Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease

• Grant number: 18/16909-1
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• Effective date (Start): April 15, 2019
• Effective date (End): March 24, 2020
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Carlos Ugrinowitsch
• Grantee: Carla da Silva Batista
• Supervisor: Fay Horak
• Host Institution: Escola de Educação Física e Esporte (EEFE). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Research place: Oregon Health & Science University, United States
• Associated to the scholarship: 16/13115-9 - Effects of resistance training with instability on clinical outcomes, spinal mechanisms, and brain metrics in individuals with freezing of gait in Parkinson's disease, BP.PD

Abstract

Freezing of gait (FOG) in Parkinson's disease (PD) affects approximately 26% of individuals with moderate PD and 80% of individuals with severe PD, and it is one of the most common causes of falls, dependency, and poor quality of life. FOG is because of impaired coupling between postural and locomotor components that result in reduced connectivity in frontal motor regions, prefrontal cortices, and subcortical areas. Moreover, deficits in spinal control and cognitive dysfunction seem to contribute to FOG. Thus, studies should investigate the effects of powerful innovative therapeutic interventions on central, spinal and cognitive outcomes, as pharmacological, surgical and therapeutic interventions (e.g., use of external cues) do not seem to effectively decrease FOG episodes. Therefore, the objective of this randomized controlled trial will be to examine the effects of 12 weeks of resistance training with instability (RTI) on clinical outcomes, spinal mechanisms, and cerebral metrics of individuals with FOG between stages 3 and 4 of the PD. Thirty individuals (will be tested and trained in the "on" medication state) that meet the inclusion criteria will be randomized into two groups: RTI group (RTIG) and physiotherapy group (PG). While the PG will perform physiotherapy at Brazil Parkinson's Association and at Movement Disorders Clinic at School of Medicine at University of São Paulo three time a week on non-consecutive days, the RTI group will go three time per week on non-consecutive days to the gym at University of São Paulo to perform 7 exercises with high motor complexity (i.e., 7 progressive resistance exercises [no machine only free weights] concomitantly with progressive unstable devices). Both groups will perform 90 minutes of physiotherapy or RTI per session. Will be assessed before and after the 12 week clinical outcomes, spinal inhibitory mechanism, and brain metrics. Appropriate statistical analysis will be conducted to verify the effect of RTI on clinical outcomes, spinal mechanism, and brain metrics after 12 weeks compared to PG. (AU)

Scientific publications

(11)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

VIEIRA-YANO, BIANCA; MARTINI, DOUGLAS N.; HORAK, FAY B.; DE LIMA-PARDINI, ANDREA; ALMEIDA, FILIPE; SANTANA, VAGNER P.; LIMA, DANIEL; BATISTA, ALANA X.; MARQUESINI, RAQUEL; LIRA, JUMES; et al. The Adapted Resistance Training with Instability Randomized Controlled Trial for Gait Automaticity. MOVEMENT DISORDERS, v. 36, n. 1, p. 152-163, JAN 2021. (18/16909-1, 16/13115-9)

LIRA, JUMES LEOPOLDINO OLIVEIRA; UGRINOWITSCH, CARLOS; COELHO, DANIEL BOARI; TEIXEIRA, LUIS AUGUSTO; DE LIMA-PARDINI, ANDREA CRISTINA; MAGALHAES, FERNANDO HENRIQUE; BARBOSA, EGBERTO REIS; HORAK, FAY B.; SILVA-BATISTA, CARLA. Reply from Jumes Leopoldino Oliveira Lira, Carlos Ugrinowitsch, Daniel Boari Coelho, Luis Augusto Teixeira, Andrea Cristina de Lima-Pardini, Fernando Henrique Magalhaes, Egberto Reis Barbosa, Fay B. Horak, and Carla Silva-Batista RESPONSE. JOURNAL OF PHYSIOLOGY-LONDON, v. 600, n. 2, DEC 2021. (15/13096-1, 18/16909-1, 16/13115-9)

SILVA-BATISTA, CARLA; DE LIMA-PARDINI, ANDREA CRISTINA; NUCCI, MARIANA PENTEADO; COELHO, DANIEL BOARI; BATISTA, ALANA; PIMENTEL PIEMONTE, MARIA ELISA; BARBOSA, EGBERTO REIS; TEIXEIRA, LUIS AUGUSTO; CORCOS, DANIEL M.; AMARO JR, EDSON; et al. A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait. MOVEMENT DISORDERS, v. 35, n. 9, p. 11-pg., 2020-06-18. (16/13115-9, 18/16909-1)

