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1.
Z Gerontol Geriatr ; 53(2): 119-122, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32140765

RESUMO

Parasomnias are characterized by abnormal experiences, dreams, movements and behavior during sleep. They may occur in the middle of the sleep during REM (rapid eye movement) or NREM (non-rapid eye movement), during falling asleep or waking up. Characteristically for REM behavior disorder is an increased muscle tone although usually REM is defined by an absence of muscle tone. For these forms aggressive dreams may lead to violating bed partners or self-injury of the sleeping person. Even killing bed partners has been described. Many of the patients develop a kind of Parkinson's disease (synucleinopathies). The rate of phenoconversion is more than 30% in 5 years and nearly 100% after 15 years. There are several recommendations regarding a safe sleeping environment. Medicinal treatment consists of either melatonin or clonazepam.


Assuntos
Parassonias/psicologia , Doença de Parkinson/fisiopatologia , Transtorno do Comportamento do Sono REM/fisiopatologia , Sono REM/fisiologia , /fisiopatologia , Humanos , Movimento , Parassonias/diagnóstico , Doença de Parkinson/complicações , Transtorno do Comportamento do Sono REM/complicações , /complicações
2.
Zhonghua Yi Xue Za Zhi ; 100(3): 207-212, 2020 Jan 21.
Artigo em Chinês | MEDLINE | ID: mdl-32008288

RESUMO

Objective: To find more objective evidence and support for clinical classification of Parkinson's disease by means of tremor analysis in patients with early confirmed Parkinson's disease. Methods: A cross-sectional study was conducted to collect 65 patients with early Parkinson's disease treated in the Third Hospital of Peking University from January 2015 to December 2016. Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr scale (H-Y scale), Mini-mental state examination (MMSE), Hamilton depression scale (HAMD) were recorded in all patients. According to the ratio of UPDRS rigidity score to tremor score, the patients were divided into tremor dominant (TD), postural instability/gait difficulty (PIGD) and mixed types. All patients were examined by tremor analysis and the results were analyzed and compared. Results: Among the 65 patients, the mean age of onset was (63±10) years, the course of disease was (14±8) months. Twenty-one patients were classified to TD group, 28 patients were classified to PIGD type, and 16 patients with mixed type. There was no significant difference in frequency and amplitude of tremor between the three groups (P>0.05), but the proportion of alternating contraction and harmonic resonance of active and antagonistic muscles in TD group was significantly higher (P<0.05). Twenty patients (71.4%) in TD group showed typical Parkinson's disease manifestations in tremor analysis. Only four patients (14.3%) in PIGD group showed the typical manifestations. More patients in PIGD group showed no clear main peak of tremor at rest. Some patients showed 6-8 Hz/sec peak frequency in posture position and simultaneous contraction of the active and antagonist muscles. These two manifestations occured simultaneously in mixed type patients, including 10 cases (62.5%) with typical Parkinson's disease manifestations. Conclusion: As an objective electrophysiological method to evaluate tremor type, tremor analysis can be used as an important assistant method for clinical classification of Parkinson's disease. It can provide information of the pathway of pathological loss in different types and give important hints in prognosis and treatment.


Assuntos
Transtornos Neurológicos da Marcha/fisiopatologia , Doença de Parkinson/classificação , Doença de Parkinson/fisiopatologia , Tremor/fisiopatologia , Idade de Início , Idoso , Estudos Transversais , Feminino , Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Tremor/etiologia
3.
Brain Nerve ; 72(2): 107-117, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32036336

RESUMO

REM sleep behavior disorder (RBD) can progress to Parkinson's disease, Lewy body dementia, or multiple system atrophy within 20 years of onset. Accurate diagnosis of RBD is therefore important for early intervention. The development of markers that can more sensitively evaluate the effects of high-risk groups or candidate therapies that develop α-synucleinopathy in the short term is the key to a successful clinical trial. Clinical protocols for early diagnosis of α-synucleinopathy are currently being developed. The next stage will be to conduct clinical trials for candidate therapies.


