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Although breast cancer treatments reduce mortality, their adverse effects can increase depression which impacts one’s quality of life (QoL). Physical activity (PA) seems to improve the QoL of breast cancer survivors (BCS). However, an unanswered question is the influence of PA on the QoL in BCS with depressive symptoms. Thus, we analyzed the influence of PA on the QoL in BCS with persistent depressive symptoms during 12 months of follow-up. The sample included 70 female BCS. Depression and QoL domains (i.e., functional capacity, physical limitations, body pain, general health status, vitality, social and emotional aspects, and mental health) were assessed at baseline and follow-up periods by the Hospital Anxiety and Depression Scale and SF-36, respectively. Habitual PA was assessed by Baecke’s questionnaire. Our results indicate a prevalence of 17.1% of depressive symptoms. Non-depressives BCS improved their physical limitations and general health status domains over time, but there were no observed differences in depressive BCS. BCS with persistent depressive symptoms (baseline and follow-up) showed worse QoL scores than non-depressives in all domains, regardless of confounding factors. When adjusted for PA, the difference between BCS depressives and non-depressives lost its significance in the functional capacity domain. In conclusion, habitual PA practice positively influenced the functional capacity domain of the QoL in BCS.

Extended periods of time on screen devices and sitting are the main activities that characterize sedentary behavior (SB), which negatively impacts the quality of life. This negative influence was demonstrated mainly by cross-sectional studies performed in high-income countries in which the effects of screen time on health-related quality of life (HRQoL) is not considered. Thus, we analyzed the association between the different domains of SB (i.e., subdomains of screen time—television, computer, cellphone) and the HRQoL in adults that live in Brazil during two years of follow-up. The sample included 331 adults. Subdomains of screen time (i.e., watching television, using computers, and cellphones) and of HRQoL (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and current health perception) were assessed by a structured questionnaire and SF-36, respectively. Our results indicate a significant increase in screen time during the two years of follow-up. Linear regression models indicated that although domains of SB were differently associated with HRQoL, in general, screen time was negatively associated with social functioning and positively associated with physical functioning during locomotion and activities of daily living (ADL), role-physical (i.e., physical issues during work and ADLs), and role-emotional (i.e., emotional issues during work and ADLs) after the two-year follow-up. In conclusion, screen time may positively or negatively influence some domains of HRQoL in adults.

Made available in DSpace on 2022-05-01T05:29:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-19 It is challenging for people with Parkinson's disease (PwPD) to adjust their gait to perturbations, including fatigue. Obstacle negotiation increases the risk of tripping and falling in PD. Being physically active can improve gait control and the ability to negotiate obstacles while walking under fatigue state. We thus determined the effects of Parkinson's disease, fatigue, and level of physical activity on gait during the approach to and crossing an obstacle during gait. Forty participants were stratified to people with Parkinson's disease active and inactive, and control individuals active and inactive. Participants walked on an 8 m walkway and stepped over an obstacle placed at the middle (4 m). They performed three trials before and after repeated sit-to-stand (rSTS)-induced fatigue state. Maximum voluntary force was assessed before and after rSTS. We measured the length, width, duration, and velocity of the approach (stride before obstacle) and crossing (step over the obstacle) phases and the leading and trailing placements and clearance during crossing phase. Fatigue trait was determined by multidimensional fatigue inventory. Before rSTS, people with Parkinson's disease inactive vs. other subgroups approached the obstacle using 18–28% shorter, wider and slower steps and crossed the obstacle slower (all p < 0.04). After rSTS, people with Parkinson's disease inactive increased (23–34%) stride length and velocity and decreased (-21%) the step width (p < 0.01). People with Parkinson's disease approached the obstacle similarly to control individuals. Physical activity minimizes Parkinson's disease-typical gait impairments during obstacle negotiation and affords a protective effect against fatigue-effects on obstacle negotiation. São Paulo State University (UNESP) Graduate Program in Movement Sciences Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences Department of Physical Education Human Movement Research Laboratory (MOVI-LAB) University of Groningen University Medical Center Groningen Center for Human Movement Sciences Institute of Sport Sciences and Physical Education Faculty of Sciences University of Pécs Somogy County Kaposi Mór Teaching Hospital São Paulo State University (UNESP) Graduate Program in Movement Sciences Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences Department of Physical Education Human Movement Research Laboratory (MOVI-LAB)

Postural instability is common in neurological diseases. Although transcranial direct current stimulation (tDCS) seems to be a promising complementary therapy, emerging evidence indicates mixed results and protocols' characteristics. We conducted a systematic review and meta-analysis on PubMed, EMBASE, Scopus, and Web of Science to synthesize key findings of the effectiveness of single and multiple sessions of tDCS alone and combined with other interventions on balance in adults with neurological disorders. Thirty-seven studies were included in the systematic review and 33 in the meta-analysis. The reviewed studies did not personalize the stimulation protocol to individual needs/characteristics. A random-effects meta-analysis indicated that tDCS alone (SMD = -0.44; 95%CI = -0.69/-0.19; p 0.001) and combined with another intervention (SMD = -0.31; 95%CI = -0.51/-0.11; p = 0.002) improved balance in adults with neurological disorders (small to moderate effect sizes). Balance improvements were evidenced regardless of the number of sessions and targeted area. In summary, tDCS is a promising therapy for balance rehabilitation in adults with neurological disorders. However, further clinical trials should identify factors that influence responsiveness to tDCS for a more tailored approach, which may optimize the clinical use of tDCS.

This study analyzed the influence of sedentary behavior (SB) on the association between dietary patterns and adiposity in community-dwelling adults. Eight hundred and forty-three adults (age: 56.5 ± 18.3 years) participated in this cross-sectional epidemiological study. Dietary patterns were evaluated using self-report questions regarding the weekly frequency of consumption of certain foods. Adiposity was determined using anthropometric measurements of weight, waist circumference, and height. SB was evaluated according to the time spent on screen devices. The usual physical activity level and socioeconomic status were considered confounding factors. Associations were determined using multivariate linear models with simultaneous adjustments for confounding variables. A statistical analysis indicated that fruit consumption was negatively related to the body mass index, regardless of the adjustment for SB domains. Red meat consumption was positively related to the body mass index, and fried food consumption was positively related to the waist-to-height ratio, regardless of the adjustment for SB domains. The consumption of fried food was positively associated with global and central adiposity after the adjustments for confounding factors and time spent on screen devices. We concluded that dietary habits are related to adiposity in adults. However, SB domains seem to influence the relationship between body adiposity and dietary habits, mainly regarding the consumption of fried foods.

