Effects of resistance training on postural control in Parkinson’s disease: a randomized controlled trial

Janini CHEN; Hsin Fen CHIEN; Debora Cristina Valente FRANCATO; Alessandra Ferreira BARBOSA; Carolina de Oliveira SOUZA; Mariana Callil VOOS; Julia Maria D'Andréa GREVE; Egberto Reis BARBOSA

doi:10.1590/0004-282X-ANP-2020-0285

Arquivos de Neuro-Psiquiatria, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(06): 511-520
DOI: 10.1590/0004-282X-ANP-2020-0285

Articles

Effects of resistance training on postural control in Parkinson’s disease: a randomized controlled trial

Efeitos de um treinamento de resistência muscular no controle postural em indivíduos com doença de Parkinson: um estudo aleatorizado controlado

Authors

Janini CHEN

¹Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Neurologia, Clínica de Distúrbios do Movimento, São Paulo SP, Brazil.

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.

³Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo SP, Brazil.
Hsin Fen CHIEN

¹Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Neurologia, Clínica de Distúrbios do Movimento, São Paulo SP, Brazil.

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.

³Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Ortopedia e Traumatologia, São Paulo SP, Brazil.
Debora Cristina Valente FRANCATO

¹Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Neurologia, Clínica de Distúrbios do Movimento, São Paulo SP, Brazil.

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.
Alessandra Ferreira BARBOSA

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.

⁴Universidade de São Paulo, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brazil.
Carolina de Oliveira SOUZA

¹Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Neurologia, Clínica de Distúrbios do Movimento, São Paulo SP, Brazil.

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.
Mariana Callil VOOS

²Grupo de Pesquisa em Reabilitação em Distúrbios do Movimento, São Paulo SP, Brazil.

⁴Universidade de São Paulo, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brazil.
Julia Maria D'Andréa GREVE

⁵Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Instituto de Ortopedia e Traumatologia, Laboratório de Estudo do Movimento, São Paulo SP, Brazil.
Egberto Reis BARBOSA

¹Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Departamento de Neurologia, Clínica de Distúrbios do Movimento, São Paulo SP, Brazil.

Abstract

ABSTRACT

Background: Postural instability affects Parkinson’s disease (PD) patients’ postural control right from the early stages of the disease. The benefits of resistance training (RT) for balance and functional capacity have been described in the literature, but few studies have been conducted showing its effects on PD patients’ postural control. Objective: To investigate the effects of a three-month RT intervention on static posturography (SP) measurements and clinical functional balance assessment among PD patients. Methods: Seventy-four patients were randomly assigned to a three-month RT intervention consisting of using weightlifting machines at a gym (gym group) or RT consisting of using free weights and elastic bands (freew group), or to a control group. The participants were evaluated at baseline, three months and six months. We evaluated changes of SP measurements under eyes-open, eyes-closed and dual-task conditions (primary endpoint), along with motor performance and balance effects by means of clinical scales, dynamic posturography and perceptions of quality of life (secondary endpoints). Results: There were no significant interactions in SP measurements among the groups. Unified Parkinson Disease Rating Scale (UPDRS-III) motor scores decreased in both RT groups (p<0.05). Better perceived quality of life for the mobility domain was reported in the gym group while functional balance scores improved in the freew group, which were maintained at the six-month follow-up (p<0.05). Conclusions: This study was not able to detect changes in SP measurements following a three-month RT intervention. Both RT groups of PD patients showed improved motor performance, with positive balance effects in the freew group and better perceived quality of life in the gym group.

RESUMO

Introdução: A instabilidade postural afeta o controle postural desde os estágios iniciais da doença de Parkinson (DP). A literatura descreve benefícios do programa de fortalecimento muscular no equilíbrio, na capacidade funcional, porém poucos estudos investigaram seus efeitos no controle postural na DP. Objetivo: Investigar os efeitos de um programa de três meses de fortalecimento nas medidas da posturografia estática (PE) e nos testes clínicos na DP. Métodos: Participaram do ensaio aleatório controlado 74 pacientes, designados em um dos seguintes grupos: fortalecimento utilizando aparelhos de musculação (gmusc); fortalecimento com pesos livres e elásticos (gpeso); e grupo controle. As avaliações ocorreram antes da intervenção, 3 e 6 meses após intervenção. Foram avaliados alterações nas medidas da PE nas condições de olhos abertos, olhos fechados e dupla tarefa (desfecho primário), efeitos sobre sintomas motores, equilíbrio por meio de escalas clínicas, posturografia dinâmica e percepção da qualidade de vida (desfechos secundários). Resultados: Não houve interações significativas nas medidas da PE entre os grupos. As pontuações motoras da Escala Unificada de Avaliação da Doença de Parkinson (UPDRS-III) diminuíram em ambos os grupos de fortalecimento (p<0,05). Houve melhora da percepção da qualidade de vida para o domínio mobilidade no gmusc, assim como ganhos nas pontuações dos testes funcionais no gpeso, mantido no seguimento após seis meses (p<0,05). Conclusões: O programa de fortalecimento não altera o controle postural medida pela PE. Apesar disso, ambos os grupos de fortalecimento apresentaram melhor desempenho motor, efeitos positivos a médio prazo no equilíbrio no gpeso e melhor desempenho na qualidade de vida no gmusc.

Keywords:

Resistance Training - Parkinson Disease - Postural Balance - Rehabilitation - Quality of Life

Palavras-chave:

Treinamento de Resistência - Doença de Parkinson - Equilíbrio Postural - Reabilitação - Qualidade de Vida

Volltext

Referenzen

References
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