Assuntos
Doença por Corpos de Lewy , Atrofia de Múltiplos Sistemas , Doença de Parkinson , Transtorno do Comportamento do Sono REM , Biomarcadores , Humanos , Doença por Corpos de Lewy/complicações , Doença por Corpos de Lewy/diagnóstico , Atrofia de Múltiplos Sistemas/complicações , Atrofia de Múltiplos Sistemas/diagnóstico , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Transtorno do Comportamento do Sono REM/complicações , Transtorno do Comportamento do Sono REM/diagnóstico , /diagnóstico , alfa-Sinucleína
4.
Nervenarzt ; 91(2): 107-113, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31989210

RESUMO

BACKGROUND: The development of delirium in patients with idiopathic Parkinson's disease (IPD) is a feared complication, which is often associated with sustained worsening of motor symptoms and psychopathological sequelae. Little is known regarding the prevalence and incidence rates, course and prognosis. Clinical studies from which recommendations for evidence-based management of delirium in IPD can be derived are lacking. OBJECTIVE: To summarize the state of the art regarding epidemiological and clinical features of delirium in IPD. Discussion of prevention strategies and non-pharmacological and pharmacological treatment options. METHODS: A literature search was carried out in PubMed. RESULTS: The IPD is an independent risk factor for the development of delirium. Patients with IPD show poorer clinical outcome frequently with cognitive worsening and motor complications following development of delirium. CONCLUSION: So far no validated rating scales for recognition and course evaluation of delirium in IPD are available. Preventive strategies and non-pharmacological measures should be consistently implemented to improve management. There are insufficient data concerning pharmacotherapy with quetiapine and clozapine, whereas other neuroleptics are contraindicated for delirium in IPD due to antidopaminergic side effects.


Assuntos
Antipsicóticos , Clozapina , Delírio , Doença de Parkinson , Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Delírio/tratamento farmacológico , Delírio/etiologia , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Fatores de Risco
5.
Adv Clin Exp Med ; 29(1): 115-121, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31990459

RESUMO

BACKGROUND: Parkinson's disease (PD) is a progressive neurodegenerative disorder with a characteristic clinical picture. Apart from classical movement disorders, a significant role is also played by non-motor symptoms, in particular cognitive impairments, which have a significant impact on the quality of life of the patients. Tau protein and amyloid beta are well-known non-specific biomarkers in Alzheimer's disease (AD). OBJECTIVES: The study assessed the practical value of determining tau protein and amyloid beta (Aß42) in the blood serum of patients with PD and their relationship with cognitive impairments, radiographic image and the used dose of L-DOPA. MATERIAL AND METHODS: The neuropsychological assessment was carried for 64 patients with PD. The levels of amyloid beta 1-42 (Aß42) and tau proteins in serum were also measured. RESULTS: The Aß42 level in the serum was statistically higher in patients with longer duration of the disease (p < 0.05) and those who were taking a higher dose of L-DOPA (p < 0.05). The average level of tau protein in the serum was slightly lower in the study groups than in the control group and showed no statistical significance. No correlation was found between the levels of tau protein and Aß42 and the results of neuropsychological tests. Tau protein correlated with hippocampal atrophy (p < 0.05). CONCLUSIONS: Serum levels of Aß42 and tau protein in PD may be a useful marker for the assessment of cognitive impairments. The role of L-DOPA in the process of dementia in PD remains unclear.


