Balance and fear of falling in subjects with Parkinson's disease is improved after exercises with motor complexity

Autor(es)

Silva-Batista, Carla ^{[1, 2]} ; Corcos, Daniel M. ^{[3, 4]} ; Kanegusuku, Helcio ^[5] ; Pimentel Piemonte, Maria Elisa ^[6] ; Bucken Gobbi, Lilian Teresa ^[7] ; de Lima-Pardini, Andrea C. ^{[2, 8, 9]} ; de Mello, Marco Tulio ^[10] ; Forjaz, Claudia L. M. ^[5] ; Ugrinowitsch, Carlos ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Phys Educ & Sport, Lab Neuromuscular Adaptat Strength Training, Sao Paulo - Brazil

^[3] Northwestern Univ, Dept Phys Therapy & Human Movement Sci, Chicago, IL 60611 - USA

^[4] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 - USA

^[5] Univ Sao Paulo, Sch Phys Educ & Sport, Exercise Hemodynam Lab, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Fac Med Sci, Sao Paulo - Brazil

^[7] Sao Paulo State Univ Rio Claro, Posture & Gait Studies Lab, Rio Claro - Brazil

^[8] Univ Sao Paulo, Sch Phys Educ & Sport, Human Motor Syst Lab, Sao Paulo - Brazil

^[9] Univ Sao Paulo, Dept Radiol, LIM 44, Sao Paulo - Brazil

^[10] Univ Fed Sao Paulo, Ctr Psychobiol & Exercise Studies, Dept Psychobiol, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: GAIT & POSTURE; v. 61, p. 90-97, MAR 2018.
• Citações Web of Science: 9

Resumo

Resistance training with instability (RTI) uses exercises with high motor complexity that impose high postural control and cognitive demands that may be important for improving postural instability and fear of falling in subjects with Parkinson's disease (PD). Here, we hypothesized that: 1) RTI will be more effective than resistance training (RT) in improving balance (Balance Evaluation Systems Test {[}BESTest] and overall stability index {[}Biodex Balance System (R)]) and fear of falling (Falls Efficacy Scale-International {[}FES-I] score) of subjects with Parkinson's disease (PD); and 2) changes in BESTest and FES-I after RTI will be associated with changes in cognitive function (Montreal Cognitive Assessment {[}MoCA] score -previously published) induced by RTI. Thirty-nine subjects with moderate PD were randomly assigned to a nonexercising control, RT, and RTI groups. While RT and RTI groups performed progressive RT twice a week for 12 weeks, the RTI group added progressive unstable devices to increase motor complexity of the resistance exercises. There were significant group x time interactions for BESTest, overall stability index, and FES-I scores (P < 0.05). Only RTI improved BESTest, overall stability index and FES-I scores, and RTI was more effective than RT in improving biomechanical constraints and stability in gait (BESTest sections) at post-training (P < 0.05). There were strong correlations between relative changes in BESTest and MoCA (r= 0.72, P= 0.005), and FES-I and MoCA (r=-0.75, P= 0.003) after RTI. Due to the increased motor complexity in RTI, RTI is recommended for improving balance and fear of falling, which are associated with improvement in cognitive function of PD. (AU)

• Processo FAPESP: 12/03056-4 - Influência dos treinamentos funcional e de força nas adaptações neuromusculares e na funcionalidade associados à fraqueza muscular em idosos sadios e com Doença de Parkinson
• Beneficiário: Carlos Ugrinowitsch
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/04970-4 - Influência dos treinamentos funcional e de força nas adaptações neuromusculares, funcionalidade e qualidade de vida em indivíduos com Doença de Parkinson
• Beneficiário: Carla da Silva Batista
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto