Mobilidade funcional em indivíduos com doença de Parkinson: associações com alterações motoras e não motoras

Autores

  • Paula Luciana Scalzo Universidade Federal de Minas Gerais – UFMG
  • Iza de Faria-Fortini Universidade Federal de Minas Gerais – UFMG
  • Jéssica Ramos Pereira Universidade Federal de Minas Gerais – UFMG
  • Lílian Viana dos Santos Azevedo Universidade Federal de Minas Gerais – UFMG
  • Ana Carolina de Souza Cruz Universidade Federal de Minas Gerais – UFMG

DOI:

https://doi.org/10.11606/issn.2317-0190.v28i2a184547

Palavras-chave:

Doença de Parkinson, Limitação da Mobilidade, Fadiga, Depressão

Resumo

Mobilidade funcional (MF) é a capacidade das pessoas de se movimentarem em diferentes ambientes, incluindo em casa, no trabalho e na comunidade, a fim de realizar atividades ou tarefas funcionais, de forma independente e segura. Objetivo: Investigar quais variáveis (gravidade das alterações motoras, sintomas depressivos e fadiga) têm maior impacto na MF avaliada por meio da Escala Modificada de Atividade em Parkinson (mPAS) em indivíduos com doença de Parkinson (DP). Método: A MF avaliada por meio da mPAS, que inclui 14 atividades em três domínios (transferências de cadeira, acinesia da marcha, mobilidade na cama). Escala Unificada de Avaliação da Doença de Parkinson (UPDRS) Parte III, Inventário de Depressão de Beck (BDI) e Escala de Fadiga da Doença de Parkinson-16 (PFS-16) foram usados. Resultados: 45 indivíduos (idade: 65 ± 11 anos) com DP (duração do DP: 7 ± 4 anos) participaram deste estudo transversal e exploratório. A gravidade das alterações motoras explicou 36% (F= 17,85, p <0,001) da variância nos escores de MF. Quando os sintomas depressivos foram incluídos no modelo, a variância explicada aumentou para 45% (F= 12,77, p <0,001). Isso indicou que indivíduos com menor gravidade das alterações motoras e sintomas depressivos eram menos propensos a ter limitações na MF. Conclusão: As alterações motoras foram o principal preditor da MF em indivíduos com DP, de acordo com os escores da mPAS. Além disso, a presença de sintomas depressivos não deve ser negligenciada.

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Referências

Bouça-Machado R, Maetzler W, Ferreira JJ. What is Functional Mobility Applied to Parkinson's Disease? J Parkinsons Dis. 2018;8(1):121-130. Doi: https://doi.org/10.3233/JPD-171233

Gomes WL, Miranda LMS, Silva NM, Davi GKS, Costa RCS, Regalado IC, et al. Analysis of functional profile and mobility in Parkinson’s disease: a cross sectional study. MTP & Rehab J. 2018;16:557. Doi: https://doi.org/10.17784/mtprehabjournal.2018.16.557

Mirelman A, Bonato P, Camicioli R, Ellis TD, Giladi N, Hamilton JL, et al. Gait impairments in Parkinson's disease. Lancet Neurol. 2019;18(7):697-708. Doi: https://doi.org/10.1016/S1474-4422(19)30044-4

Pinto C, Schuch CP, Balbinot G, Salazar AP, Hennig EM, Kleiner AFR, et al. Movement smoothness during a functional mobility task in subjects with Parkinson's disease and freezing of gait - an analysis using inertial measurement units. J Neuroeng Rehabil. 2019;16(1):110. Doi: https://doi.org/10.1186/s12984-019-0579-8

Cano-de-la-Cuerda R, Vela-Desojo L, Moreno-Verdú M, Ferreira-Sánchez MDR, Macías-Macías Y, Miangolarra-Page JC. Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson's Disease: An Exploratory Study. Sensors (Basel). 2020;20(9):2482. Doi: https://doi.org/10.3390/s20092482

King LA, Priest KC, Nutt J, Chen Y, Chen Z, Melnick M, Horak F. Comorbidity and functional mobility in persons with Parkinson disease. Arch Phys Med Rehabil. 2014;95(11):2152-7. Doi: https://doi.org/10.1016/j.apmr.2014.07.396

Aktar B, Balci B, Donmez Colakoglu B. Physical activity in patients with Parkinson's disease: A holistic approach based on the ICF model. Clin Neurol Neurosurg. 2020;198:106132. Doi: https://doi.org/10.1016/j.clineuro.2020.106132

Yoshii F, Moriya Y, Ohnuki T, Ryo M, Takahashi W. Postural deformities in Parkinson's disease -Mutual relationships among neck flexion, fore-bent, knee-bent and lateral-bent angles and correlations with clinical predictors. J Clin Mov Disord. 2016;3:1. Doi: https://doi.org/10.1186/s40734-016-0029-8

van Uem JMT, Cerff B, Kampmeyer M, Prinzen J, Zuidema M, Hobert MA, et al. The association between objectively measured physical activity, depression, cognition, and health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord. 2018;48:74-81. Doi: https://doi.org/10.1016/j.parkreldis.2017.12.023