Assuntos
Doença de Alzheimer , Peptídeos beta-Amiloides , Disfunção Cognitiva , Doença de Parkinson , Fragmentos de Peptídeos , Proteínas tau , Adulto , Idoso , Peptídeos beta-Amiloides/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Disfunção Cognitiva/sangue , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Fragmentos de Peptídeos/sangue , Qualidade de Vida , Proteínas tau/sangue
6.
Accid Anal Prev ; 134: 105328, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31639583

RESUMO

Patients with Parkinson's Disease (PD) often exhibit difficulties with visual search that may impede their ability to recognize landmarks and cars while driving. The main objective of this study was to investigate visual search performances of both billboards and cars in patients with PD using a driving simulator. A second objective was to examine the role of cognitive functions in performing the visual search task while driving. Nineteen patients with PD (age: 68 ±â€¯8yo, sex (Men/Women): 15/4) and 14 controls (age: 60 ±â€¯11yo, sex: 7/7) first performed a battery of cognitive tests. They then drove in a simulator and were instructed to follow a lead vehicle while searching for billboards with the letter A (stationary target) or red cars (moving target) among other distractors. Accuracy and response times of visual search were the main outcome variables. Standard deviation of lateral position (SDLP) was the secondary outcome. During driving, patients were less accurate in identifying the targets, particularly for the stationary billboards located in the outer periphery. Within the group of patients, significant correlations were found between several measures of cognitive tests and simulator-based visual search accuracy. By contrast, only the score on the MOCA test correlated significantly with visual search accuracy in controls. Findings suggest that patients with PD have impaired visual search for more eccentric stationary targets while driving a simulator, which is likely due to cognitive deficits. Difficulties identifying objects in the outer periphery may have implications for driving safety. Decreased functional field of view under increased cognitive load may have attributed to the difficulties identifying these landmarks. This may impact the ability to identify, anticipate, and respond to important information (e.g., pedestrians, navigation signs, landmarks), especially in complex driving situations (e.g. urban driving or intersections).Future studies should be conducted in a larger sample size to determine whether a visual search task on a driving simulator may predict on-road driving performances.


Assuntos
Condução de Veículo , Cognição/fisiologia , Doença de Parkinson/complicações , Transtornos da Visão/etiologia , Idoso , Estudos de Casos e Controles , Transtornos Cognitivos/etiologia , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor/fisiologia
8.
J Ethnopharmacol ; 247: 112226, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31574343

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Licorice preparations are used as neuroprotective remedies in Persian ethnomedicine, in order to prevent from disabilities in neurodegenerative conditions like Parkinson's disease (PD). AIM OF THE STUDY: This study was designed to determine the licorice (root of Glycyrrhiza glabra L.) effectiveness as an adjunct treatment in the PD management. MATERIAL AND METHODS: In this double-blinded trial, 128 patients were assessed for eligibility criteria. Seventy-eight patients were ineligible and 11 of them refused from participating. Thirty-nine PD patients (YAHR staging ≤ 3) were divided into two groups by random. The patients received oral licorice or placebo syrups with a dose of 5 cc, twice a day for 6 months. High-performance liquid chromatography and spectrophotometric instruments determined licorice syrup constituents. The patients' situation for Unified Parkinson's rating scale (UPDRS) was assessed every 6 weeks for the duration of six months. In addition, patients' blood pressure, blood glucose, sodium and potassium levels, quality of life and dizziness were determined. RESULTS: Six weeks after intervention, total UPDRS, daily activities and tremor were significantly improved with a considerable effect size. A significant better motor test and rigidity scores were observed 4 months after licorice intake (p > 0.05). No electrolyte abnormality, significant changes in blood pressure or blood glucose levels were observed during the study. Each 5cc of syrup contained 136 mg of licorice extract with 12.14 mg glycyrrhizic acid, and also 136 µg of polyphenols. CONCLUSION: The licorice intake could improve the symptoms in PD patients without serious adverse events.


