Role of Sensory Input and Muscle Strength in Maintenance of Balance, Gait, and Posture in Parkinson???s Disease

Nallegowda, Mallikarjuna; Singh, Upinderpal; Handa, Gita; Khanna, Meeka; Wadhwa, Sanjay; Yadav, Shiv Lal; Kumar, Guresh; Behari, Madhuri

doi:10.1097/01.phm.0000146505.18244.43

Cited by 158 publications

(147 citation statements)

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“…So, this could contribute to a better ankle performance compared to the hip. Nallegowda et al 27 also observed no differences in ankle dorsiflexor peak torque values between the groups at 90°/s, 120º/s, and 15 0º/s speeds for individuals with mild PD. Future studies aiming to better evaluate the relationships between axial and distal muscles in PD should include a larger sample.…”

Section: Discussionmentioning

confidence: 96%

Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

Lima

Cardoso

Teixeira-Salmela

et al. 2016

Arq. Neuro-Psiquiatr.

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Parkinson's disease (PD) is a neuro-degenerative disease in which the progressions of the symptoms are associated with progressive loss of strength and power, which leads to deterioration of physical abilities 1,2 . Studies that employed measures of peak torque have observed muscular deficits in individuals at various stages of PD, mainly in the intermediate and advanced phases 3,4 . Usually, these individuals demonstrated bilateral motor impairments, which are associated with deficits in balance and gait and may contribute to immobility and poorer functional performance 5 .Recently, studies have found that in the early stages, individuals with PD already demonstrate cognitive decline 6 , impaired planning 7 , altered dynamic postural control 8 , and functional losses when compared to those without the disease 9 . In addition to these impairments, it is possible that muscle deficits may also contribute to the functional losses. However, few studies have investigated muscular performance in individuals in the early stages of PD. Bridgewater and Sharpe 10 showed decreases in trunk extensor torque during the early-stages of PD, which could contribute to the flexed posture observed in the advanced stages. Koller and Kase 11 observed decreases in the maximal isotonic knee strength of individuals in the early stages of the disease; however, the hip and ankle muscular groups were not assessed. Furthermore, several studies have AbstrACtStudies which have investigated muscular performance during the initial stages of Parkinson´s disease (PD) without L-dopa treatments were not found. Objective: to assess whether muscular performance, work and power, of the trunk and lower limbs in L-dopa naïve patients in the early stages of PD was lower than those of healthy subjects and to compare muscular performance between the lower limbs. Method: Ten subjects with PD, Hoehn and Yahr (HY) I-II, L-dopa naïve and 10 subjects in the control group were assessed with the isokinetic dynamometer. Results: ANOVAs revealed that work and power measures of the trunk, hip, knee, and ankle muscular groups were lower in PD compared with the control group (p < 0.05). There were no significant differences in muscular performance between the lower limbs. Conclusion:The results suggested the use of specific exercises, as rehabilitation strategies, to improve the ability to produce work and power with this population.Keywords: Parkinson's disease; muscle strength; Muscle strength dynamometer; rehabilitation; physical therapy speciality. resumo Estudos que investigaram o desempenho muscular durante os estágios iniciais da doença de Parkinson (DP), sem tratamento com L-dopa não foram encontrados. Objetivo: Avaliar se o desempenho muscular, por meio de medidas de trabalho e potência, do tronco e dos membros inferiores em pacientes sem o uso de L-dopa nas fases iniciais da DP é menor do que o de indivíduos saudáveis e comparar o desempenho muscular entre os membros inferiores. Método: Dez indivíduos com DP, Hoehn and Yahr (HY) I-II, sem L-dopa e 10 indiv...

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Section: Discussionmentioning

confidence: 96%

Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

Lima

Cardoso

Teixeira-Salmela

et al. 2016

Arq. Neuro-Psiquiatr.

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“…Studies in such line by Schmitz-Hübsch et al, (Schmitz-Hübsch, et al, 2006) demonstrated -after 3, 6 and 12 months-that there were more patients whose symptoms improved in the Qigong group than in control group within a 3 and 6-month period (P = 0.0080 for 3 months and P = 0.0503 for 6 months; using the Fisher's exact test); depression scores diminished in both groups, while the incidence of non-motor symptoms only diminished in the treatment group (Schmitz-Hübsch, et al, 2006). Nallegowda et al (Nallegowda, et al, 2004), showed that medication improves muscular strength, gait-speed and ankle optimization when gaiting, and did not observe worsening of the propioceptive sense. However, it was observed a correlation among muscle strength, static and dynamic balance, and gait in both on and off phases (Nallegowda, et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Versus no Intervention – Only a Continued Intensive Program Conducted Statistically Significant Improvements Motor Skills in Parkinson's Disease Patients

