Background: Parkinson's disease (PD) is a neurodegenerative and progressive disease marked by the presence of motor and non-motor symptoms, as psychological and cognitive impairment. Physical exercises have been prescribed as complementary therapy for PD, and the type of intervention and duration of the intervention should be taken into account. Objective: We aimed to compare the effect of different exercise modalities (functional mobility, multimodal and cognitive) and length (4 and 8 months) on psychological and cognition in people with PD. This study followed the CONSORT extension for non-pharmacological trials. Methods: In this randomized controlled trial, we assessed 107 participants between 2011 and 2013. At the end of 3 years, participants with PD (mild to moderate stages) who achieved the criteria were assessed considering 3 different groups of exercise: Multimodal (n = 38), Functional Mobility (n = 33) and Mental/Leisure (n = 36). All 3 interventions were performed for 32 weeks, twice a week, with 60 min for each session (64 sessions in total). Psychological and cognitive function were assessed at baseline and after 4 and 8 months. Results: The Functional Mobility and Mental/Leisure training had a potential effect on maintaining cognitive function (executive function, attention and work memory). The Multimodal training did not show a benefit for cognitive features and was not even able to delay the progressive decline in cognitive functions; however, this modality had a positive effect on physical stress after 8 months of exercise. Conclusions: An intervention that requires high complexity and specific activities, such as locomotor and cognitive exercise, provides a maintenance effect against the degeneration in cognition associated with the progression of PD and thus can delay the progressive decline in cognitive function in PD.
This study assesses the association between disease onset side (dominant or non-dominant) and vision on postural control of Parkinson's disease patients. Patient volunteers composed two groups, according to the onset side affected: Dominant group (n=9; M age=66.1 yr., SD=7.2; 6 women, 3 men) and Non-dominant group (n=9; M age=67.4 yr., SD=6.4; 6 women, 3 men). The groups' postural control was assessed by posturography during quiet upright stance in two conditions, Eyes open and Eyes closed. Two-way analyses of variance (ANOVAs; group×condition) with repeated measures for the second factor assessed the differences associated with affected hemibody and vision on postural control. Analyses indicated that patients with the dominant side affected also presented significantly greater variation in center of pressure than those with the non-dominant side affected, mainly in the Eyes closed condition. The results demonstrate a higher reliance on vision in the dominant side, possibly to compensate somatosensory system impairments. These results also highlight the importance of analyzing the hemibody affected by the disease when postural control is assessed in this population.
[Purpose] Sit-to-walk performance is linked to proper proprioceptive information
processing. Therefore, it is believed that an increase of proprioceptive inflow (using
muscle vibration) might improve sit-to-walk performance. However, before testing muscle
vibration effects on a frail population, assessment of its effects on healthy young people
is necessary. Thus, the aim of this study was to investigate the effects of muscle
vibration on sit-to-walk performance in healthy young adults. [Subjects and Methods]
Fifteen young adults performed the sit-to-walk task under three conditions: without
vibration, with vibration applied before movement onset, and with vibration applied during
the movement. Vibration was applied bilaterally for 30 s to the tibialis anterior, rectus
femoris, and upper trapezius muscles bellies. The vibration parameters were as follows:
120 Hz and 1.2 mm. Kinematics and kinetic data were assessed using a 3D motion capture
system and two force plates. The coordinates of reflective markers were used to define the
center-of-mass velocities and displacements. In addition, the first step spatiotemporal
variables were assessed. [Results] No vibration effect was observed on any dependent
variables. [Conclusion] The results show that stimulation of the proprioceptive system
with local muscle vibration does not improve sit-to-walk performance in healthy young
adults.
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