Submitted by Lilian Teresa Gobbi (lilian.gobbi@unesp.br) on 2021-05-20T23:07:36Z No. of bitstreams: 1 Manuscript_accepted.pdf: 2005538 bytes, checksum: a08c00a8a6e0666817369b6853a61115 (MD5) Rejected by Marcia Correa Bueno Degasperi null (mcbueno@rc.unesp.br), reason: Prezado Gabriel, O documento enviado para a coleção Campus Unesp Rio Claro foi recusado pelo(s) seguinte(s) motivo(s): - É necessário o autor indicar o prazo de embargo para o artigo conforme normas da revista. Em consulta ao Sherpa Romeo, verificamos que o embargo para versão postprint é de 12 meses: https://v2.sherpa.ac.uk/id/publication/6992?template=romeo Tutorial para autoarquivamento de artigos preprint, postprint e publicados: https://www2.unesp.br/Home/cgb/tutorial-autoarquivamento-artigos-e-capitulos-de-livro-versao-1.0.pdf Em caso de dúvidas entre em contato pelos e-mails: stati.rc@unesp.br marcia.bueno@unesp.br WhatsApp (19) 3526-9666 Solicitamos que realize uma nova submissão seguindo as orientações destacadas. Agradecemos a compreensão. Atenciosamente, Márcia Correa Bueno Degasperi Biblioteca Campus Rio Claro Repositório Institucional UNESP https://repositorio.unesp.br on 2021-08-23T19:00:22Z (GMT) Submitted by Lilian Teresa Gobbi (lilian.gobbi@unesp.br) on 2021-08-23T20:10:19Z No. of bitstreams: 1 Manuscript_accepted.pdf: 2005538 bytes, checksum: a08c00a8a6e0666817369b6853a61115 (MD5) Approved for entry into archive by Marcia Correa Bueno Degasperi null (mcbueno@rc.unesp.br) on 2021-08-24T13:44:55Z (GMT) No. of bitstreams: 1 moraca_gag_postprint_rcla_center.pdf: 2005538 bytes, checksum: a08c00a8a6e0666817369b6853a61115 (MD5) Made available in DSpace on 2021-08-24T13:44:55Z (GMT). No. of bitstreams: 1 moraca_gag_postprint_rcla_center.pdf: 2005538 bytes, checksum: a08c00a8a6e0666817369b6853a61115 (MD5) Previous issue date: 2022-04-27 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Falls are associated with impairment in postural control in people with Parkinson's disease (PwPD). We aimed to predict the fall risk through models combining postural responses with clinical and cognitive measures. Also, we compared the center of pressure (CoP) between PwPD fallers and non-fallers after unpredictable external perturbations. We expected that CoP parameters combined with clinical and cognitive measures would predict fall risk. Seventy-five individuals participated in the study. CoP parameters were measured during postural responses through five trials with unpredictable translations of the support-surface in posterior direction. Range and peak of CoP were analyzed in two periods: early and late responses. Time to peak (negative peak) and recovery time were analyzed regardless of the periods. Models included the CoP parameters in early (model 1), late responses (model 2), and temporal parameters (model 3). Clinical and cognitive measures were entered into all models. Twenty-nine participants fell at least once, and 46 PwPD did not fall during 12 months following the postural assessment. Range of CoP in late responses was associated with fall risk (p = .046). However, although statistically non-significant, this parameter indicated low accuracy in predicting fall risk (area under the curve = 0.58). Fallers presented a higher range of CoP in early responses than non-fallers (p = .033). In conclusion, although an association was observed between fall risk and range of CoP in late responses, this parameter indicated low accuracy in predicting fall risk in PwPD. Also, fallers demonstrate worse postural control during early responses after external perturbations than non-fallers, measured by CoP parameters. Postprint Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (Unesp), Rio Claro, Brazil Graduate Program in Movement Sciences, São Paulo State University (Unesp), Rio Claro, Brazil Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Department of Neurology, Oregon Health & Science University, Portland, OR, USA FAPESP: 16/00503-0. FAPESP: 19/01203-9. CNPq: 429549/2018-0. CNPq: 309045/2017-7. CAPES: 001

Submitted by Lilian Teresa Gobbi (lilian.gobbi@unesp.br) on 2021-01-21T17:11:25Z No. of bitstreams: 1 beretta_vs_postprint_rcla_effect.pdf: 7014041 bytes, checksum: 8735a4ef9586943afabc9ccc76cd5ccb (MD5) Approved for entry into archive by Ana Paula Santulo Custódio de Medeiros null (asantulo@rc.unesp.br) on 2021-04-08T20:36:14Z (GMT) No. of bitstreams: 1 beretta_vs_postprint_rcla_effect.pdf: 7189173 bytes, checksum: 78e2dc7fbcf9b63779e41b77973a09c8 (MD5) Made available in DSpace on 2021-04-08T20:36:14Z (GMT). No. of bitstreams: 1 beretta_vs_postprint_rcla_effect.pdf: 7189173 bytes, checksum: 78e2dc7fbcf9b63779e41b77973a09c8 (MD5) Previous issue date: 2020-11 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background. Habituation of postural response to perturbations is impaired in people with Parkinson’s disease (PD) due to deficits in cortico-basal pathways. Although transcranial direct current stimulation (tDCS) modulate cortico-basal networks, it remains unclear if it can benefit postural control in PD. Objective. To analyze the effect of different intensities of anodal tDCS on postural responses and prefrontal cortex (PFC) activity during the habituation to the external perturbation in patients with PD (n = 24). Methods. Anodal tDCS was applied over the primary motor cortex (M1) with 1 mA, 2 mA, and sham stimulation in 3 different sessions (~2 weeks apart) during 20 minutes immediately before the postural assessment. External perturbation (7 trials) was applied by a support base posterior translation (20 cm/s and 5 cm). Primary outcome measures included lower limb electromyography and center of pressure parameters. Measures of PFC activity are reported as exploratory outcomes. Analyses of variance (Stimulation Condition × Trial) were performed. Results. Habituation of perturbation was evidenced independent of the stimulation conditions. Both active stimulation intensities had shorter recovery time and a trend for lower cortical activity in the stimulated hemisphere when compared to sham condition. Shorter onset latency of the medial gastrocnemius as well as lower cortical activity in the nonstimulated hemisphere were only observed after 2 mA concerning the sham condition. Conclusions. tDCS over M1 improved the postural response to external perturbation in PD, with better response observed for 2 mA compared with 1 mA. However, tDCS seems to be inefficient in modifying the habituation of perturbation. Postprint São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, São Paulo, Brazil Oregon Health & Science University, Portland, OR, USA FAPESP: 2018/07385-9 FAPESP: 2016/21499-1 FAPESP: 2014/22308-0 CNPq: 142057/2017-7 CNPq: 309045/2017-7 CAPES: 001