Assuntos
Antiparkinsonianos/administração & dosagem , Glycyrrhiza/química , Doença de Parkinson/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Antiparkinsonianos/efeitos adversos , Glicemia/análise , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Método Duplo-Cego , Quimioterapia Combinada/métodos , Etnofarmacologia , Feminino , Humanos , Irã (Geográfico) , Masculino , Medicina Arábica/métodos , Pessoa de Meia-Idade , Destreza Motora/efeitos dos fármacos , Rigidez Muscular/sangue , Rigidez Muscular/tratamento farmacológico , Rigidez Muscular/etiologia , Doença de Parkinson/sangue , Doença de Parkinson/complicações , Placebos , Extratos Vegetais/efeitos adversos , Raízes de Plantas/química , Qualidade de Vida , Resultado do Tratamento
9.
Neurology ; 94(4): e384-e396, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31848257

RESUMO

OBJECTIVE: To investigate in a cross-sectional study the contributions of altered cerebellar resting-state functional connectivity (FC) to cognitive impairment in Parkinson disease (PD). METHODS: We conducted morphometric and resting-state FC-MRI analyses contrasting 81 participants with PD and 43 age-matched healthy controls using rigorous quality assurance measures. To investigate the relationship of cerebellar FC to cognitive status, we compared participants with PD without cognitive impairment (Clinical Dementia Rating [CDR] scale score 0, n = 47) to participants with PD with impaired cognition (CDR score ≥0.5, n = 34). Comprehensive measures of cognition across the 5 cognitive domains were assessed for behavioral correlations. RESULTS: The participants with PD had significantly weaker FC between the vermis and peristriate visual association cortex compared to controls, and the strength of this FC correlated with visuospatial function and global cognition. In contrast, weaker FC between the vermis and dorsolateral prefrontal cortex was found in the cognitively impaired PD group compared to participants with PD without cognitive impairment. This effect correlated with deficits in attention, executive functions, and global cognition. No group differences in cerebellar lobular volumes or regional cortical thickness of the significant cortical clusters were observed. CONCLUSION: These results demonstrate a correlation between cerebellar vermal FC and cognitive impairment in PD. The absence of significant atrophy in cerebellum or relevant cortical areas suggests that this could be related to local pathophysiology such as neurotransmitter dysfunction.


Assuntos
Cerebelo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Vias Neurais/fisiopatologia , Doença de Parkinson/fisiopatologia , Idoso , Disfunção Cognitiva/etiologia , Estudos Transversais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Descanso
10.
Artigo em Russo | MEDLINE | ID: mdl-31793542

RESUMO

AIM: To evaluate the efficacy of a proprietary method based on stimulation of the hindfoot when lifting the foot from the surface of the support and bringing it forward in the treatment of walking disorders in patients with Parkinson's disease (PD). MATERIAL AND METHODS: The study included 19 patients with walking disorders, akinetic-rigid and mixed form of PD. The stage of the disease on the Hoehn-Yahr scale at the time of the study was 2.56±0,41. During the treatment of walking disorders using the proprietary method, correction of anti-parkinsonian therapy was not carried out. Correction of walking disorders was carried out by using 'activating platforms', which allow mechanical stimulation of the hindfoot at the moment of lifting the foot from the surface of the support. Neurological examination, computer stabilometry (CS), gait function evaluation by means of the LA-1 laser analyzer of kinematic parameters of gait, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Unified Parkinson's Disease Rating Scale (UPDRS) were used before and after treatment. RESULTS: A significant decrease in core values of LA-1 and positive dynamics on BBS, DGI, UPDRS was revealed after treatment. CONCLUSION: The original method based on stimulation of foot lifting from the surface and moving the foot forward, effectively improves the pattern of walking in patients with PD and can be recommended as a non-pharmacological method of treatment of impaired walking at the third stage of PD.


Assuntos
Transtornos Neurológicos da Marcha , Doença de Parkinson , Caminhada , Terapia por Exercício , Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Exame Neurológico , Doença de Parkinson/complicações
11.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 32-36, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825387

RESUMO

Speech disorders are widely spread in patients with Parkinson's disease, and these symptoms are only getting worse as the disease progresses. Nevertheless, only a few percent of the population have an access to an adequate and qualified care. This review describes the pathophysiology of parkinsonian speech disorders, methods of diagnostics and monitoring and treatment modalities, which include pharmacotherapy, speech therapy and surgical approaches. The authors believe that treatment of parkinsonism-related speech disorder is an integral part of a multidisciplinary patient care.


