Acute and chronic effect of motor and non-motor intervention on gait asymmetry in patients with Parkinson's Disease

• Grant number: 23/07329-0
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: July 01, 2023
• End date: June 30, 2027
• Field of knowledge: Health Sciences - Physical Education
• Principal Investigator: Fabio Augusto Barbieri
• Grantee: Jônatas Augusto Cursiol
• Host Institution: Faculdade de Ciências (FC). Universidade Estadual Paulista (UNESP). Campus de Bauru. Bauru , SP, Brazil
• Associated research grant: 22/02971-2 - Unrevealing the gait asymmetry in patients with Parkinson’s Disease: from the neural and motor mechanisms to rehabilitation: AsymmGait-Parkinson study, AP.PNGP.PI
• Associated scholarship(s): 25/04534-7 - Investigating neural control of gait asymmetry using fNIRS, BE.EP.DR

Abstract

Gait asymmetry, along with variability, is directly related to more severe gait impairments, such as freezing, falls, and stumbling, in patients with Parkinson's disease (PD). Determining the neural mechanisms and causes of gait asymmetry in PD is relevant for the diagnosis and its pathogenesis. Also, considering that PD progression is related to motor asymmetry, knowing how to treat gait asymmetry is important to design rehabilitation strategies specific targeting this symptom. Thus, the purposes of this scientific project are to determine clinical, personal, neural (size, shape and functionality of brain structures, and iron concentration determined by magnetic resonance imaging), blood (quantification of the concentration of the metallic particles) and motor factors associated with gait asymmetry in patients with PD; and to investigate the acute and chronic effect of motor and non-motor interventions on gait asymmetry in patients with PD. Five studies were designed to achieve the proposed aims: 1 and 2) two clinical trials will be performed to analyze the acute effect of motor and non-motor interventions on gait asymmetry in patients with PD. First, we will investigate whether an exercise protocol prioritizing the side most affected by PD reduces gait asymmetry. Then, we will investigate how a combination of exercise and intermittent hypoxia modifies gait asymmetry. These studies will guide a 3) 12-week intervention to verify the chronic effects of rehabilitation on gait asymmetry in patients with PD. The research project will elucidate the mechanisms that cause gait asymmetry in PD and assist in developing assertively strategies for gait asymmetry rehabilitation program. (AU)