Sousa NMF, Macedo RC. Relationship between cognitive performance and mobility in patients with Parkinson's disease: A cross-sectional study. Dement Neuropsychol. 2019;13(4):403-409. Doi: https://doi.org/10.1590/1980-57642018dn13-040006

Carvalho DV, Santos RMS, Magalhães HC, Souza MS, Christo PP, Almeida-Leite CM, et al. Can fatigue predict walking capacity of patients with Parkinson's disease? Arq Neuropsiquiatr. 2020;78(2):70-5. Doi: https://doi.org/10.1590/0004-282X20190136

Ünlüer NÖ, Ateş Y, Balbaba A, Sücüllü Karadağ Y. Investigation of non-motor symptoms, balance, muscle strength, and functional mobility in patients with parkinson's disease. Somatosens Mot Res. 2021;38(1):20-6. Doi: https://doi.org/10.1080/08990220.2020.1834377

Lawrence BJ, Gasson N, Kane R, Bucks RS, Loftus AM. Activities of daily living, depression, and quality of life in Parkinson's disease. PLoS One. 2014;9(7):e102294. Doi: https://doi.org/10.1371/journal.pone.0102294

Bouça-Machado R, Duarte GS, Patriarca M, Castro Caldas A, Alarcão J, Fernandes RM, et al. Measurement Instruments to Assess Functional Mobility in Parkinson's Disease: A Systematic Review. Mov Disord Clin Pract. 2019;7(2):129-39. Doi: https://doi.org/10.1002/mdc3.12874

Keus SH, Nieuwboer A, Bloem BR, Borm GF, Munneke M. Clinimetric analyses of the Modified Parkinson Activity Scale. Parkinsonism Relat Disord. 2009;15(4):263-9. Doi: https://doi.org/10.1016/j.parkreldis.2008.06.003

Rajput DR. Accuracy of clinical diagnosis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry. 1993;56(8):938-9. Doi: https://doi.org/10.1136/jnnp.56.8.938

Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19(9):1020-8. Doi: https://doi.org/10.1002/mds.20213

Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral. Impacto da escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7.

Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003;18(7):738-50. Doi: https://doi.org/10.1002/mds.10473

Santos MP, Silva BA, Ovando AC, Ilha J, Swarowsky A. Comparison between two functional mobility scales for Parkinson's disease directly applied to physical therapy practice: cross-cultural adaptation and measurement properties. Eur J Phys Rehabil Med. 2017;53(5):664-75. Doi: https://doi.org/10.23736/S1973-9087.16.04148-4

Santos MP, Ovando AC, Silva BA, Fontana SR, Espírito Santo CC, Ilha J, et al. Parkinson Activity Scale: cross-cultural adaptation and reliability of the Brazilian version. Geriatr Gerontol Int. 2015;15(1):89-95. Doi: https://doi.org/10.1111/ggi.12235

Nieuwboer A, De Weerdt W, Dom R, Bogaerts K, Nuyens G. Development of an activity scale for individuals with advanced Parkinson disease: reliability and "on-off" variability. Phys Ther. 2000;80(11):1087-96.

Silberman CD, Laks J, Capitão CF, Rodrigues CS, Moreira I, Engelhardt E. Recognizing depression in patients with Parkinson's disease: accuracy and specificity of two depression rating scale. Arq Neuropsiquiatr. 2006;64(2B):407-11. Doi: https://doi.org/10.1590/s0004-282x2006000300011

Kummer A, Scalzo P, Cardoso F, Teixeira AL. Evaluation of fatigue in Parkinson's disease using the Brazilian version of Parkinson's Fatigue Scale. Acta Neurol Scand. 2011;123(2):130-6. Doi: https://doi.org/10.1111/j.1600-0404.2010.01364.x

Audigé L. Veterinary epidemiologic research: I. Dohoo, W. Martin, H. Stryhn, Atlantic Veterinary College, Charlottetown, PE, Canada, 2003. Prev Vet Med. 2005;68(2–4):289-92. Doi: https://doi.org/10.1016/j.prevetmed.2004.11.001

Munro BH. Statistical methods for health care research. 5nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2005.

Domingos J, Keus SHJ, Dean J, de Vries NM, Ferreira JJ, Bloem BR. The European Physiotherapy Guideline for Parkinson's Disease: Implications for Neurologists. J Parkinsons Dis. 2018;8(4):499-502. Doi: https://doi.org/10.3233/JPD-181383

Mänty M, de Leon CF, Rantanen T, Era P, Pedersen AN, Ekmann A, et al. Mobility-related fatigue, walking speed, and muscle strength in older people. J Gerontol A Biol Sci Med Sci. 2012;67(5):523-9. Doi: https://doi.org/10.1093/gerona/glr183

Garg H, Bush S, Gappmaier E. Associations Between Fatigue and Disability, Functional Mobility, Depression, and Quality of Life in People with Multiple Sclerosis. Int J MS Care. 2016;18(2):71-7. Doi: https://doi.org/10.7224/1537-2073.2015-013

Kader M, Ullén S, Iwarsson S, Odin P, Nilsson MH. Factors Contributing to Perceived Walking Difficulties in People with Parkinson's Disease. J Parkinsons Dis. 2017;7(2):397-407. Doi: https://doi.org/10.3233/JPD-161034

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Publicado

2021-06-30

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