Introduction Transcranial direct current stimulation (tDCS) improves postural response to perturbation in patients with Parkinson's disease (PwPD). However, the influence of baseline characteristics such as clinical/cognitive and postural performance on the response to tDCS remains unclear. Objective To investigate whether baseline level of postural control (performance during sham condition) and clinical/cognitive characteristics are associated with tDCS-related changes in postural responses to external perturbations in PwPD. Methods Twenty-four PwPD participated in this study. Clinical assessment included disease severity, disease duration, levodopa equivalent dose and global cognition. Anodal tDCS protocols targeting the primary motor cortex were applied in two separate sessions (at least 2 weeks apart): active (2 mA for 20 min) and sham stimulation. Seven trials with the backward translation of the support base (20 cm/s and 5 cm) were performed after tDCS. Postural outcomes included the recovery time to stable position and onset latency of the medial gastrocnemius (MG). Pearson and Spearman correlation tests were performed. Results No significant correlations were observed between clinical/cognitive characteristics and tDCS-related changes in postural responses. Negative associations were observed between the baseline level of postural control and tDCS-related changes in postural responses for the recovery time (r = −0.657; p < 0.001) and the MG onset latency (rs = −0.539; p = 0.007). PwPD with worse baseline postural control demonstrated greater improvement after active stimulation. Conclusions Findings suggest that tDCS-related effects on postural response to perturbation are related to the baseline level of postural control, but not to clinical characteristics in PwPD. Those with worse baseline postural control responded better to tDCS.

Made available in DSpace on 2019-10-06T16:08:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação para o Desenvolvimento da UNESP (FUNDUNESP) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Postural control asymmetry is an important aspect of Parkinson's disease (PD) that may be associated with falls. The aim of this study was to compare the postural control asymmetry during postural tasks between fallers and non-fallers in people with PD and neurological healthy age-matched controls (CG). Individuals with idiopathic PD (n = 24) and CG (n = 24) were sub-divided into groups of fallers and non-fallers based on their fall history over the past year. Participants performed blocks of three 30-s trials of quiet standing with feet in a side-by-side and semi-tandem stance position. The center of pressure parameters for each limb were measured and used to calculate the symmetry index. Fallers compared to non-fallers had decreased asymmetry of vertical force in the side-by-side condition. During the tandem-front leg condition, PD non-fallers increased asymmetry of the medial-lateral velocity of sway compared to CG non-fallers. In addition, for the tandem–back leg condition, PD non-fallers increased asymmetry of total displacement and medial-lateral root mean square and mean velocity of sway compared to PD fallers. The results of the study did not support the hypothesis that PD fallers are more asymmetric than PD non-fallers. On the contrary, our results indicated that PD non-fallers had higher postural control asymmetry, especially during the more challenging (semi-tandem standing) postural task. São Paulo State University (UNESP) – Campus Bauru Graduate Program in Movement Science Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education University of British Columbia School of Kinesiology São Paulo State University (UNESP) – Campus Rio Claro Graduate Program in Movement Science Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education São Paulo State University (UNESP) – Campus Bauru Graduate Program in Movement Science Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education São Paulo State University (UNESP) – Campus Rio Claro Graduate Program in Movement Science Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education FUNDUNESP: 0716/011 FAPESP: 2012/24040-9 FAPESP: 2013/00925-4

Introduction Cognitive components are necessary to maintain posture during external perturbations. However, few studies have investigated postural control when external perturbations are associated with a concomitant cognitive task (DT). Objectives To analyze the behavior of reactive adjustments after perturbation with different intensities and displacements in active young adults; and to analyze the influence of DT on predictive and reactive adjustments in different perturbation conditions. Methods Twenty-eight physically active young adults stood on an item of equipment that produced displacements of the base. Four experimental conditions were introduced in a single task (ST) and DT (cognitive-report how many times a pre-established number appeared in the audio): 1 (5 cm and 10 cm/s); 2 (5 cm and 25 cm/s); 3 (12 cm and 10 cm/s) and 4 (12 cm and 25 cm/s). Three attempts were carried out for each condition (total=24). Center of pressure (CoP) parameters were analyzed considering the following windows: predictive (-250 to +50 ms), reactive 1 (+50 to +200 ms) and reactive 2 (+200 to +700 ms), in comparison to the start of the CoP activity. One-way ANOVAs were performed to analyze predictive adjustments, while two-way ANOVAs with factor for task (STxDT) and condition (1x2x3x4), with repeated measurements, were performed for the reactive adjustments. Results One-way ANOVA (predictive) indicated that the subjects had higher CoP parameters in ST vs DT. In reactive adjustments 1 and 2, ANOVA indicated greater CoP parameters in condition 2 and 4 when compared to 1 and 3, and in the ST vs DT. The subjects took longer to recover stable position in conditions 1 and 3 than in conditions 2 and 4. Conclusion Perturbation intensity has a greater influence on postural adjustments to maintain balance than on magnitude. Moreover, the association of cognitive tasks with external perturbation decreases CoP oscillation. Therefore, cognitive resources play an important role in postural control after perturbation. Level of evidence III; Study of nonconsecutive patients, with no “gold” standard applied uniformly. RESUMO Introdução Componentes cognitivos são necessários para manter a postura nas perturbações externas. Porém, poucos estudos investigaram o controle postural quando perturbações externas são associadas à tarefa cognitiva concomitante (TD). Objetivo Analisar o comportamento dos ajustes reativos após perturbação com diferentes intensidades e deslocamentos em adultos jovens ativos; e analisar a influência da TD nos ajustes preditivos e reativos em diferentes condições de perturbação. Métodos Permaneceram em pé sobre um equipamento que provocou deslocamento da base de suporte 28 adultos jovens fisicamente ativos. Quatro condições experimentais foram realizadas em tarefa simples (TS) e TD (cognitiva-reportar quantas vezes um número preestabelecido apareceu no áudio): uma (5cm e 10cm/s); duas (5cm e 25cm/s); três (12cm e 10cm/s) e quatro (12cm e 25cm/s). Foram realizadas três tentativas para cada condição (total=24). Os parâmetros do centro de pressão (CoP) foram analisados em janelamentos: preditivo (-250 a +50ms), reativo 1 (+50 a +200ms) e reativo 2 (+200 a +700ms), em relação ao início da atividade do CoP. ANOVAs one-way foram realizadas para análise dos ajustes preditivos. Já para os ajustes reativos, foram realizadas ANOVAs two-way com fator para tarefa (TS×TD) e condição (1×2×3×4) com medidas repetidas. Resultados ANOVA one-way (preditivo) apontou que os indivíduos apresentaram maiores parâmetros do CoP na TS em relação à TD. Nos reativos 1 e 2, a ANOVA apontou maiores parâmetros do CoP na segunda e na quarta condição quando comparada à primeira e à terceira, e na TS em relação às TD. Apresentaram maior tempo para recuperar a posição estável na primeira e na terceira condição em comparação à segunda e à quarta. Conclusão A intensidade da perturbação influencia mais nos ajustes posturais para manutenção do equilíbrio do que a magnitude. Ainda, as tarefas cognitivas concomitantes à perturbação externa diminuem a oscilação do CoP. Com isso, recursos cognitivos possuem relevância no controle postural após perturbação. Nível de evidência III; Estudos de pacientes não consecutivos, sem padrão de referência “ouro” aplicado uniformemente. RESUMEN Introducción Los componentes cognitivos son necesarios para mantener la postura en perturbaciones externas. Sin embargo, pocos estudios investigaron el control postural cuando son asociadas perturbaciones a la tarea cognitiva concomitante (TD). Objetivo Analizar el comportamiento de los ajustes reactivos después de una perturbación con diferentes intensidades y desplazamientos en adultos jóvenes activos; y analizar la influencia de la TD en ajustes predictivos y reactivos en diferentes condiciones de perturbación. Métodos Veintiocho adultos jóvenes físicamente activos permanecieron en pie sobre un equipo que provocó desplazamiento de la base de soporte. Cuatro condiciones experimentales fueron realizadas en tareas simples (TS) y TD (cognitiva-reportar cuántas veces un número preestablecido apareció en el audio): una (5 cm y 10 cm/s); dos (5 cm y 25 cm/s); tres (12 cm y 10 cm/s) y cuatro (12 cm y 25 cm/s). Fueron realizadas tres tentativas para cada condición (total=24). Los parámetros del centro de presión (CoP) fueron analizados en ventanas: predictiva (-250 a +50 ms), reactiva 1 (+50 a +200 ms) y reactiva 2 (+200 a +700 ms) en relación al inicio de la actividad del CoP. Fueron realizadas ANOVAs one-way para análisis de los ajustes predictivos. Fueron realizadas ANOVAs two-way con factor para tarea (TSxTD) y condición (1x2x3x4) con medidas repetidas para análisis de los ajustes reactivos. Resultados ANOVA one-way (predictivo) mostró que los individuos presentaron parámetros mayores de CoP en TS con relación a TD. En los reactivos 1 y 2, ANOVA mostró parámetros del CoP en la segunda y cuarta condición cuando comparada a la primera y la tercera, y en la TS con relación a las TD. Presentaron tiempo mayor para recuperar la posición estable en la primera y tercera condición en comparación a la segunda y la cuarta. Conclusión La intensidad de perturbación influencia más en los ajustes posturales para mantenimiento del equilibrio que la magnitud. Además, las tareas cognitivas concomitantes a la perturbación externa disminuyen la oscilación del CoP. Con eso, los recursos cognitivos poseen relevancia en el control postural después de la perturbación. Nivel de evidencia III; Estudios de pacientes no consecutivos, sin estándar de referencia “oro” aplicado uniformemente.

