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Acute effect of automatic mechanical peripheral stimulation in the cinematics of the march and function in individuals with Parkinson's Disease

Grant number: 17/08232-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): December 01, 2017
Effective date (End): November 30, 2018
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Nise Ribeiro Marques
Grantee:Marina Hiromi Kuroda
Home Institution: Centro de Ciências da Saúde. Universidade do Sagrado Coração (USC). Bauru , SP, Brazil

Abstract

Introduction: As life expectancy increases, the prevalence of chronic neurodegenerative diseases increases. Among these diseases the second most prevalent is Parkinson's disease. Parkinson's disease is a chronic and progressive condition of the nervous system, which leads to the death of Dopamine. Among the symptoms of Parkinson's disease are stiffness, instability Postural, akinesia, bradykinesia and tremor, besides gait alterations. Between the Changes in gait are the reduction of step length and speed; And the presence of freezing, which leads to a reduction in mobility and Quality of life, as well as increased risk of falls. Peripheral stimulation Automated mechanics (EPMA) was developed to perform sensory Bilateral feet in specific areas (the base of the first metatarsus and the head of the hallux). It is suggested that this mechanism be effective in reducing gait freezing, slowing movement (bradykinesia) and promoting postural stability. However, the capacity of this intervention to reeducate the gait of the elderly with Parkinson's disease is not yet clear. Objective: To analyze the effect of an EPMA session on postural control, gait kinematics and functional performance in individuals with Parkinson's disease. Method: The present study is a double blind crossover clinical trial. We will recruit 30 participants with clinical diagnosis of Parkinson's disease, with no history of peripheral neuropathy and other degenerative or neurological diseases. Data collection will be performed in two visits to the collection environment, separated by an interval of at least 72 hours between visits. Scales will be used: Hoehn and Yahr scale and unified scale of evaluation of Parkinson's disease (UPDRS); Short Physical Performance Battery (SPPB); And the test: Timed Up and Go (TUG) and Miniexame of mental state; Before and after the intervention. The gait evaluation will be performed through footswitches located in the calcaneus and the base of the hallux to determine gait phases. With the aid of the accelerometer fixed in the spinous process in L5, the evaluation of the postural control will be carried out. The intervention will be through the EPMA and placebo. The kinematics will be evaluated by the parameters: gait velocity, stride length, support time, balance, single support, double support and last, as well as, the variability of these parameters will be calculated by means of the standard deviation. In addition, the total mid-lateral displacement of the center of gravity will be calculated. (AU)