Caminhada nórdica na doença de parkinson : percepções do sujeito praticante e aspectos cinético-funcionais

Abstract

Parkinson’s Disease (PD) is an idiopathic, chronic-degenerative, and progressive condition of the Central Nervous System (CNS) that causes motor and non-motor signs and symptoms in the affected individual. Such changes cause damage to posture and balance, interfering with the somatosensory, neuromusculoskeletal, vestibular, and vision systems, among others. One of the non-pharmacological interventions that have been studied for the adjuvant treatment of PD is the Nordic Walk (NW), which is a walk supported by sticks. Among its benefits, the improvement of individuals' motor skills and functional mobility, as well as the reduction in the rate of falls. Furthermore, participation in NW groups seems to help in the management of mood disorders and depressive symptoms. Therefore, this research studied the perception of people with PD regarding the regular practice of NW and the kinetic-functional impact of the presence of bats on the mobility of such individuals in their daily lives. In addition, it assessed the impact of the NW practice in reducing the participants' concern with the occurrence of falls from their height. This is a cross-sectional, observational study, with qualitative and quantitative cuts. The qualitative cut consisted of a focus group and data treatment by discourse analysis. In the quantitative cut, evaluations were carried out in the ON phase of the medication (when Levodopa has its action and reduces motor symptoms). On the first day of assessment, the International Fall Efficacy Scale (FES-I), Parkinson Disease Questionnaire-39 (PDQ-39) and Unified Parkinson's Disease Rating Scale (UPDRS III – motor exam), and the Hoehn & Yahr Scale (H&Y) were applied. On the second day, the 6-minute walk test (6MWT), the Timed Up and Go (TUG), the 1-minute Sit-Up Test (TSL1M), and the Montreal Cognitive Assessment (MoCA) were applied. The exercise protocol based on NW was composed of 60 sessions performed twice a week, lasting one hour each. From the participants' statements, five main categories emerged: NW benefits for people with Parkinson's Disease; incorporation of the bats used in the NW in everyday life; the NW group coexistence as an aid device in the treatment; feelings of people with Parkinson’s Disease about their condition; and, finally, the present and the future: expectations and delivery. In the quantitative cut, the NW training protocol was not enough to reduce the concern with the occurrence of falls in participants with PD. In general, he observed that NW generated content compatible with a positive coping in the face of coping with the disease, something that goes beyond the kinetic-functional and biomechanical issues described in the literature. It is concluded that NW is beneficial to its practitioners, both to improve the perception of functionality and to assist in the posture of coping with the disease.