Postural response impairments in postural instability and gait disorders (PIGD) subtype patients may be attributed to Parkinson's disease (PD)-deterioration in central-set (programing/modulating of central outputs during motor responses). Although additional information improves some PD motor impairments, an unanswered question is whether additional information can benefit postural response in PIGD subtype.To analyze the effect of cumulative additional information on postural responses after perturbation in PIGD and neurologically healthy older adults (CG).Perturbations were applied in 16 PIGD and 19 CG by the support-base translation. Participants performed 3 blocks of 5 trials without additional information (B1-B3, Day 1) and 5 trials of each cumulative additional information (C1-C4, Day 2): information about perturbation (C1), visual (C2), verbal (C3), and somatosensory information (C4). Electromyography and center of pressure (CoP) parameters were analyzed by ANOVAs with Group (PIGD × CG) and Block (B1 × B2 × B3) and with Group (PIGD × CG) and Condition (B3 × C1 × C2 × C3 × C4).PIGD decreased the range of CoP in B3 while CG decreased both range of CoP and the integral of antagonist's muscle activity (iEMG) in B2. Also, PIGD decreased the recovery time in C4 while CG increased the iEMG of agonist's muscle in C2 and antagonist's muscle in all conditions except C2.Additional information provided before postural control assessment influences the postural response in PIGD and CG differently. PIGD demonstrated inflexibility of central-set in modulating the neuromuscular control regardless of additional information. CG presents a flexible system evidenced by the increase of agonist muscle iEMG when provided visual information.

Made available in DSpace on 2021-06-25T11:17:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Since people with Parkinson disease (PD) rely on limited prefrontal executive resources for the control of gait, interventions targeting the prefrontal cortex (PFC) may help in managing PD-related gait impairments. Transcranial direct current stimulation (tDCS) can be used to modulate PFC excitability and improve prefrontal cognitive functions and gait. Objective: We investigated the effects of adding anodal tDCS applied over the PFC to a session of aerobic exercise on gait, cognition, and PFC activity while walking in people with PD. Methods: A total of 20 people with PD participated in this randomized, double-blinded, sham-controlled crossover study. Participants attended two 30-minute sessions of aerobic exercise (cycling at moderate intensity) combined with different tDCS conditions (active- or sham-tDCS), 1 week apart. The order of sessions was counterbalanced across the sample. Anodal tDCS (2 mA for 20 minutes [active-tDCS] or 10 s [sham-tDCS]) targeted the PFC in the most affected hemisphere. Spatiotemporal gait parameters, cognitive functions, and PFC activity while walking were assessed before and immediately after each session. Results: Compared with the pre-assessment, participants decreased step time variability (effect size: −0.4), shortened simple and choice reaction times (effect sizes: −0.73 and −0.57, respectively), and increased PFC activity in the stimulated hemisphere while walking (effect size: 0.54) only after aerobic exercise + active-tDCS. Conclusion: The addition of anodal tDCS over the PFC to a session of aerobic exercise led to immediate positive effects on gait variability, processing speed, and executive control of walking in people with PD. São Paulo State University (UNESP) Institute of Biosciences Graduate Program in Movement Sciences Oregon Health and Science University Department of Neurology Federal University of ABC (UFABC) Center for Mathematics Computation and Cognition São Paulo State University (UNESP) Institute of Biosciences Graduate Program in Movement Sciences

Background Dopaminergic medication improves gait in people with Parkinson disease (PD). However, it remains unclear if dopaminergic medication modulates cortical activity while walking. Objective We investigated the effects of dopaminergic medication on cortical activity during unobstructed walking and obstacle avoidance in people with PD. Methods A total of 23 individuals with PD, in both off (PDOFF) and on (PDON) medication states, and 30 healthy older adults (control group [CG]) performed unobstructed walking and obstacle avoidance conditions. Cortical activity was acquired through a combined functional near-infrared spectroscopy electroencephalography (EEG) system, along with gait parameters, through an electronic carpet. Prefrontal cortex (PFC) oxygenated hemoglobin (HbO2) and EEG absolute power from FCz, Cz, and CPz channels were calculated. Results HbO2 concentration reduced for people with PDOFF during obstacle avoidance compared with unobstructed walking. In contrast, both people with PDON and the CG had increased HbO2 concentration when avoiding obstacles compared with unobstructed walking. Dopaminergic medication increased step length, step velocity, and β and γ power in the CPz channel, regardless of walking condition. Moreover, dopaminergic-related changes (ie, on-off) in FCz/CPz γ power were associated with dopaminergic-related changes in step length for both walking conditions. Conclusions PD compromises the activation of the PFC during obstacle avoidance, and dopaminergic medication facilitates its recruitment. In addition, PD medication increases sensorimotor integration during walking by increasing posterior parietal cortex (CPz) activity. Increased γ power in the CPz and FCz channels is correlated with step length improvements achieved with dopaminergic medication during unobstructed walking and obstacle avoidance in PD.