Calvo¹,

Fernández²

2011

Diagnostics and Rehabilitation of Parkinson's Disease

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“…As variá-veis foram analisadas nos sentidos anterior (VMA, EMA e CDA), posterior (VMP, EMP e CDP), direito (VMD, EMD e CDD) e esquerdo (VME, EME e CDE), sendo que os sentidos anterior e posterior caracterizaram a direção AP, e os sentidos direito e esquerdo caracterizaram a direção LL. 10,14,15 . Essa medida única pode mascarar déficits específicos da direção no LE que comprometam a execução de determinadas atividades funcionais em indivíduos com DP.…”

Section: Teste De Limite De Estabilidadeunclassified

“…Vários estudos avaliaram o LE na direção AP e reportaram uma redução dele em indivíduos com DP 9,[15][16][17] . Por outro lado, poucos estudos reportaram o LE na direção LL desses indivíduos 17,20 .…”

Section: Teste De Limite De Estabilidadeunclassified

“…Esse teste simula o que ocorre em situações de transição postural na direção ântero-posterior (AP) tanto no movimento de sentado para de pé ou na direção médio-lateral como em movimentos de alcance em ortostatismo e início da marcha 9,11 . O TLE já foi aplicado em idosos 12 , hemiplégicos 13 e em indivídu-os com doença de Parkinson (DP) 10,14,15 .…”

Section: Introductionunclassified

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Redução do limite de estabilidade direção-específica em indivíduos leve a moderadamente afetados pela doença de Parkinson

Diniz

Lima²,

Cardoso³

et al. 2011

Fisioter. Pesqui.

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CONFLITO DE INTERESSE nada a declarar Parecer de aprovação no Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (UFMG) -nº ETIC 444/05RESUMO: A instabilidade postural na doença de Parkinson (DP) tem sido associada a uma diminuição do limite de estabilidade (LE) na direção ântero-posterior (AP). Entretanto, ainda que possíveis alterações do LE na direção látero-lateral (LL) tenham sido sugeridas, tal direção não tem sido avaliada nos estudos com DP, principalmente quando o teste de limite de estabilidade (TLE) envolve movimentos intencionais que deslocam o centro de massa corporal (CMC). O objetivo do presente estudo foi investigar o LE na postura de pé durante movimentos voluntários que promovem deslocamento do CMC nas direções AP e LL de indivíduos com e sem a DP. Doze indivíduos com DP (Hoehn & Yahr=II, III) e 12 sem a doença realizaram o TLE nos sentidos anterior, posterior, direito e esquerdo. A velocidade de movimento (VM), excursão máxima (EM) e o controle direcional (CD) do CMC foram avaliados em cada sentido. Os indivíduos com DP foram significativamente mais lentos em todos os sentidos de deslocamento do CMC (p<0,05). Não houve diferença significativa na EM e CD no sentido anterior entre os grupos (p>0,05). Por outro lado, a EM e CD do CMC foram menores para o grupo DP no sentido posterior (P) e na direção LL (p<0,05). Indivíduos leves a moderadamente afetados pela DP apresentaram redução do LE no sentido P e na direção LL quando comparados ao grupo controle. Os resultados sugerem que tal direção e sentido devam ser treinados em ortostatismo, com movimentos que deslocam voluntariamente o CMC, desde fases iniciais da DP. The movement velocity (MV), maximum excursion (ME), and directional control (DC) of the COM were evaluated in all investigated directions. Individuals with PD demonstrated smaller COM displacements in all directions (p<0.05). There were no significant differences between the groups regarding the ME and DC in the anterior direction (p>0.05). However, the ME and DC of the COM were smaller for the PD group in the backward, right, and left directions (p<0.05). Individuals with mild to moderate PD demonstrated decreases in the LOS in the posterior and LL directions, when compared to individuals without the disease. These findings suggested that such directions should be trained in the standing position with voluntary movements of the COM from the early stages of PD.

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Role of Sensory Input and Muscle Strength in Maintenance of Balance, Gait, and Posture in Parkinson???s Disease

Cited by 158 publications

References 32 publications

Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

Rehabilitation Versus no Intervention – Only a Continued Intensive Program Conducted Statistically Significant Improvements Motor Skills in Parkinson's Disease Patients

Redução do limite de estabilidade direção-específica em indivíduos leve a moderadamente afetados pela doença de Parkinson

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