Doença de Parkinson : análise da marcha e uso de pistas visuais / Parkinson s disease : gait analysis and visual cues

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

05/09/2011

RESUMO

The Idiopathic Parkinson s disease (IPD) is a neurodegenerative disease. Characteristics of IPD generate changes in gait pattern. Some clinical instruments have been used to characterize gait alterations in IPD, however, there are few publications correlating kinematic analysis and temporal-spatial data with clinical instruments, or instruments that evaluate the effect of two types of spatial visual cues (transverse and parallel) in comparison to no visual cue on mobility. The objective of Article 1 was compare the spatial temporal and kinematic variables of Parkinsonian gait with the healthy elder (HE) subjects and measure the relation between these variables and clinical instruments. Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. The results related to gait velocity, stride length (SL) and hip joint kinematic data (on initial contact, on maximum extension during terminal contact and on maximum flexion during swing) have demonstrated significant differences between groups. Regarding clinical instruments, there was significant correlated between gait velocity and SL. Thus, can assert that the used clinical instruments are not adequate for a descriptive and objective evaluation of gait in individuals with IPD, which was possible through a 3D analysis. Several studies have reported that adequate external influences, such as visual and/or auditory cues, can improve gait pattern of patients with IPD, thus generate gait pattern closer to normal. Thus, the objective of the Article 2 was to evaluate, in people with IPD, the effect of 2 types of spatial visual cues: transverse visual cues condition (TVC) and parallel visual cues (PVC), comparing no-visual cue during walking. Twelve patients with IPD were assessed for clinical instruments and gait assessment, through the analysis system in 3D. In this study the gait velocity was higher with the use of visual cues (parallel and transverse), than without them (p= 0.003). The SL with TVC was significantly longer (p= 0.006) when compared with the two other situations. Regarding the kinematic data with TVC, the knee joint presented smaller range of flexion during initial contact, and larger maximum range of flexion during swing phase. Therefore, gait assessment with visual cues have demonstrated that the use of transverse cues produces better results compared to parallel cues, and even without cues. Thus, the rehabilitation in individuals with IPD should emphasize the use of these cues to compensate gait alterations

ASSUNTO(S)

biomecânica articulações fisioterapia biomechanics joints physical therapy

ACESSO AO ARTIGO

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