MOREIRA-NETO, ACACIO; UGRINOWITSCH, CARLOS; COELHO, DANIEL BOARI; DE LIMA-PARDINI, ANDREA CRISTINA; BARBOSA, EGBERTO REIS; TEIXEIRA, LUIS AUGUSTO; AMARO JR, EDSON; HORAK, FAY B.; MANCINI, MARTINA; NUCCI, MARIANA PENTEADO; et al. Freezing of gait, gait initiation, and gait automaticity share a similar neural substrate in Parkinson's disease. HUMAN MOVEMENT SCIENCE, v. 86, p. 11-pg., 2022-11-02. (16/13115-9, 18/16909-1)

SILVA-BATISTA, CARLA; DE LIMA-PARDINI, ANDREA CRISTINA; NUCCI, MARIANA PENTEADO; COELHO, DANIEL BOARI; BATISTA, ALANA; PIMENTEL PIEMONTE, MARIA ELISA; BARBOSA, EGBERTO REIS; TEIXEIRA, LUIS AUGUSTO; CORCOS, DANIEL M.; AMARO JR, EDSON; et al. A Randomized, Controlled Trial of Exercise for Parkinsonian Individuals With Freezing of Gait. MOVEMENT DISORDERS, JUN 2020. (18/16909-1, 16/13115-9)

LIRA, JUMES LEOPOLDINO OLIVEIRA; UGRINOWITSCH, CARLOS; COELHO, DANIEL BOARI; TEIXEIRA, LUIS AUGUSTO; DE LIMA-PARDINI, ANDREA CRISTINA; MAGALHAES, FERNANDO HENRIQUE; BARBOSA, EGBERTO REIS; HORAK, FAY B.; SILVA-BATISTA, CARLA. Loss of presynaptic inhibition for step initiation in parkinsonian individuals with freezing of gait. JOURNAL OF PHYSIOLOGY-LONDON, v. 598, n. 8, p. 1611-1624, APR 2020. (18/16909-1, 15/13096-1, 16/13115-9)

DE ALMEIDA, FILIPE OLIVEIRA; SANTANA, VAGNER; CORCOS, DANIEL M.; UGRINOWITSCH, CARLOS; SILVA-BATISTA, CARLA. Effects of Endurance Training on Motor Signs of Parkinson's Disease: A Systematic Review and Meta-Analysis. SPORTS MEDICINE, v. N/A, p. 27-pg., 2022-02-03. (18/16909-1)

SILVA-BATISTA, CARLA; DE OLIVEIRA LIRA, JUMES LEOPOLDINO; DAVID, FABIAN J.; CORCOS, DANIEL M.; TAVARES MATTOS, EUGENIA CASELLA; COELHO, DANIEL BOARI; DE LIMA-PARDINI, ANDREA C.; TORRIANI-PASIN, CAMILA; DE FREITAS, TATIANA BELINE; UGRINOWITSCH, CARLOS. Short-term resistance training with instability reduces impairment in V wave and H reflex in individuals with Parkinson's disease. Journal of Applied Physiology, v. 127, n. 1, p. 89-97, JUL 2019. (18/16909-1, 16/13115-9)

COELHO, DANIEL BOARI; DE SOUZA, CAROLINE RIBEIRO; DE LIMA-PARDINI, ANDREA CRISTINA; TREZA, RENATA DE CASTRO; FUJIOKA SHIDA, THIAGO KENZO; SILVA-BATISTA, CARLA; TEIXEIRA, LUIS AUGUSTO. Is freezing of gait correlated with postural control in patients with moderate-to-severe Parkinson's disease?. European Journal of Neuroscience, v. 53, n. 4, NOV 2020. (18/16909-1, 16/13115-9)

SILVA-BATISTA, CARLA; RAGOTHAMAN, ANJANIBHARGAVI; MANCINI, MARTINA; CARLSON-KUHTA, PATRICIA; HARKER, GRAHAM; JUNG, SE HEE; NUTT, JOHN G.; FAIR, DAMIEN A.; HORAK, FAY B.; MIRANDA-DOMINGUEZ, OSCAR. Cortical thickness as predictor of response to exercise in people with Parkinson's disease. Human Brain Mapping, v. 42, n. 1, p. 139-153, JAN 2021. (18/16909-1)

DE ALMEIDA, FILIPE OLIVEIRA; UGRINOWITSCH, CARLOS; BRITO, LEANDRO C.; MILLIATO, ANGELO; MARQUESINI, RAQUEL; MOREIRA-NETO, ACACIO; BARBOSA, EGBERTO REIS; HORAK, FAY B.; MANCINI, MARTINA; SILVA-BATISTA, CARLA. Poor sleep quality is associated with cognitive, mobility, and anxiety disability that underlie freezing of gait in Parkinson's disease. GAIT & POSTURE, v. 85, p. 7-pg., 2021-02-09. (13/04970-4, 16/13115-9, 18/16909-1)