Efeitos da fisioterapia aquática na qualidade de vida de sujeitos com doença de Parkinson

Abstract

A doença de Parkinson (DP) é uma doença degenerativa e progressiva do sistema nervoso central, e seus sintomas podem proporcionar um declínio da qualidade de vida (QV) dos pacientes, que pode ser influenciada positivamente pela fisioterapia aquática (FA). A FA é um recurso fisioterapêutico que utiliza os efeitos físicos, fisiológicos e cinesiológicos advindos da imersão do corpo em piscina aquecida. O questionário da doença de Parkinson 39 (PDQ-39) é o instrumento mais apropriado para a avaliação da QV do paciente com DP. O objetivo deste estudo foi avaliar os efeitos da FA na QV de pacientes com DP nos estágios de leve a moderado, utilizando-se do PDQ-39. Foram incluídos 13 pacientes com DP, com idade entre 45 e 74 anos, entre os estágios 1 a 3 da doença (Hoehn-Yahr). Os pacientes foram submetidos a 16 sessões de FA, duas vezes por semana, com duração de uma hora, em piscina terapêutica aquecida. A percepção da QV foi mensurada por meio do PDQ-39, antes e depois da FA. Depois da FA, ocorreu uma redução estatisticamente significativa (p<0,0001) tanto no escore total do PDQ-39 quanto em todos os seus domínios (p=0,032). A QV foi mais afetada em maiores estágios da doença. Antes da FA, a QV era pior no estágio mais avançado da doença, e apesar da melhora dos escores de QV depois da FA, o estágio mais avançado continuou apresentando pior percepção da QV. A FA proporcionou uma melhora na qualidade de vida dos pacientes com doença de Parkinson neste estudo.

Effect of the Ai-Chi Method on Functional Activity, Quality of Life, and Posture in Patients With Parkinson Disease

“…The PDQ-39 is capable of analyzing the effects of aquatic exercises in subjects with PD. 19 The reason for the lack of signifi cant results in the individual domains of the questionnaire in this study can be attributed to the fact that participants were not, at the start of the program, adapted to the aquatic environment. As a result, there was an improvement in the QOL of participants highlighting the psychological issue.…”

“…19 It is necessary to point out that in the literature there are a number of studies aimed at evaluating QOL using the PDQ-39 tool; however, no research study was found that used the application of an "Ai-Chi" protocol as a methodology for us to make comparisons closer to reality of the procedure performed. 19 It is necessary to point out that in the literature there are a number of studies aimed at evaluating QOL using the PDQ-39 tool; however, no research study was found that used the application of an "Ai-Chi" protocol as a methodology for us to make comparisons closer to reality of the procedure performed.…”

“…The results derived from the postural assessment bring us to the question of a postural reference standard, 19 where a symmetrical posture does not occur in the general population; even if these people do not exhibit any pain in the musculoskeletal system, they present changes in posture. The lack of a standard that approximates to reality in terms of alignment causes problems in comparing data from a patient's precise technical evaluation and also the evolution of physical therapy with an acceptable reference standard.…”

Multidisciplinary care and the reduction of levodopa intake of patients with advanced Parkinson's disease

“…Thus, further research on the multidisciplinary care in the management of PD, with special attention to the costs and effectiveness, is still necessary 14,18 for which control groups of intervention, as well as a description of the therapeutic processes is suggested.…”

“…16 In the contextual human development, the integrative approach between the person, his / her functions and / or tasks, and the environment in which he or she lives can contribute to new insights into quality of life. 17 In this perspective, there is now a breakthrough in joining multidisciplinary therapies for promotion, prevention and rehabilitation of the population health, with emphasis on meditation, yoga, hydrogymnastics, massage therapy, acupuncture, music therapy, manipulative therapies, Tai Chi, dance, among others 18 performed mainly by the elderly population as a resource for quality of life improvements and reduction of functional limitations.…”