Search

Introduction: Parkinson’s disease (PD) leads to deficits in upper limb strength and manual dexterity and consequently resulting in functional impairment. Handgrip strength is correlated with the motor symptom severity of the disease, but there is a gap in the literature about the influence of freezing in PD patients. Objective: The objective is to study the correlation between handgrip strength and motor symptom severity considering the freezing phenomenon and to verify variables that can predict Unified Parkinson’s Disease Rating Scale (UPDRS) III. Methods: This is a multicenter cross-sectional study in PD. 101 patients were divided into 2 groups: freezing of gait (FOG) (n = 51) and nonfreezing (nFOG) (n = 52). Freezing of Gait Questionnaire (FOGQ); UPDRS II and III sections; Hoehn and Yahr (HY) scale; handgrip dynamometry (HD); 9 Hole Peg Test (9-HPT) were assessed. Results: In both groups, HD was correlated to UPDRS III (nFOG: −0.308; FOG: −0.301), UPDRS total (nFOG: −0.379; FOG: −0.368), UPDRS item 23 (nFOG: −0.404; FOG: −0.605), and UPDRS item 24 (nFOG: −0.405; FOG: −0.515). For the correlation to UPDRS II (0.320) and 9-HPT (−0.323), only nFOG group presented significance. For the UPDRS 25 (−0.437), only FOG group presented statistical significance. The UPDRS III can be predicted by 9-HPT, age, and HY in nFOG patients (Adjusted R2 = 0.416). In FOG group, UPDRS III can be predicted by HD, 9-HPT, age, and HY (Adjusted R2 = 0.491). Conclusion: Handgrip strength showed to be predictive of motor impairment only in the FOG group. Our results showed clinical profile differences of motor symptoms considering freezers and nonfreezers with PD.

Parkinson’s disease (PD) has numerous motor and non-motor symptoms. Among non-motor manifestations impulse control disorders (ICDs) stand out. ICDs include compulsions for gambling, shopping, eating, and sexual behavior, and “related disorders” such as hobbyism, simple motor activities, and dopamine dysregulation syndrome. There is no rating scale translated and adapted transculturally into Brazilian Portuguese language. Therefore, we cross-culturally adapted and investigated the measurement properties of the Brazilian version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS). Fifty-three patients participated in the study. Inter-evaluator and test–retest (patient and health professional) reliabilities (intraclass correlation coefficient) were all excellent (0.93, 0.93, and 0.99). The internal consistency was high (α = 0.92). The Minimal detectable change (MDC) value was 5.8 (patient) and 2.3 (health professional) points. There was a floor, but no ceiling, effect. In summary, the Brazilian version of the QUIP-RS has high reliability and content validity.

The effects of physical-therapy intervention on the motor function of upper limbs and the quality of life in patients with Parkinson’s disease (PD) are not fully understood. We evaluated the effects of a progressive muscle-strengthening protocol for upper limbs on the functionality and quality of life. Patients were divided into two groups: Intervention (n = 6) and Control (n = 7). Assessment tools used were: Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire, Nine-Hole Peg Test (9HPT), Test d’Evaluation des Membres Superieurs de Personnes Âgees (TEMPA), 10-Repetition Maximum (10-RM) and handgrip dynamometer, which were applied pre- and post-intervention, with follow-up for one month after the last training session. Only, the Intervention group (post-intervention) showed significant statistical differences, with the following outcomes: UPDRS III (p = 0.042); 9HPT, right (p = 0.028) and left side (p = 0.028); TEMPA for total right side (p = 0.028), left side (p = 0.028) and total bilateral tasks (p = 0.028); TEMPA task 2 – open a jar and take a spoonful of coffee (p = 0.028), task 3 – pick up a pitcher and pour water into a glass for right (p = 0.046) and left side (p = 0.028), task 5 – write on an envelope and stick on a stamp (p = 0.028), and task 6 – shuffle and deal playing cards (p = 0.028). We observed significant statistical differences between groups (post-intervention) for TEMPA task 6 (p = 0.032), total right side (p = 0.032), and total bilateral tasks (p = 0.032). An increase in the maximum load in the post-intervention stage, based on the 10-RM test, was observed on the right (p = 0.003) and left (p = 0.007) sides. Our results showed an improvement in upper-limb functionality in PD patients submitted to progressive muscle-strength training, although not in quality of life.

