Aquatic physical therapy effects on cardiorespiratory variables in Parkinson's disease / Efeitos da fisioterapia aquática sobre variáveis cardiorrespiratórias na doença de Parkinson

Abstract Introduction Parkinson's (PD) is a neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra. It has motor and non-motor symptoms which is directly related to these people's decreased autonomy and quality of life. Aquatic physical therapy (APT) is a non-drug treatment option that is a resource to complement functional rehabilitation and/or prevention. Objective To analyze the effects of an APT program on cardiovascular and fatigue conditions in individuals with PD. Methods The cardiorespiratory conditions were assessed with vital signs - heart rate (HR) and blood pressure (BP), measured before and after each intervention. The double product (DP) and the Fatigue Severity Scale (FSS), measured pre- and post-intervention, were also used as variables. The intervention had eight 40- minute biweekly sessions over 4 weeks, with immersion in a heated swimming pool at 33 ºC on average. The statistical analysis was made with the paired t-test (to analyze the FSS) and the repeated measures ANOVA test (for DP, BP and HR); significance was set at p < 0.05. Results Fatigue perception with FSS improved significantly (p = 0.037), from 4.7 ± 1.6 (pre-intervention) to 4.3 ± 1.6 (post-intervention). There were no statistically significant differences in DP, BP and HR (p = 1). Conclusion HR and BP remained at appropriate values for older people, and DP remained within a safe submaximal training range. Furthermore, the proposed APT program statistically decreased fatigue in this specific group of people with PD.

Resumo Introdução A Doença de Parkinson (DP) é uma doença neurodegenerativa caracterizada pela perda de neurônios dopaminérgicos na substância negra. Apresenta sintomas motores e não motores ligados à diminuição da autonomia e qualidade de vida. Entre os tratamentos prescritos está a fisioterapia aquática (FA), sendo um recurso na reabilitação e/ou prevenção de alterações funcionais. Objetivo Analisar os efeitos de um programa de FA nas condições cardiovasculares e fadiga em indivíduos com DP. Métodos Foram utilizados os sinais vitais frequência cardíaca (FC) e pressão arterial (PA), mensurados antes e depois de cada intervenção, e o duplo-produto (DPr) e Escala de Severidade da Fadiga (ESF) pré e pós-intervenção. A intervenção consistiu em oito encontros, durante quatro semanas, duas vezes por semana, com 40 minutos de imersão em piscina aquecida com média de 33 ºC. A análise estatística deu-se pelo test T pareado para a ESF e teste Anova para medidas repetidas do DPr, PA e FC, adotando p < 0,05. Resultados Houve melhora significativa na percepção de fadiga pela ESF (p = 0,037) de 4,7 ± 1,6 (pré-intervenção) para 4,3 ± 1,6 (pós-intervenção). DPr, PA e FC não apresentaram diferença significativa (p = 1). Conclusão Os sinais vitais de FC e PA se mantiveram em valores apropriados para idosos, bem como o DPr se manteve dentro de uma faixa segura de treinamento submáximo. Assim, o programa de FA proposto foi capaz de diminuir de forma significativa a fadiga nesta amostra de pessoas com DP.

Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease: A randomized clinical trial with a 3-month follow-up.

OBJECTIVE: To evaluate the effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease (PD). DESIGN: A randomized, single-blind trial was used. Twenty-eight (28) individuals met the inclusion criteria and were randomized in the Experimental Group (EG) and Control Group (CG). EG was subjected to a dual-task aquatic exercise program, twice a week for 10 weeks. Each session lasted 40 min, in a heated pool (33 °C). The individuals were assessed at the beginning (AS1), after an exercise program (AS2), and after a three-month follow-up (AS3). Functional mobility ("Timed Up & Go" Test, and "Five Times Sit to Stand" Test), balance (Berg Balance Scale) and gait (Dynamic Gait Index) were verified. RESULTS: 25 individuals were analyzed (14 EG and 11 CG). There was a time-group effect of the EG when compared to the CG: TUG (p = 0.03 and p = 0.015 to AS2 and AS3), FTSST (p = 0.001 and p = 0.004, for AS2 and AS3), BBS (p = 0.002 and p = 0.002, for AS2 and AS3), DGI (p = 0.001 and p = 0.003, for AS2 and AS3). CONCLUSIONS: The suggested dual-task aquatic exercise program was able to improve functional mobility, balance and gait of individuals with PD, which shows that such type of exercise is a promising possibility of therapy.

Exercícios físicos aquáticos e equilíbrio em idosos: uma revisão sistemática / Aquatic physical exercises and balance in the elderly: a systematic review / Ejercicios físicos acuáticos y el equilibrio en los ancianos: una revisión sistemática

O objetivo foi verificar os efeitos de exercícios aquáticos no equilíbrio de idosos. Os artigos foram identificados por busca sistemática no Pubmed, SciELO e Lilacs, descritores "elderly", "exercise" e "water"; "elderly", "water" e "balance"; "elderly", "water" e "gait"; "elderly", "water" e "balance". A fase inicial totalizou 545 artigos e, afinal, ficaram 9 artigos para análise na revisão sistemática. Conclui-se que o exercício aquático é capaz de promover melhoras e manutenção no equilíbrio de idosos.

