinson's Disease Rating Scale, cognitive aspects, depressive symptoms, fear of falling, freezing gait, history of falls, physical activity level, gait speed, walking performance and balance, were verified. Results: The 479 individuals had an average age of 65.2 ± 11.0 years, 88% were in the HY I-III stages and 43.4% were under physiotherapy treatment. The analysis identified two determinant variables related to the use of the physiotherapy service: level of education (OR = 1.24) and walking performance (OR = 0.82). Decreased walking performance and a higher educational level increased the use of a physiotherapy service in individuals with PD living in Brazil. Conclusions: The present study shows that individuals with PD, residents from different regions of Brazil, have limited access to physiotherapy services. In addition, the Brazilian Public Health Care System, as well as local programs, need to target PD individuals with a low educational level to improve their access to physiotherapy services. Goals should aim towards the development of physical exercise programs to improve the patients’ functional performance for a longer period.

New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review

“…Patients with neurodegenerative diseases carrying out different types of physical activities: dance and fitness training, yoga, walking workout, light, moderate or high intensity aerobic exercise and daily activities for living, showed improvements in cardiovascular function, physical performance of the gait pattern, speed and length of the step and balance as well as delays in the decline of motor skills [10,23,35].…”

“…The following tools were used to assess the impact on emotional status, cognitive functions impairments, sleeping disorders and quality of life in home confinement: the Mini-mental Scale Examination (MMSE), which evaluates cognitive functions impairments [20][21][22]; the Montreal Cognitive Assessment (MOCA) [23]; the Geriatric -Depression Scale (GDS) [24,25]; Beck Depression Inventory-II (BDI-II), with score from 0 to 63, and high values means an increasing level of depression [26,27]; the Cognitive Emotion Regulation Questionnaire (CERQ) [28]; Social Support (SOZU-K) [29]; the Brief Resilience Scale (BRS) [30]; State Trait Anxiety Inventory (STAI); Optimist-5 point Scale; Quality of Life (QOL); Hoehn and Yahr (HY), Quality of Life short version (SF-8); Mental Component Summary (MCS); Motor experiences daily living (UPDRS) [10]; New-onset/worsening of sleep (NOWS), Restless legs syndrome (RLS), REM Sleep Behavior Disorder (REMBD), Item Content Validity Index (I-CVI), Scale Content Validity Index (S-CVI), Scale content validity Index Universal agreement (S-CVI-UA); Likert Scale; Sleep Disordered Breathing (SDB) [31].…”

The Mini-BESTest is an independent predictor of falls in Parkinson Disease

“…The data used in this study were part of the Rede Parkinson Brasil (REPARK-BR) 15 which was a cross-sectional multicenter study composed of a network of researchers dedicated to identify and describe the physical and functional profile of Brazilian individuals with PD. This study was approved by the Ethics and Research Committee of the institutions involved: Universidade Federal de Minas Gerais (CAAE: 15050713.…”

Multidimensional Factors Can Explain the Clinical Worsening in People With Parkinson's Disease During the COVID-19 Pandemic: A Multicenter Cross-Sectional Trial

“…Brazil is a continental country with large socioeconomic differences, where people with PD have to deal with the deficiency of the healthcare system toward disease treatment and with precarious telemedicine and e-health systems (9). In addition, the restricted access to healthcare and physical exercise during social distancing might produce additional stress and worsening of motor and non-motor symptoms in this population (10), which have been reported by people with PD living in Egypt during the COVID-19 lockdown (3).…”