Assuntos
Doença de Parkinson , Distúrbios da Fala , Disartria , Humanos , Doença de Parkinson/complicações , Distúrbios da Fala/etiologia , Distúrbios da Fala/terapia , Fonoterapia
12.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 37-43, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825388

RESUMO

Parkinson's disease is the second most common neurodegenerative disease of the elderly caused by the neurodegenerative process in different parts of the brain, which resulted in motor and non-motor symptoms. Investigation of non-motor symptoms of Parkinson's disease is increasingly rising for the last years. Social cognition is a special type of cognitive process, which provides people interaction in the society and their impairment also can be observed in Parkinson's disease. Social cognitive functions include many aspects: the theory of the mind, morality, personality changes and behavioral disorders. Each of these aspects is based on different neurophysiological, neurochemical and neuroanatomical substrates. This article is an effort to get closer to understanding of the changes, which occur in the brain of a patient with Parkinson's disease.


Assuntos
Transtornos Cognitivos , Doenças Neurodegenerativas , Doença de Parkinson , Comportamento Social , Idoso , Cognição , Transtornos Cognitivos/etiologia , Humanos , Doença de Parkinson/complicações
13.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 44-50, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825389

RESUMO

BACKGROUND: Excessive daytime sleepiness (DS) is a common symptom of Parkinson's disease (PD), which can occur at any stage of the disease and decrease the quality of life of patients. The relationship between excessive daytime sleepiness and Parkinson's disease is determined by neurodegenerative process in the brain structures. However, there are many other factors, which can contribute to this phenomenon. AIM: To assess the prevalence and causes of DS as well as its impact on the quality of life of patients. MATERIAL AND METHODS: Seventy patients (mean age 65.0±8.4 years) with PD, stage I-III, including 48 patients with DS and 22 without DS, were examined. All patients underwent clinical/neurological and neuropsychological examinations using a set of scales and polysomnography, if necessary. RESULTS AND CONCLUSION: Sleep disorders are the most frequent non-motor symptoms of PD. The prevalence of subjective DS is determined for the first time. The disassociation between subjective and objective DS is observed in 32,5% of patients. Clinical combinations of DS with other sleep disorders are described. Taking dopaminergic medication contributes significantly to the development of DS and affective disorders (anxiety, depression) play a role in subjective DS.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Doença de Parkinson , Transtornos do Sono-Vigília , Idoso , Distúrbios do Sono por Sonolência Excessiva/etiologia , Humanos , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Polissonografia , Qualidade de Vida , Transtornos do Sono-Vigília/etiologia
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 51-55, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825390

RESUMO

Erectile dysfunction (ED) significantly deteriorates the quality of life of patients with Parkinson's disease (PD). Until recently, treatment of ED received insufficient attention. Management of ED in patients with PD requires an integrated and multidisciplinary approach. Pharmacotherapy with apomorphine or sildenafil (or other inhibitors of phosphodiesterase-5) has shown encouraging results in most patients with PD and ED. This review of literature addresses problems of ED in patients with PD.


Assuntos
Disfunção Erétil , Doença de Parkinson , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/etiologia , Humanos , Masculino , Doença de Parkinson/complicações , Inibidores de Fosfodiesterase/uso terapêutico , Piperazinas , Purinas , Qualidade de Vida , Sulfonas
15.
Medicine (Baltimore) ; 98(51): e17897, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860947

RESUMO

Parkinson disease (PD) is the second most common neurodegenerative disease which affects population older than 65 years. Tremor represents one of the main symptomatic triads in PD, particularly in rest state.We enrolled 41 idiopathic PD patients, to validate the assessment of tremor symptoms.To be enrolled in the study, patients had to fulfill the movement disorder society clinical diagnostic criteria for PD.We used an innovative home-made, low-cost device, able to quantify the frequency and amplitude of rest tremor and stress conditionOur results confirmed the presence of tremor during muscular effort in a significant number of patients and the influence of emotional stress.We suppose that this new device should be validated in clinical practice as a support of differential diagnosis and therapeutic management of PD patients.


