Efeitos do treinamento multicomponente e Mat Pilates na marcha em situação de dupla tarefa de indivíduos com Doença de Parkinson: ensaio clínico randomizado-controlado unicego

Abstract

Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease, pathophysiologically characterized by the loss of dopaminergic neurons in the central nervous system nigra. It presents changes in gait parameters that are responsible for the quality reduction and the high number of falls in this population. In order to minimize the motor symptoms of PD, physical exercise presents increased functionality, mobility and reduced number of falls. However, the objective of the study was to evaluate the effect of Mat Pilates (MP) and Multicomponent Training (TM) on the temporal variables of dual task gait in individuals with Parkinson's Disease (PD). This is a single-blind randomized controlled trial with n = 22 individuals diagnosed with idiopathic Parkinson's disease, classified in stages I and II according to the Hoehn & Yahr Scale. They were subdivided into G1 = 10 (Mat Pilates) G2 = 12 (Multicomponent Training) and randomized. Only the evaluators were blinded in the study. For the evaluation of gait time variables and kinematic data acquisition, the Noraxon® kinematic analysis software and pressure sensors, foot switch, were used. The volunteers were instructed to walk on the catwalk at the speed they routinely walk 3 times with an additional 10% of their body weight evenly divided in the upper limbs. The results showed statistical difference with increase of the speed variable in the MP (p = 0.047) and TM (p = 0.015) in the time effect. Cadence presented reduction and statistical difference only in MP with (p = 0.005) and presented strong effect size in MP = (1.12) and moderate for TM (0.53) and statistical difference in interaction time x group p = (0.001). . The swing time, double support and stride time showed no statistical difference. The study was approved by the Research Ethics Committee of the Federal University of Uberlândia (CAAE 89858518.6.0000.5152) and registered in the Brazilian Registry of Clinical Trials (ReBEC) under the number (RBR-3z39v3). We conclude that both interventions have positive effect on walking speed. However, the MP presented a spatiotemporal adjustment of speed and cadence that may increase gait stability that was not found in the TM.