Introduction: Physiotherapy has been identified in the literature as an important treatment for individuals with Parkinson’s disease (PD) to improve functional capacity. Little is discussed about the physiotherapy practice environment for this population. Objective: To assess pragmatically the effects of two physiotherapy protocols: Conventional Physiotherapy (CP) and Treadmill Training and Kinesiotherapy (TTK) in PD patients. Method: Twenty-four PD patients classified from 1 to 3 on the Hoehn and Yahr scale were randomly distributed into two groups. In CP group (12 patients), exercises aimed to improve range of motion, bradykinesia, postural adjustments and gait. In TTK group (12 patients), exercises aimed to improve physical fitness, mobility and functional independence. The treatments were performed for 50 minutes, twice a week for 14 weeks. The following evaluations were performed before and after the interventions: Unified Parkinson’s Disease Rating Scale (UPDRS); gait speed (GS); up stairs (US) and down stairs (DS) tests; timed get-up-and-go test (TUG) and 6-Minute Walk Distance Test (6-MWDT). Sociodemographic and clinical data were presented as descriptive analysis. Variables with normal and non-normal distributions were analyzed by specific statistical tests. Results: Intragroup analysis showed significant results for the TTK group (TUG, US, DS, GS, UPDRS total and UPDRS II) and for the CP group only UPDRS total. Intergroup analysis was favorable for the TTK group (TUG, US, DS, 6-MWDT). Conclusion: CP group improved the patients’ general clinical status, while treadmill and kinesiotherapy improved the physical-functional and clinical aspects. Resumo Introdução: A fisioterapia tem sido apontada na literatura como um importante tratamento para indivíduos com doença de Parkinson (DP) para melhorar a capacidade funcional. Pouco se discute sobre o ambiente da prática fisioterapêutica para essa população. Objetivo: Avaliar pragmaticamente os efeitos de dois protocolos fisioterapêuticos: Fisioterapia Convencional (FC) e Treinamento em Esteira e Cinesioterapia (TEC) em pacientes com DP. Método: Vinte e quatro pacientes com DP entre 1 e 3 da escala Hoehn e Yahr foram alocados aleatoriamente em dois grupos. No grupo FC (12 pacientes) foram aplicados exercícios visando melhorar a amplitude de movimento, bradicinesia, ajustes posturais e marcha. No grupo TEC (12 pacientes) foram aplicados exercícios visando melhorar a aptidão física, mobilidade e independência funcional. Os tratamentos foram conduzidos por 50 minutos, duas vezes por semana durante 14 semanas. Avaliações realizadas antes e após a intervenção: Unified Parkinson’s Disease Rating Scale (UPDRS); velocidade da marcha (VM); subir escadas (SE) e descer escadas (DE); timed get up and go test (TUG) e Teste de Caminhada de 6 Minutos (TC6’). Dados sociodemográficos e clínicos apresentados como análise descritiva. Variáveis com distribuição normal e não-normal foram analisadas por testes estatísticos específicos. Resultados: Análise intragrupo mostrou resultado significativo para o grupo TEC (TUG, SE, DE, VM, UPDRS total e UPDRS II) e para o grupo FC apenas UPDRS total. Análise intergrupo foi favorável para o grupo TEC (TUG, SE, DE, TC6’). Conclusão: A FC melhorou o estado clínico geral dos pacientes, enquanto a esteira ergométrica e cinesioterapia melhoraram aspectos físico-funcionais e clínicos. Resumen Introducción: La fisioterapia se ha señalado en la literatura como un importante tratamiento para las personas con enfermedad de Parkinson (EP) para mejorar la capacidad funcional. Poco se discute sobre el ambiente de la práctica fisioterapéutica para esa población. Objetivo: Evaluar pragmáticamente los efectos de dos programas de tratamiento fisioterapéutico: Fisioterapia Convencional (FC); Entrenamiento en la cinta de correr y la Cinesioterapia (ECCC) en pacientes con EP. Método: Veinticuatro pacientes con EP entre 1 y 3 de la escala Hoehn y Yahr, se asignaron al azar en dos grupos. En el grupo FC (12 pacientes) se aplicaron ejercicios para mejorar la amplitud de movimiento, bradicinesia, ajustes posturales y marcha. En el grupo ECCC (12 pacientes) se aplicaron ejercicios para mejorar la aptitud física, movilidad e independencia funcional. Los tratamientos se realizaron durante 50 minutos, dos veces por semana durante 14 semanas. Evaluaciones realizadas antes y después de la intervención: Unified Parkinson’s Disease Rating Scale (UPDRS); velocidad de marcha (VM); subir escaleras (SE) y bajar escaleras (BE); timed get up and go test (TUG) y Prueba de Caminata de 6 Minutos (TC6’). Datos sociodemográficos y clínicos presentados como análisis descriptivo. Las variables con distribución normal y no normal se analizaron mediante pruebas estadísticas específicas. Resultados: El análisis intragrupo mostró un resultado significativo para el grupo ECCC (TUG, SE, BE, VM, UPDRS total y UPDRS II) y para el grupo FC sólo UPDRS total. El análisis intergrupo fue favorable para el grupo ECCC (TUG, SE, BE, TC6’). Conclusión: La FC mejoró el estado clínico general de los pacientes, mientras que la cinta de correr y la cinesioterapia mejoraron aspectos físico-funcionales y clínicos.