Assuntos
Técnicas Biossensoriais/instrumentação , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Tremor/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Técnicas Biossensoriais/métodos , Estudos de Coortes , Intervalos de Confiança , Desenho de Equipamento , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/tratamento farmacológico , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Tremor/etiologia
16.
Medicine (Baltimore) ; 98(51): e18444, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861016

RESUMO

Both of periodic limb movements during sleep (PLMS) and Parkinson disease (PD) were related with dopaminergic system dysfunction. We aimed to investigate the detailed association of PLMS severity and PD.Clinical and overnight polysomnographic data of 2230 adults older than 40 from a community hospital between November 2011 and June 2017 in Taiwan were collected retrospectively. The association of PLMS severity and PD was analyzed by Fisher exact test, univariate, and multivariate logistic regression.The mean age was 55.6 years old (standard deviation = 9.8, range = 40-91) for all subjects. There were 2205 subjects without PD and 25 subjects with PD in this study. The distribution of PLMS severity was not significantly different between subjects without PD and with PD (Fischer exact test, P = .215). Also, PLMS was not significantly associated with PD using univariate and multivariate logistic regression.The PLMS severity was not associated with PD.


Assuntos
Síndrome da Mioclonia Noturna/complicações , Doença de Parkinson/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 98(45): e17874, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702655

RESUMO

BACKGROUND: Stepping in place (SIP) is a useful locomotor training intervention. The purpose of this study was to investigate the effects of single auditory-cued SIP training on cortical excitability, rhythmic movements and walking ability in patients with Parkinson's disease(PD). METHODS: Cross-over randomized control trial. Each participant completed two interventions with at least one-week washout period in between: (1) SIP with concurrent auditory cues (AC condition) and (2) SIP without auditory cues (NC condition). RESULTS: In the primary outcome, the cortical silent period (CSP) duration increased (P = .005), whereas short intracortical inhibition (SICI) decreased after training (P = .001). Freezers demonstrated enhanced inhibition in the resting motor threshold and CSP duration. SICI and intracortical facilitation were modulated in both groups under the AC condition. In the secondary outcomes, the stepping variability decreased significantly (AC: P = .033; NC: P = .009), whereas walking cadence increased after training (AC: P = .019; NC: P = .0023). CONCLUSIONS: Auditory-cued SIP training improved the lower-limb movement variability and modulated the cortical excitability in patients with PD. Freezers may benefit more from this training than nonfreezers.


Assuntos
Estimulação Acústica/métodos , Sinais (Psicologia) , Transtornos Neurológicos da Marcha/terapia , Estimulação Magnética Transcraniana/métodos , Idoso , Estudos Cross-Over , Potenciais Evocados Auditivos/fisiologia , Transtornos Neurológicos da Marcha/etiologia , Humanos , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Desempenho Físico Funcional , Modalidades de Fisioterapia , Caminhada/fisiologia
18.
Codas ; 31(5): e20180230, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31691746

RESUMO

PURPOSE: To develop a protocol for the evaluation of acquired speech disorders in individuals with Parkinson's disease (PADAF) and to validate its content and determine its inter-judge reliability. METHODS: The study was carried out in three stages: in the first one, the protocol was prepared and its content validated through the analysis of seven specialists; in the second, the instrument was applied to 25 individuals with idiopathic Parkinson's disease (PD); in the third and last stage, the inter-judge reliability was determined. RESULTS: The final version of PADAF consisted of 32 items that evaluated breathing, phonation, resonance, articulation, and prosody. It was shown to be valid, with a content validity index (CVI) much higher than that established in the literature, and with perfect agreement in the determination of inter-judge reliability. CONCLUSION: PADAF for PD individuals was developed and its content was validated, showing perfect instrument reliability.