The objective was to verify the effects of aquatic exercises on the balance of the elderly. The articles were identified by systematic search in Pubmed, SciELO and Lilacs, descriptors "elderly", "exercise" and "water"; "Elderly", "water" and "balance"; "Elderly", "water" and "gait"; "Elderly", "water" and "balance". The initial phase totaled 545 articles and the final one was 9 articles for analysis in the systematic review. It is concluded that aquatic exercise is capable of promoting improvements and maintenance in the balance of the elderly.

El objetivo fue verificar los efectos de los ejercicios acuáticos sobre el equilibrio de los ancianos. Los artículos fueron identificados por búsqueda sistemática en Pubmed, SciELO y Lilacs, descriptores "ancianos", "ejercicio" y "agua"; "Ancianos", "agua" y "equilibrio"; "Ancianos", "agua" y "marcha"; "Ancianos", "agua" y "equilibrio". La fase inicial totalizó 545 artículos y la última fue de 9 artículos para su análisis en la revisión sistemática. Se concluye que el ejercicio acuático es capaz de promover mejoras y mantenimiento en el equilibrio de los ancianos.

Psychomotor Intervention to stimulate Motor Development in 8-10-year-old schoolchildren / Intervenção Psicomotora para estímulo do Desenvolvimento Motor de escolares de 8 a 10 anos

Abstract The human being does not have static development throughout life. From conception to death, there are physical, psychological, social transformations and modifications, being vulnerable to restrictions. Interventions seek to reduce the effects of these restrictions, as children and adolescents are influenced by impoverished motor experiences in the family and school environment. The aim of this study was to evaluate the effects of an intervention program on 8-10-year-old schoolchildren in the public school system of Matinhos/PR, Brazil. Ninety-one 8-10-year-old schoolchildren from the 3rd, 4th and 5th grades were evaluated by the Motor Development Scale (MDS). Fifty-four of them presented risk of delay. Of these, 27 who performed weekly physical education classes were randomized into Control Group (CG), and 27 (Experimental Group - EG) to a psychomotor intervention program twice a week for four weeks. After interventions, EG and CG were reassessed. In the analysis of the General Motor Quotient (GMQ), it was verified that in all grades, EG presented a significant increase compared to the moment of evaluation, which was not observed among children in the CG. There was a significant increase in the averages in the reevaluation of CG and GE, however, EG presented significant differences in the Fine Motor and Balance dimensions. Intervention improved GMQ, Fine Motor and Balance compared to traditional Physical Education class.

Resumo O ser humano não tem um desenvolvimento estático ao longo da vida. Desde a concepção à morte, são conhecidas transformações e modificações físicas, psicológicas e sociais, estando vulneráveis a restrições. As intervenções buscam reduzir efeitos destas restrições, pois crianças e adolescentes sofrem influência de vivências motoras empobrecidas no meio familiar e ambiente escolar. Objetivou-se avaliar efeitos de um programa de intervenção em escolares de oito a dez anos da rede pública de ensino do município de Matinhos/PR, Brasil. Foram avaliados 91 escolares, de oito a dez anos, do 3º, 4º e 5º ano, foram avaliadas pela Escala de Desenvolvimento Motor (EDM). Destas, 54 apresentaram risco de atraso no desenvolvimento. Das 54 crianças, 27 que realizaram semanalmente aulas de Educação Física curriculares foram randomizadas no Grupo Controle (GC), e 27 (Grupo Experimental – GE) foram submetidas a uma intervenção psicomotora, duas vezes na semana, durante quatro semanas. Após as intervenções, o GE e GC foram reavaliadas. Na análise do Quociente Motor Geral (QMG), verificou-se que em todos os anos, o GE apresentou aumento significativo comparado ao momento de avaliação, fato nãoobservado entre crianças do GC. Houve elevação significativa das médias na reavaliação no GC e no GE, contudo, o GE apresentou diferenças significativas em relação ao GC, nas dimensões Motricidade Fina e Equilíbrio. A intervenção melhorou o QMG, a Motricidade fina e Equilíbrio em comparação com a aula de Educação Física tradicional.

Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy

Abstract Aim: To assess motor abilities and functioning of institutionalized children and adolescents with cerebral palsy (CP) within a contextual model of development. Methods: Eleven institutionalized Brazilian children and adolescents aged 2-19 (14 ± 5) years, 5 males and 6 females, were evaluated through the Gross Motor Function Measure (GMFM-88 and 66) and the Functional Independence Measure (FIM), and classified according to the ICF core set. Results: The evaluated individuals have severe impairments as indicated by their GMFM scores and confirmed by their need for full assistance in basic activities of daily living according to the FIM assessment. The difficulties manifested reflected on the ICF body functions and activities and participation domains. Conclusion: Most institutionalized children and adolescents with CP had GMFM-66 scores comparable to those indicated in literature. The ICF-based assessment identified environmental barriers that might be considered for improvement in order to facilitate activities and participation.