Efeitos de exercícios pendulares no equilíbrio e na mobilidade de indivíduos portadores da Doença de Parkinson

Abstract

Importance: The efficacy of combined body suspension with tilting exercises (Chordata Method) in Parkinson’s disease (PD) is unclear. Objective: Design a clinical study to assess the efficacy of body suspension with tilting exercises on functional and quality of life outcomes in PD. Design, Setting, and Participants: This is an assessor-blinded, randomized and controlled clinical trial. A total of 48 subjects with moderate PD were recruited from the Neurological Service of São Lucas Hospital, PUCRS, Brazil. Recruitment took place between September 2015 and May 2016. The entire protocol study lasted 16 weeks, with 8 weeks of exercise protocol and 8 weeks of follow-up. Interventions: Subjects were randomly assigned to either body suspension with tilting exercises (intervention group) or stretching exercises (control group). Main Outcomes and Measures: The primary outcome was the Timed Up and Go test at the 8th week. Secondary outcomes were Berg Balance Scale (BBS); Functional Reach Test (FRT); Unified Parkinson’s Disease Rating Scale (UPDRS) and Parkinson’s Disease Questionnaire (PDQ-39). These measures were assessed at baseline (before trial entry) and then at the 8th (end of exercise protocols) and 16th weeks (8 weeks of follow-up) after randomization. Results: Of the 48 subjects randomized in the study 20 received the intervention (71.3±6.3 years old) and 20 were controls (66.7±6.4 years old). Eight of them were lost during the trial (four per group). Analysis of co-variance, with adjustment for baseline measurement, revealed a between-group difference in the Timed Up and Go test at 8th week [CI95% difference of -4.90 (-5.80 a -4.00), p<0.0001] and in the follow-up [CI95% difference of -4.94 sec (-5.82 to -4.06), p<0.0001], which was our primary outcome. Significant between-groups differences were also found for all secondary outcomes (BBS, UPDRS-III, FRT, and PDQ-39) at 8th week and follow-up (16th week) assessments. Conclusions and relevance: We suggest the body suspension with tilting exercises protocol (the Chordata Method) improves functionality and quality of life in subjects with moderate PD. This evidence supports the Chordata method appears to be a new effective therapeutic option to treat Parkinson-related mobility and balance dysfunctions.