Variabilidade da ativação muscular em idosos com Doença de Parkinson durante simulação de travessia de rua

Abstract

Introduction: Crossing the street can be considered a risk situation because pedestrians must pay attention to traffic signs and traffic while walking, characterizing a multiple task. Elderly people with Parkinson's disease (PD) present gait impairment when dual-task activities are required, thus they may be more vulnerable to the risks of falls and accidents on urban roads. Objective: to analyze the muscle activation variability during different simulations of street crossing in elderly with PD. Material and methods: Participants from this observational cross-sectional study were 19 elderly patients with idiopathic PD at an early stage, with classification I to II of the Hoehn & Yahr scale. The electromyographic (EMG) variability of the vastus lateralis (VL), bíceps femoralis (BF), anterior tibialis (TA) and lateral gastrocnemius (GL) was analyzed during three conditions: simulation of street crossing at preference speed (Gait I), simulation of street crossing in normal time (Gait II) and simulation of street crossing in reduced time (Gait II). The electromyographic data were calculated by means of the mean of the standard deviations considering 10 consecutive initial gait cycles of each participant and in each of the three gait conditions evaluated. The Shapiro-Wilk test was used to verify the normality of the data and the Wilcoxon test to compare the activation variability of the evaluated muscles. Results: The results showed that there was no significant difference in muscle activation variability for VL, BF, TA and GL comparing Gait I and III (p=0.658; p=0.136; p=0.184 e p=0.227, respectively) and Gait II and III (p= 0.658, p=0.295; p=0.376 and p=0.601, respectively). Conclusions: Elderly persons with PD, when subjected to challenging situations, such as the street crossing, did not present significant changes in EMG variability in relation to normal gait, which characterizes an adaptation deficit of gait in the face of environmental demands, increasing the chances to suffer falls and accidents during such daily activity.