Mobilidade funcional em indivíduos com doença de Parkinson: associações com alterações motoras e não motoras
DOI:
https://doi.org/10.11606/issn.2317-0190.v28i2a184547Palavras-chave:
Doença de Parkinson, Limitação da Mobilidade, Fadiga, DepressãoResumo
Mobilidade funcional (MF) é a capacidade das pessoas de se movimentarem em diferentes ambientes, incluindo em casa, no trabalho e na comunidade, a fim de realizar atividades ou tarefas funcionais, de forma independente e segura. Objetivo: Investigar quais variáveis (gravidade das alterações motoras, sintomas depressivos e fadiga) têm maior impacto na MF avaliada por meio da Escala Modificada de Atividade em Parkinson (mPAS) em indivíduos com doença de Parkinson (DP). Método: A MF avaliada por meio da mPAS, que inclui 14 atividades em três domínios (transferências de cadeira, acinesia da marcha, mobilidade na cama). Escala Unificada de Avaliação da Doença de Parkinson (UPDRS) Parte III, Inventário de Depressão de Beck (BDI) e Escala de Fadiga da Doença de Parkinson-16 (PFS-16) foram usados. Resultados: 45 indivíduos (idade: 65 ± 11 anos) com DP (duração do DP: 7 ± 4 anos) participaram deste estudo transversal e exploratório. A gravidade das alterações motoras explicou 36% (F= 17,85, p <0,001) da variância nos escores de MF. Quando os sintomas depressivos foram incluídos no modelo, a variância explicada aumentou para 45% (F= 12,77, p <0,001). Isso indicou que indivíduos com menor gravidade das alterações motoras e sintomas depressivos eram menos propensos a ter limitações na MF. Conclusão: As alterações motoras foram o principal preditor da MF em indivíduos com DP, de acordo com os escores da mPAS. Além disso, a presença de sintomas depressivos não deve ser negligenciada.
Downloads
Referências
Bouça-Machado R, Maetzler W, Ferreira JJ. What is Functional Mobility Applied to Parkinson's Disease? J Parkinsons Dis. 2018;8(1):121-130. Doi: https://doi.org/10.3233/JPD-171233
Gomes WL, Miranda LMS, Silva NM, Davi GKS, Costa RCS, Regalado IC, et al. Analysis of functional profile and mobility in Parkinson’s disease: a cross sectional study. MTP & Rehab J. 2018;16:557. Doi: https://doi.org/10.17784/mtprehabjournal.2018.16.557
Mirelman A, Bonato P, Camicioli R, Ellis TD, Giladi N, Hamilton JL, et al. Gait impairments in Parkinson's disease. Lancet Neurol. 2019;18(7):697-708. Doi: https://doi.org/10.1016/S1474-4422(19)30044-4
Pinto C, Schuch CP, Balbinot G, Salazar AP, Hennig EM, Kleiner AFR, et al. Movement smoothness during a functional mobility task in subjects with Parkinson's disease and freezing of gait - an analysis using inertial measurement units. J Neuroeng Rehabil. 2019;16(1):110. Doi: https://doi.org/10.1186/s12984-019-0579-8
Cano-de-la-Cuerda R, Vela-Desojo L, Moreno-Verdú M, Ferreira-Sánchez MDR, Macías-Macías Y, Miangolarra-Page JC. Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson's Disease: An Exploratory Study. Sensors (Basel). 2020;20(9):2482. Doi: https://doi.org/10.3390/s20092482
King LA, Priest KC, Nutt J, Chen Y, Chen Z, Melnick M, Horak F. Comorbidity and functional mobility in persons with Parkinson disease. Arch Phys Med Rehabil. 2014;95(11):2152-7. Doi: https://doi.org/10.1016/j.apmr.2014.07.396
Aktar B, Balci B, Donmez Colakoglu B. Physical activity in patients with Parkinson's disease: A holistic approach based on the ICF model. Clin Neurol Neurosurg. 2020;198:106132. Doi: https://doi.org/10.1016/j.clineuro.2020.106132
Yoshii F, Moriya Y, Ohnuki T, Ryo M, Takahashi W. Postural deformities in Parkinson's disease -Mutual relationships among neck flexion, fore-bent, knee-bent and lateral-bent angles and correlations with clinical predictors. J Clin Mov Disord. 2016;3:1. Doi: https://doi.org/10.1186/s40734-016-0029-8
van Uem JMT, Cerff B, Kampmeyer M, Prinzen J, Zuidema M, Hobert MA, et al. The association between objectively measured physical activity, depression, cognition, and health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord. 2018;48:74-81. Doi: https://doi.org/10.1016/j.parkreldis.2017.12.023
Sousa NMF, Macedo RC. Relationship between cognitive performance and mobility in patients with Parkinson's disease: A cross-sectional study. Dement Neuropsychol. 2019;13(4):403-409. Doi: https://doi.org/10.1590/1980-57642018dn13-040006