Submitted by Lilian Teresa Gobbi (lilian.gobbi@unesp.br) on 2021-11-17T19:47:18Z No. of bitstreams: 1 beretta_vs_postprint_rcla_does.pdf: 8207632 bytes, checksum: 0352da417800c416e8a5e93404af214d (MD5) Approved for entry into archive by Marcia Correa Bueno Degasperi null (mcbueno@rc.unesp.br) on 2022-01-05T18:34:18Z (GMT) No. of bitstreams: 2 beretta_vs_postprint_rcla_does.pdf: 8207632 bytes, checksum: 0352da417800c416e8a5e93404af214d (MD5) beretta_vs_ressalva_rcla_does.pdf: 26685 bytes, checksum: e3d6f95e5184ee30b5ee34c40a27dfee (MD5) Made available in DSpace on 2022-01-05T18:34:18Z (GMT). No. of bitstreams: 2 beretta_vs_postprint_rcla_does.pdf: 8207632 bytes, checksum: 0352da417800c416e8a5e93404af214d (MD5) beretta_vs_ressalva_rcla_does.pdf: 26685 bytes, checksum: e3d6f95e5184ee30b5ee34c40a27dfee (MD5) Previous issue date: 2021-04-22 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: How people with Parkinson’s disease habituate their postural response to unpredictable translation perturbation is not totally understood. We compared the capacity to change the postural responses after unexpected external perturbation and investigated the habituation plateaus of postural responses to non-sequential perturbation trials in people with Parkinson’s disease and healthy older adults. Methods: In people with Parkinson’s disease (n = 37) and older adults (n = 20), sudden posterior support-surface translational were applied in 7 out of 17 randomized trials to ensure perturbation unpredictability. Electromyography and center of pressure parameters of postural response were analyzed by ANOVAs (Group vs. Trials). Two simple planned contrasts were performed to determine at which trial the responses first significantly habituate, and by which trials the habituation plateaus. Findings: Older adults demonstrated a first response change in trial 5 and habituation plateaus after trial 4, while for people with Parkinson’s disease, the first change occurred in trial 2 and habituation plateau after trial 5 observed by center of pressure range. People with Parkinson’s disease demonstrated a greater center of pressure range in trial 1 compared to older adults. Independent of trial, people with Parkinson’s disease vs. older adults demonstrated a greater ankle muscle co-activation and recovery time. Interpretation: Despite the greater center of pressure range in the first trial, people with Parkinson’s disease can habituate to unpredictable perturbations. This is reflected by little, to no difference in the time-course of adaptation for all but 2 parameters that showed only marginal differences between people with Parkinson’s disease and older adults. Postprint São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, São Paulo, Brazil School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada São Paulo State University (Unesp), School of Sciences, Graduate Program in Movement Sciences, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands FAPESP: 2016/00503-0 Capes: 001 CNPq 142057/2017-7 CNPq 309045/2017-7

Made available in DSpace on 2021-06-25T11:14:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-04-01 Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different betweenPD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy-electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TDand PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles. São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO), Avenida 24-A, 1515 Department of Neurology Oregon Health and Science University Department of Materials and Production Aalborg University São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO), Avenida 24-A, 1515

Background Declines in gait parameters are common with aging and more pronounced in tasks with increased executive demand. However, the neural correlates of age-related gait impairments are not fully understood yet. Objectives To investigate ( a) the effects of aging on prefrontal cortex (PFC) activity and gait parameters during usual walking, obstacle crossing and dual-task walking and ( b) the association between PFC activity and measures of gait and executive function. Methods Eighty-eight healthy individuals were distributed into 6 age-groups: 20-25 (G20), 30-35 (G30), 40-45 (G40), 50-55 (G50), 60-65 (G60), and 70-75 years (G70). Participants walked overground under 3 conditions: usual walking, obstacle crossing, and dual-task walking. Changes in oxygenated and deoxygenated hemoglobin in the PFC were recorded using functional near-infrared spectroscopy. Gait spatiotemporal parameters were assessed using an electronic walkway. Executive function was assessed through validated tests. Results Between-group differences on PFC activity were observed for all conditions. Multiple groups (ie, G30, G50, G60, and G70) showed increased PFC activity in at least one of the walking conditions. Young adults (G20 and G30) had the lowest levels of PFC activity while G60 had the highest levels. Only G70 showed reduced executive function and gait impairments (which were more pronounced during obstacle crossing and dual-task walking). PFC activity was related to gait and executive function. Conclusions Aging causes a gradual increase in PFC activity during walking. This compensatory mechanism may reach the resource ceiling in the 70s, when reduced executive function limits its efficiency and gait impairments are observed.

Made available in DSpace on 2020-12-12T02:42:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-07-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investigate the effect of dopaminergic medication on PFC activity and gait parameters during dual task walking in people with PD. Methods. A total of 20 individuals with PD (69.8 ± 5.9 years) and 30 healthy older people (68.0 ± 5.6 years) performed 2 walking conditions: single and dual task (walking while performing a digit vigilance task). A mobile functional near infrared spectroscopy system and an electronic sensor carpet were used to analyze PFC activation and gait parameters, respectively. Relative concentrations of oxygenated hemoglobin (HbO2) from the left and right PFC were measured. Results. People with PD in the off state did not present changes in HbO2 level in the left PFC across walking conditions. In contrast, in the on state, they presented increased HbO2 levels during dual task compared with single task. Regardless of medication state, people with PD presented increased HbO2 levels in the right PFC during dual task walking compared with single task. The control group demonstrated increased PFC activity in both hemispheres during dual task compared with single task. People with PD showed increases in both step length and velocity in the on state compared with the off state. Conclusions. PD limits the activation of the left PFC during dual task walking, and dopaminergic medication facilitates its recruitment. Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences São Paulo State University (UNESP) FAPESP: 2014/22308-0 FAPESP: 2016/21499-1 CNPq: 429549/2018-0 CAPES: Finance Code 001

