ABSTRACT
OBJECTIVE: To investigate parameters of lung function and respiratory muscle strength in different stages of Parkinson's disease (PD), as well as to determine their correlation with motor function and quality of life. METHODS: This was a cross-sectional study conducted at a referral center for PD in the city of Recife, Brazil. Respiratory muscle strength and lung function, as well as their relationship with motor function and quality of life, were evaluated in patients with PD, stratified by the level of severity, and were compared with the data obtained for a control group. After confirming the normality of data distribution, we performed one-way ANOVA with a post hoc t-test. RESULTS: The sample comprised 66 individuals, in two groups: PD (n = 49) and control (n = 17). All of the parameters investigated showed inverse correlations with PD severity, and there were significant differences among the levels of severity, as well as between the PD and control groups, in terms of the MIP, MEP, FVC, FEV1, and FEF25-75%. The lung function parameters also showed moderate to weak inverse correlations with bradykinesia and rigidity. On a quality of life questionnaire, the total score and mobility domain score both presented a moderate inverse correlation with FVC, FEV1, PEF, and MEP. CONCLUSIONS: Respiratory muscle strength and some lung function parameters are impaired from the early stages of PD onward, bradykinesia and rigidity being the cardinal signs that correlate most strongly with impairment of those parameters. Such alterations negatively affect the quality of life of patients with PD.
Subject(s)
Lung/physiopathology , Muscle Strength/physiology , Parkinson Disease/physiopathology , Quality of Life , Respiratory Muscles/physiopathology , Aged , Analysis of Variance , Body Size/physiology , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Reference Values , Respiratory Function Tests , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
ABSTRACT Objective: To investigate parameters of lung function and respiratory muscle strength in different stages of Parkinson's disease (PD), as well as to determine their correlation with motor function and quality of life. Methods: This was a cross-sectional study conducted at a referral center for PD in the city of Recife, Brazil. Respiratory muscle strength and lung function, as well as their relationship with motor function and quality of life, were evaluated in patients with PD, stratified by the level of severity, and were compared with the data obtained for a control group. After confirming the normality of data distribution, we performed one-way ANOVA with a post hoc t-test. Results: The sample comprised 66 individuals, in two groups: PD (n = 49) and control (n = 17). All of the parameters investigated showed inverse correlations with PD severity, and there were significant differences among the levels of severity, as well as between the PD and control groups, in terms of the MIP, MEP, FVC, FEV1, and FEF25-75%. The lung function parameters also showed moderate to weak inverse correlations with bradykinesia and rigidity. On a quality of life questionnaire, the total score and mobility domain score both presented a moderate inverse correlation with FVC, FEV1, PEF, and MEP. Conclusions: Respiratory muscle strength and some lung function parameters are impaired from the early stages of PD onward, bradykinesia and rigidity being the cardinal signs that correlate most strongly with impairment of those parameters. Such alterations negatively affect the quality of life of patients with PD.
RESUMO Objetivo: Investigar a repercussão de parâmetros de função pulmonar e de força muscular respiratória nos diversos estágios da doença de Parkinson (DP) e suas correlações com a funcionalidade e a qualidade de vida desses pacientes. Métodos: Estudo de corte transversal realizado em um serviço de referência para DP em Recife (PE). Foram avaliadas a força muscular respiratória e a função pulmonar, assim como suas relações com a funcionalidade e a qualidade de vida, em pacientes com DP estratificados por gravidade da DP e comparados a um grupo controle. Após a verificação da normalidade da amostra, foi realizada one-way ANOVA e teste t post hoc. Resultados: A amostra foi composta por 66 indivíduos, sendo 49 no grupo DP e 17 no grupo controle. Houve reduções nos parâmetros investigados com a progressão da doença, em comparação com o grupo controle, sendo encontradas diferenças significativas em PImáx, PEmáx, CVF, VEF1 e FEF25-75% em todos os estágios da DP. Houve correlações inversas (de fraca a moderada) de alguns parâmetros estudados com bradicinesia e rigidez. Os escores totais do questionário de qualidade de vida e de seu domínio mobilidade apresentaram moderada correlação inversa com CVF, VEF1, PFE e PEmáx. Conclusões: A força muscular respiratória e alguns parâmetros de função pulmonar encontram-se reduzidos desde os estágios iniciais da DP, sendo a bradicinesia e a rigidez os sinais cardinais mais correlacionados ao prejuízo desses parâmetros. Essas alterações repercutem negativamente na qualidade de vida desses pacientes.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Parkinson Disease/physiopathology , Quality of Life , Respiratory Muscles/physiopathology , Muscle Strength/physiology , Lung/physiopathology , Reference Values , Respiratory Function Tests , Case-Control Studies , Cross-Sectional Studies , Surveys and Questionnaires , Analysis of Variance , Statistics, Nonparametric , Body Size/physiologyABSTRACT
Introdução: Pessoas com Doença de Parkinson (DP) apresentam instabilidade postural com tendência a um aumento na frequência das quedas e fraturas em consequência do agravamento das alterações posturais. Objetivo: Analisar o risco de quedas em pessoas com Doença de Parkinson através da versão brasileira da Escala de Avaliação do Equilíbrio e da Marcha Orientada pelo Desempenho (POMA) e através do sistema de estabilidade Biodex. Material e métodos: Este foi um estudo transversal. O risco de quedas foi analisado nos sujeitos controles através da POMA. Nos sujeitos DP a análise foi feita com: escala de Hoehn e Yahr, POMA e com o sistema de estabilidade Biodex. Em ambos os grupos foram excluídos os indivíduos com doença vestibular, deficiência visual grave, labirintite ou outra que afetasse o equilíbrio. Resultados: A amostra foi composta por 58 sujeitos, sendo 31 com DP leve a moderada e 27 no grupo controle. O risco de queda avaliado através da POMA foi significativamente maior nos sujeitos com DP em relação ao controle (P < 0,0001). Conclusão: Neste estudo, o grupo com DP apresentou maior risco de queda do que a população sem a doença, com uma chance duas vezes maior de cair e risco de queda que aumentou com a progressão da doença. (AU)
Introduction: Persons with Parkinson's disease (PD) showing postural instability have increased frequency of falls and fractures as a result of the aggravation of postural changes. Objective: To evaluate the falls risk in persons with Parkinson's disease through Brazilian version of Performance Oriented Mobility Assessment (POMA) and Stability System Biodex. Methods: This was a cross-sectional study. The risk of falling was analyzed in controls subjects by POMA. In subjects PD the analysis was performed with original version Hoehn e Yahr (HY) scale; POMA and Stability System Biodex, falls risk protocol. Both groups excluded the subjects with vestibular disease, severe visual impairment, labyrinthitis or other that could affect the balance. Results: The sample consisted of 58 subjects, 31 with mild to moderate PD and 27 in the control group. The falls risk assessed by POMA was significantly higher in subjects with PD compared to control (P < 0.0001). Conclusion: In this study, the group with PD showed a higher risk of falling than people without the disease, with a twice as likely to fall and fall risk has increased with the progression of the disease. (AU)