Carvalho DV, Santos RMS, Magalhães HC, Souza MS, Christo PP, Almeida-Leite CM, et al. Can fatigue predict walking capacity of patients with Parkinson's disease? Arq Neuropsiquiatr. 2020;78(2):70-5. Doi: https://doi.org/10.1590/0004-282X20190136
Ünlüer NÖ, Ateş Y, Balbaba A, Sücüllü Karadağ Y. Investigation of non-motor symptoms, balance, muscle strength, and functional mobility in patients with parkinson's disease. Somatosens Mot Res. 2021;38(1):20-6. Doi: https://doi.org/10.1080/08990220.2020.1834377
Lawrence BJ, Gasson N, Kane R, Bucks RS, Loftus AM. Activities of daily living, depression, and quality of life in Parkinson's disease. PLoS One. 2014;9(7):e102294. Doi: https://doi.org/10.1371/journal.pone.0102294
Bouça-Machado R, Duarte GS, Patriarca M, Castro Caldas A, Alarcão J, Fernandes RM, et al. Measurement Instruments to Assess Functional Mobility in Parkinson's Disease: A Systematic Review. Mov Disord Clin Pract. 2019;7(2):129-39. Doi: https://doi.org/10.1002/mdc3.12874
Keus SH, Nieuwboer A, Bloem BR, Borm GF, Munneke M. Clinimetric analyses of the Modified Parkinson Activity Scale. Parkinsonism Relat Disord. 2009;15(4):263-9. Doi: https://doi.org/10.1016/j.parkreldis.2008.06.003
Rajput DR. Accuracy of clinical diagnosis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry. 1993;56(8):938-9. Doi: https://doi.org/10.1136/jnnp.56.8.938
Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19(9):1020-8. Doi: https://doi.org/10.1002/mds.20213
Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral. Impacto da escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7.
Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003;18(7):738-50. Doi: https://doi.org/10.1002/mds.10473
Santos MP, Silva BA, Ovando AC, Ilha J, Swarowsky A. Comparison between two functional mobility scales for Parkinson's disease directly applied to physical therapy practice: cross-cultural adaptation and measurement properties. Eur J Phys Rehabil Med. 2017;53(5):664-75. Doi: https://doi.org/10.23736/S1973-9087.16.04148-4
Santos MP, Ovando AC, Silva BA, Fontana SR, Espírito Santo CC, Ilha J, et al. Parkinson Activity Scale: cross-cultural adaptation and reliability of the Brazilian version. Geriatr Gerontol Int. 2015;15(1):89-95. Doi: https://doi.org/10.1111/ggi.12235
Nieuwboer A, De Weerdt W, Dom R, Bogaerts K, Nuyens G. Development of an activity scale for individuals with advanced Parkinson disease: reliability and "on-off" variability. Phys Ther. 2000;80(11):1087-96.
Silberman CD, Laks J, Capitão CF, Rodrigues CS, Moreira I, Engelhardt E. Recognizing depression in patients with Parkinson's disease: accuracy and specificity of two depression rating scale. Arq Neuropsiquiatr. 2006;64(2B):407-11. Doi: https://doi.org/10.1590/s0004-282x2006000300011
Kummer A, Scalzo P, Cardoso F, Teixeira AL. Evaluation of fatigue in Parkinson's disease using the Brazilian version of Parkinson's Fatigue Scale. Acta Neurol Scand. 2011;123(2):130-6. Doi: https://doi.org/10.1111/j.1600-0404.2010.01364.x
Audigé L. Veterinary epidemiologic research: I. Dohoo, W. Martin, H. Stryhn, Atlantic Veterinary College, Charlottetown, PE, Canada, 2003. Prev Vet Med. 2005;68(2–4):289-92. Doi: https://doi.org/10.1016/j.prevetmed.2004.11.001
Munro BH. Statistical methods for health care research. 5nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2005.
Domingos J, Keus SHJ, Dean J, de Vries NM, Ferreira JJ, Bloem BR. The European Physiotherapy Guideline for Parkinson's Disease: Implications for Neurologists. J Parkinsons Dis. 2018;8(4):499-502. Doi: https://doi.org/10.3233/JPD-181383
Mänty M, de Leon CF, Rantanen T, Era P, Pedersen AN, Ekmann A, et al. Mobility-related fatigue, walking speed, and muscle strength in older people. J Gerontol A Biol Sci Med Sci. 2012;67(5):523-9. Doi: https://doi.org/10.1093/gerona/glr183
Garg H, Bush S, Gappmaier E. Associations Between Fatigue and Disability, Functional Mobility, Depression, and Quality of Life in People with Multiple Sclerosis. Int J MS Care. 2016;18(2):71-7. Doi: https://doi.org/10.7224/1537-2073.2015-013
Kader M, Ullén S, Iwarsson S, Odin P, Nilsson MH. Factors Contributing to Perceived Walking Difficulties in People with Parkinson's Disease. J Parkinsons Dis. 2017;7(2):397-407. Doi: https://doi.org/10.3233/JPD-161034
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2021 Acta Fisiátrica
![Creative Commons License](http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png)
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.