Assuntos
Disartria/diagnóstico , Doença de Parkinson/complicações , Inquéritos e Questionários , Idoso , Protocolos Clínicos , Disartria/etiologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fonação , Reprodutibilidade dos Testes
19.
Clin Rehabil ; 33(12): 1949-1962, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31571503

RESUMO

OBJECTIVE: To investigate the psychometric properties of measures of balance and falls risk prediction in people with Parkinson's disease (PD). DATA SOURCES: PubMed, Embase, CINAHL, Ovid Medline, Scopus, and Web of Science were searched from inception to August 2019. REVIEW METHOD: Studies testing psychometric properties of measures of balance and falls risk prediction in PD were included. The four-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) assessed quality. RESULTS: Eighty studies testing 68 outcome measures were reviewed; 43 measures assessed balance, 9 assessed falls risk prediction, and 16 assessed both. The measures with robust psychometric estimation with acceptable properties were the (1) Mini-Balance Evaluation Systems Test (Mini-BEST), (2) Berg Balance Scale, (3) Timed Up and Go test, (4) Falls Efficacy Scale International, and (5) Activities-Specific Balance Confidence scale. These measures assess balance and falls risk prediction at the body, structure and function level, falls risk and balance, and falls risk at the activity level. The motor examination of the Unified Parkinson's Disease Rating Scale (UPDRS-ME) with robust psychometric analysis is a condition-specific measure with acceptable properties. Except the UPDRS-ME and Mini-BESTest, the responsiveness of the other four measures has yet to be established. CONCLUSION: Six of the 68 outcome measures have strong psychometric properties for the assessment of balance and falls risk prediction in PD. Measures assessing balance and falls risk prediction at the participatory level are limited in number with a lack of psychometric validation.


Assuntos
Acidentes por Quedas , Doença de Parkinson/complicações , Equilíbrio Postural , Humanos , Atividade Motora , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Modalidades de Fisioterapia , Psicometria , Reprodutibilidade dos Testes , Estudos de Tempo e Movimento
20.
Codas ; 31(6): e20180160, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31618343

RESUMO

PURPOSE: To compare pharyngeal residues of different consistencies among groups of individuals with neurogenic oropharyngeal dysphagia. METHODS: In a cross-sectional study, a fiberoptic endoscopic evaluation was performed in 30 swallowing exams of individuals diagnosed with neurological disease and oropharyngeal dysphagia, regardless of the time or stage of the disease. The individuals were divided into three groups according to etiology: group I, 10 post-stroke, 8 male and 2 female, aged 51 to 80 years (average age: 67 years); group II, 10 individuals with amyotrophic lateral sclerosis, 5 male and 5 female, aged 39 to 78 years (average age: 57 years); group III, 10 examinations of individuals with Parkinson's disease, 5 male and 5 female aged 65-88 years (average age: 74 years). The Yale Pharyngeal Residue Severity Rating Scale was applied by two independent raters in a blind manner for the analysis of pharyngeal residues in valleculae and pyriform sinuses based on the first swallowing of 5 mL of pureed and thickened liquid. RESULTS: No statistically significant difference was observed among groups in the degree of pharyngeal residues of puree food or thickened liquid in the valleculae (p = 0.25/p = 0.18) or the pyriform sinuses (p = 1.41/0.49). CONCLUSION: The pharyngeal residue levels of pureed and thickened liquid were similar for the groups studied, with less severe levels being more frequent.


Assuntos
Esclerose Amiotrófica Lateral/complicações , Transtornos de Deglutição/fisiopatologia , Doença de Parkinson/complicações , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Esclerose Amiotrófica Lateral/fisiopatologia , Estudos Transversais , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/fisiopatologia , Gravação em Vídeo
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