Made available in DSpace on 2020-12-12T02:35:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-12-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Gait asymmetry during unobstructed walking in people with Parkinson’s disease (PD) has been well documented. However, under complex situations, such as environments with double obstacles, gait asymmetry remains poorly understood in PD. Therefore, the aim of this study was to analyze inter-limb asymmetry while crossing a single obstacle and double obstacles (with different distances between them) in people with PD and healthy older adults. Nineteen people with PD and 19 healthy older people performed three conditions: (i) walking with one obstacle (Single); (ii) walking with two obstacles with a 50 cm distance between them (Double-50); (iii) walking with two obstacles with a 108 cm distance between them (Double-108). The participants performed the obstacle crossing with both lower limbs. Asymmetry Index was calculated. We found that people with PD presented higher leading and trailing toe clearance asymmetry than healthy older people. In addition, participants increased asymmetry in the Double-50 compared to Single condition. It can be concluded that people with PD show higher asymmetry during obstacle crossing compared to healthy older people, independently of the number of obstacles. In addition, a challenging environment induces asymmetry during obstacle crossing in both people with PD and healthy older people. São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) Graduate Program in Movement Sciences São Paulo State University (UNESP) São Paulo State University (UNESP) Faculty of Science Human Movement Research Laboratory (MOVI-LAB) University of Groningen University Medical Center Groningen Center for Human Movement Sciences São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) Graduate Program in Movement Sciences São Paulo State University (UNESP) São Paulo State University (UNESP) Faculty of Science Human Movement Research Laboratory (MOVI-LAB) FAPESP: 2013/27032-0 CNPq: 309045/2017-7

Made available in DSpace on 2019-10-06T15:19:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-11-20 People with Parkinson's disease (PD) have decreased arm swing movements during walking, which can be related to PD motor signs and symptoms. In this context, the aim of this study was to determine the effects of an increased arm swing frequency or amplitude on the gait parameters in people with PD and healthy older adults. Seventeen individuals with PD and 19 older people were invited to walk on a 10 m pathway under three experimental conditions: (i) usual walking (no arm swing instructions); (ii) an increased arm swing amplitude; and (iii) an increased arm swing frequency. Both groups had an increased stride speed, vertical center of mass and arm swing accelerations and decreased double support time under the increased arm swing amplitude and frequency conditions. People with PD were able to modulate the gait parameters according to the experimental conditions, but at a smaller magnitude than the older individuals. These results indicate that bradykinesia and hypometria of gait can be positively overcome by increasing the amplitude and frequency of arm swing. Arm movements should be included in gait rehabilitation protocols for PD. São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) University of Groningen University Medical Center Groningen Center for Human Movement Sciences São Paulo State University (UNESP) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO)

This study aimed to determine the relationship between postural asymmetry and falls in Parkinson's disease (PD). In total, 28 patients with PD were included. Postural control was analyzed in bipedal, tandem, and unipedal standing. Center of pressure (CoP) parameters were calculated for both limbs, and asymmetry was assessed using the asymmetry index. Logistic regression was used to predict/classify fallers through postural asymmetry. The Spearman correlation was performed to relate asymmetry and falls number. Poisson regression models were created to predict the number of falls in each condition. The results demonstrated that asymmetry can classify 75% of fallers and nonfallers. Asymmetry in anteroposterior-mean velocity of CoP in unipedal standing was related to the number of falls. Poisson regression showed that anteroposterior-mean velocity of CoP predicts falls in PD, indicating that increased asymmetry results in a greater number of falls. Anteroposterior-mean velocity of CoP seems to be a sensitive parameter to detect falls in PD, mainly during a postural challenging task.

O objetivo foi comparar o controle postural reativo após perturbação externa inesperada entre pacientes com doença de Parkinson (DP) fisicamente ativos e inativos. Participaram do estudo 17 pacientes com DP fisicamente ativos (DPA) e 17 fisicamente inativos (DPI). A perturbação da postura foi realizada pelo deslocamento no sentindo posterior da base de suporte. O controle postural reativo foi analisado por meio dos parâmetros eletromiográficos e do centro de pressão (CoP). O teste t de Student para amostras independentes indicou que o DPI apresentaram maior tempo para atingir o pico no músculo GM e para recuperar a posição estável, maior coativação nos músculos GM/TA e maior amplitude do deslocamento do CoP em relação ao DPA. A partir dos resultados, podemos concluir que pacientes com DP fisicamente ativos demonstram respostas posturais mais rápidas e adequadas após perturbação externa inesperada quando comparados aos fisicamente inativos, sendo um fator importante no controle postural.

Made available in DSpace on 2018-12-11T17:31:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-02 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The authors' aim was to investigate gait asymmetry of crossing step during obstacle avoidance while walking in people with Parkinson's disease (PD) under and without the effects of dopaminergic medication. Thirteen individuals with PD and 13 neurologically healthy individuals performed 5 trials of unobstructed gait and 10 trials of obstacle crossing during gait (5 trials with each leg) and spatiotemporal parameters were analyzed. Obstacle crossing increased step duration of the crossing step for the most-affected or nondominant limb compared to the crossing step with the least-affected or dominant limb. Individuals with PD without the effects of medication increased step duration for the step with the least-affected limb compared to the step with the most-affected limb during obstacle crossing. Human Movement Research Laboratory (MOVI-LAB) Faculty of Science Department of Physical Education Universidade Estadual Paulista–UNESP Posture and Gait Studies Laboratory (LEPLO) Bioscience Institute Department of Physical Education Universidade Estadual Paulista–UNESP Human Movement Research Laboratory (MOVI-LAB) Faculty of Science Department of Physical Education Universidade Estadual Paulista–UNESP Posture and Gait Studies Laboratory (LEPLO) Bioscience Institute Department of Physical Education Universidade Estadual Paulista–UNESP FAPESP: 2013/00925-4

Background Pharmacologic therapy is the primary treatment used to manage Parkinson’s disease (PD) symptoms. However, it becomes less effective with time and some symptoms do not respond to medication. Complementary interventions are therefore required for PD. Recent studies have implemented transcranial direct current stimulation (tDCS) in combination with other modalities of interventions, such as physical and cognitive training. Although the combination of tDCS with physical and cognitive training seems promising, the existing studies present mixed results. Therefore, a systematic review of the literature is necessary. Aims This systematic review aims to (i) assess the clinical effects of tDCS when applied in combination with physical or cognitive therapies in people with PD and; (ii) analyze how specific details of the intervention protocols may relate to findings. Methods The search strategy detailed the technique of stimulation, population and combined interventions (i.e. cognitive and/or physical training). Only controlled studies were included. Results Seventeen of an initial yield of 408 studies satisfied the criteria. Studies involved small sample sizes. tDCS protocols and characteristics of combined interventions varied. The reviewed studies suggest that synergistic effects may be obtained for cognition, upper limb function, gait/mobility and posture when tDCS is combined with cognitive and/or motor interventions in PD. Conclusion The reported results encourage further research to better understand the therapeutic utility of tDCS and to inform optimal clinical use in PD. Future studies in this field should focus on determining optimal stimulation parameters and intervention characteristics for maximal benefits in people with PD.

