Efeitos da equoterapia no desempenho funcional e na qualidade de vida de pessoas com doença de Parkinson

Abstract

Introduction: Parkinson's disease is a neurodegenerative and progressive disease that has a high prevalence nowadays. Characterized by motor symptoms, such as, tremor, rigidity, and bradykinesia, Parkinson's disease is also associated with non-motor symptoms, such as anxiety and depression. One of the strategies recommended for non-drug treatment is physical exercise, for example, resistance training. However, some patients do not perform resistance training because they cannot remain in a standing position. On the other hand, hippotherapy has been proven as an effective treatment to increase functional performance and Health Related Quality of Life in people with neurological problems, but have not been studied in people with Parkinson's disease with mobility problems. Purpose: This study aimed to verify the effects of hippotherapy on functional performance and on Health Related Quality of Life in people with Parkinson's disease with mobility problems. Methods: It is a pre-experimental study. The sample consisted of nine volunteers, six men and three women with Parkinson's disease (n = 9), classified in level three or above in the Hoehn & Yahr scale. The functional performance tests: Timed Up and Go, Ten Meters Walk Test, Berg Balance Scale, 30-s Chair-Stand and the Parkinson's Disease Quality of Life Questionnaire (PDQL) were carried out and applied before and after ten weeks of training with hippotherapy to evaluate five variables: the functional mobility, the gait velocity, the balance, the functional strength of lower limbs and the Health Related Quality of Life. The Student t test for paired samples was used to verify the differences before and after the treatment, so we calculated the effect size with the Cohen's d. Results: There were identified significant improvements in balance (p = 0.044), functional mobility (p = 0.047), gait velocity (p = 0.047) and emotional functioning (p = 0.001), however, there was no difference in functional strength of lower limbs (p = 0.41). The effect size indicated effects on Health Related Quality of Life: emotional function (1.28), systemic symptoms (0.95), social function (0.89) and Parkinsonian symptoms (0.85).Conclusion: The practice of hippotherapy for 10 weeks improved significantly the balance, the functional mobility, the gait velocity and the Health Related Quality of Life of people with Parkinson's disease with mobility problems, however, it did not improve the functional strength of lower limbs.