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Made available in DSpace on 2019-10-06T16:59:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-04-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Different clinical subtypes of Parkinson's disease (PD) have long been recognized. Recent studies have focused on two PD subtypes: Postural Instability and Gait Difficulty (PIGD) and Tremor Dominant (TD). PIGD patients have greater difficulties in postural control in relation to TD. However, knowledge about the differences in reactive adjustment mechanisms following a perturbation in TD and PIGD is limited. This study aimed to compare reactive postural adjustments under unexpected external perturbation in TD, PIGD, and control group (CG) subjects. Forty-five individuals (15 TD, 15 PIGD, and 15 CG) participated in this study. Postural perturbation was applied by the posterior displacement of the support surface in an unexpected condition. The velocity (15 cm/s) and displacement (5 cm/s) of perturbation were the same for all participants. Center of pressure (CoP) and center of mass (CoM) were analyzed for two reactive windows after the perturbation (0–200 ms and 200–700 ms). The Bonferroni post hoc test indicated a higher range of CoP in the PIGD when compared to the CG (p = 0.021). The PIGD demonstrated greater time to recover the stable posture compared to the TD (p = 0.017) and CG (p = 0.003). Furthermore, the TD showed higher AP-acceleration peak of CoM when compared to the PIGD (p = 0.048) and CG (p = 0.013), and greater AP-acceleration range of CoM in relation to the CG (p = 0.022). These findings suggest that PD patients present worse reactive postural control after perturbation compared to healthy older individuals. CoP and CoM parameters are sensitive to understand and detect the differences in reactive postural mechanisms in PD subtypes. São Paulo State University (Unesp) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) Post-Graduation Program in Movement Sciences São Paulo State University - UNESP São Paulo State University (Unesp) Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) Post-Graduation Program in Movement Sciences São Paulo State University - UNESP FAPESP: 2016/00503-0

Aim The aim of the present study was to analyze the association of depressive and anxiety symptoms with usual walking and obstacle avoidance in patients with Parkinson's disease. Methods Patients were divided into three groups: without depressive and anxiety symptoms (n = 28); depressive symptoms only (n = 15); and depressive and anxiety symptoms (n = 19). Symptoms of depression and anxiety were evaluated by the Hospital Anxiety and Depression scale. Participants walked across a pathway in two experimental conditions: usual walking and obstacle avoidance. Kinematic data were recorded using an optoelectronic three-dimensional system. Results During usual walking, the depressive and anxiety symptoms group presented shorter stride length and longer double support phase compared with the without depressive and anxiety symptoms group, and lower velocity than the without depressive and anxiety symptoms and depressive symptoms groups. During the approach phase of obstacle avoidance, the depressive and anxiety symptoms group decreased the stride length and velocity, whereas the without depressive and anxiety symptoms and depressive symptoms groups did not modulate these parameters. The depressive and anxiety symptoms group also showed shorter step length and velocity, longer step duration, and wider step width during obstacle crossing. Additionally, the depressive and anxiety symptoms group presented shorter foot-to-obstacle horizontal distances, and lower horizontal mean velocities during obstacle crossing. Partial correlation analyses showed that both depressive and anxiety symptoms were associated with spatiotemporal gait parameters. Conclusion Combined symptoms of depression and anxiety are associated with walking impairments in patients with Parkinson's disease in both usual walking and obstacle avoidance. Geriatr Gerontol Int 2019; 19: 868-873.

Made available in DSpace on 2019-10-06T15:30:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) This study investigated the effects of Parkinson’s Disease (PD) on the perceptive judgment of stair step height using both exteroceptive visual and exproprioceptive judgments. We invited 14 individuals with PD and 14 neurologically healthy older adults (OA) to perform perceptual judgment tasks for first step stairway heights of 11 and 20 cm. Initially, participants performed first the exteroceptive visual judgment and then the exproprioceptive judgment in five randomized trials for each stair height. An analysis of variance for the exteroceptive visual judgment revealed no main effects or interaction between PD versus OA groups and height. However, the analysis of variance for exproprioceptive judgment revealed a significant interaction between group and height (F 1,26 = 9.519; p =.005; Pη 2 =.268) such that both groups made more errors in exproprioceptive judgment at a height of 11 cm. The OA group made more errors in exproprioceptive judgment for the 20-cm step when compared with the PD group (p =.016) but the PD group underestimated the step height. We conclude that PD influences exproprioceptive perception of step height and that steps with smaller (vs. larger) heights induce greater exproprioceptive error. Posture and Gait Studies Laboratory Institute of Biosciences São Paulo State University (UNESP) Postgraduate Program in Movement Sciences Sao Paulo State University – UNESP UNIFAFIBE–Centro Universitário Posture and Gait Studies Laboratory Institute of Biosciences São Paulo State University (UNESP) Postgraduate Program in Movement Sciences Sao Paulo State University – UNESP FAPESP: 2015/00612-1

Made available in DSpace on 2019-10-06T16:55:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-01 Background: Gait is impaired in individuals with Parkinson's disease (PD). Although the effect of habitual footwear on gait spatiotemporal parameters has already been established in neurologically healthy individuals, its effects on people with PD is unknown. Research question: This study aimed to investigate the impact of habitual footwear on the step spatiotemporal parameters in people with PD. Methods: Sixteen individuals with PD (G-PD) and 15 neurologically healthy individuals (G-HC) were assessed. Participants walked on an 8 m long pressure sensitive walkway at their preferred speed with and without their habitual footwear (3 trials per condition). Footwear included flip-flops, shoes, sneakers and sandals. The average, variability and asymmetry for step length, width, duration, and velocity and the percentage time in the swing and stance phases were calculated. Results: The results showed in both groups a reduced percentage time in the swing phase and an increased step width, duration and length with footwear (F(1,29)>5.64; p

Made available in DSpace on 2018-11-29T15:54:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-05-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: Objective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance. Research question: This study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance. Methods: Thirty-five PD patients classified as postural instability and gait disorder (PIGD) and 30 as tremor dominant (TD), as well as 45 healthy controls (CG) walked along an 8-m pathway under two conditions: (a) unobstructed walking and (b) obstacle avoidance. Outcome measures included spatiotemporal parameters recorded by an optoelectronic tridimensional system. Results: During unobstructed walking, the PIGD group exhibited shorter stride length, slower velocity, and longer double support phase compared to the TD and CG groups. The TD group also presented slower stride velocity compared to the CG. The PIGD and TD groups presented shorter stride duration than the CG. Regarding obstacle avoidance, the PIGD group exhibited shorter distances for leading foot placement before obstacle, trailing foot placement after obstacle and trailing crossing step length compared to the TD and CG groups. The PIGD group exhibited wider leading crossing step width, lower trailing toe clearance, and slower leading and trailing velocity during obstacle avoidance compared to the CG. Significance: PIGD subtype patients showed worse modifications in objective measures of unobstructed walking and obstacle avoidance. The observed modifications may contribute to increased fall occurrence in PIGD patients. Sao Paulo State Univ, UNESP, Inst Biosci, Posture & Gait Studies Lab LEPLO, Campus Rio Claro,Ave 24-A,1515 Bela Vista, BR-13506900 Rio Claro, SP, Brazil Univ Groningen, Univ Med Ctr Groningen, Ctr Human Movement Sci, Groningen, Netherlands Sao Paulo State Univ, UNESP, Inst Biosci, Posture & Gait Studies Lab LEPLO, Campus Rio Claro,Ave 24-A,1515 Bela Vista, BR-13506900 Rio Claro, SP, Brazil FAPESP: 2010/07040-0 FAPESP: 2013/27032-0 FAPESP: 2014/22308-0

Made available in DSpace on 2019-10-06T15:59:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-12-01 Our aim was investigating variability in spatiotemporal parameters and kinetics of obstacle avoidance steps of different height obstacles in people with Parkinson’s disease (PD) and healthy older people. Twenty-eight participants have included (15 PD – stage disease: 2.1 ± 0.4 pts) and 13 healthy older people (control group). Each subject performed 10 trials of the following tasks: low obstacle, intermediate obstacle and high obstacle. The presentation order was randomized by block for each condition and participant. The spatiotemporal parameters was collected by GAITRite. An optoelectronic system (Optotrak Northern Digital Inc.) with 100 Hz of frequency was used to collect obstacle parameters. The kinect parameters (propulsion impulse and braking impulse) were acquire through two force plates (AccuGait), with a frequency of acquisition 200 Hz. Intersteps variability was calculated throughout mean values, standard deviation and coefficient of variation of two obstacle avoidance steps for each trial. PD group presented greater variability than control group on vertical and horizontal distances to the obstacle. Obstacle height did not change kinect’s parameters for both groups. The combination of task complexity (obstacle height) and disease impairments (gait alteration, loss of balance, etc) contributing for greater variability of Parkinson’s group. Besides, low obstacle and high obstacle seem to exacerbate variability of distance between obstacle and foot. São Paulo State University (Unesp) - Campus Rio Claro Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education São Paulo State University (Unesp) - Campus Bauru Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education São Paulo State University (Unesp) - Campus Rio Claro Posture and Gait Studies Laboratory (LEPLO) Department of Physical Education São Paulo State University (Unesp) - Campus Bauru Human Movement Research Laboratory (MOVI-LAB) Department of Physical Education

Sensory information from visual, vestibular, and somatosensory systems plays an important role in postural control. Deficits in postural control performance are the primary cause of the increased number of falls during aging. Postural instability in older adults is related to a decline in sensory and motor function and this can be more evident when associated with Parkinson’s disease (PD). Among the declines in the sensory systems, deficits in the somatosensory function have been identified in older adults and these appear to be even higher in PD patients. Evidence supporting the importance of the somatosensory system in postural control comes from experiments that artificially reduced sensitivity in the soles of the feet and studies involving individuals with compromised plantar sensation. In an attempt to improve somatosensory input, previous research has shown that artificially enhancing cutaneous information can improve postural control. The aim of this chapter is to describe the postural control of healthy older adults and patients with PD and highlight the importance of somatosensory information to postural control in both populations. In addition, we will discuss some therapies using enhanced somatosensory information in order to improve postural control and, consequently, prevent or reduce falls.

Made available in DSpace on 2018-11-27T08:57:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson's disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n = 8) and bilateral group (n = 11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups x medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups x medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior-posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior-posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks. (C) 2015 Elsevier B.V. All rights reserved. Univ Estadual Paulista, Posture & Gait Studies Lab, Campus Rio Claro,Av 24-A,1515, BR-13506900 Rio Claro, SP, Brazil Univ Estadual Paulista, Lab Human Movement Res, Lab Informat Vis & Act, Campus Bauru, BR-17033360 Bauru, SP, Brazil Univ Estadual Paulista, Posture & Gait Studies Lab, Campus Rio Claro,Av 24-A,1515, BR-13506900 Rio Claro, SP, Brazil Univ Estadual Paulista, Lab Human Movement Res, Lab Informat Vis & Act, Campus Bauru, BR-17033360 Bauru, SP, Brazil FAPESP: 2012/24040-9 FAPESP: 2013/00925-4

Made available in DSpace on 2018-12-11T17:14:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Gait variability may serve as a sensitive and clinically relevant parameter to quantify adjustments in walking and the changes with aging and neurological disease. Variability of steps preceding obstacle avoidance (approach phase) are important for efficiency in the task, especially in people with Parkinson’s disease (PD). However, variability of gait during the approach phase to obstacle avoidance in people with PD has been rarely reported, particularly when ambulating obstacles of different heights. The aim of the present study was to investigate the effects of obstacle height on step-to-step variability (step-to-step variability provides information on the variation between the equivalent steps for all trials, and walking variability (indicates the within-step variability of each, providing information about the modulations between the steps performed. of spatial-temporal parameters during the approach phase to obstacle avoidance in people with PD and neurologically healthy older people. Twenty-eight older people; 15 with PD and 13 neurologically healthy individuals (control group), participated in the study. Participants were instructed to walk at their preferred speed until the end of the pathway and to avoid the obstacle when it was present. Each subject performed 10 trials of the following tasks: unobstructed walking, low obstacle avoidance (3cm length, height equal ankle’s height, 60 cm wide), intermediate obstacle (3cm length, low plus high obstacle height divided by 2, 60 cm wide) avoidance and high obstacle avoidance (3cm length, knee’s height, 60 cm wide). The obstacle was positioned 4m from to the start position. The step-to-step and walking variability of the spatial-temporal parameters (acquiring with GAITRite®) of the four steps before obstacle avoidance were analyzed. MANOVAs were used to compare the data. PD group showed the characteristic gait deficits associated with PD. The obstacle increased the spatial-temporal variability (step–to-step and walking variability) during the approach phase to the obstacle. Specifically, both groups increased i) the step-to- step variability of the step length during low obstacle avoidance when compared to the other conditions; ii) the variability during low obstacle avoidance in the last step before obstacle (n-1) compared to higher obstacle avoidance; iii) variability during higher obstacle avoidance in further steps (n-3 and n-4). In conclusion, the presence of the obstacle during walking increased the variability of spatial-temporal parameters in older people with PD and the control group during the steps preceding obstacle avoidance. In addition motor planning (and motor adaptations) was initiated much earlier in the approach phase for the higher obstacle conditions compared to the low obstacle condition. UNESP Univ Estadual Paulista Faculdade de Ciências Depto de Educação Física Human Movement Research Laboratory, Bauru UNESP Univ Estadual Paulista Instituto de Biociências Depto de Educação Física Posture and Gait Studies Lab UNESP Univ Estadual Paulista Faculdade de Ciências Depto de Educação Física Human Movement Research Laboratory, Bauru UNESP Univ Estadual Paulista Instituto de Biociências Depto de Educação Física Posture and Gait Studies Lab FAPESP: 2013/21841-3