masterThesis
Estimulação cerebral vibro-acústica binaural na reabilitação da marcha de indivíduos com doença de Parkinson
Fecha
2020-02-07Registro en:
MEDEIROS, Gleidson Franciel Ribeiro de. Estimulação cerebral vibro-acústica binaural na reabilitação da marcha de indivíduos com doença de Parkinson. 2020. 53f. Dissertação (Mestrado em Fisioterapia) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2020.
Autor
Medeiros, Gleidson Franciel Ribeiro de
Resumen
Parkinson's disease is a chronic, degenerative, progressive pathology of the
central nervous system that affects the basal ganglia, destroying neurons of the
substantia nigra and reducing dopamine in the brain, causing bradykinesia, tremor at
rest, stiffness, postural changes, balance and gait. Among the main motor
rehabilitation protocols for Parkinson's gait, treadmill training stands out. In addition to
this, there is currently cerebral modulation with direct current. Binaural vibro-acoustic
brain stimulation (ECVAB) is a less expensive type of brain modulation, with few
studies in the area of motor rehabilitation, reasons for which this work is justified. The
aim of this study was to investigate the effects of ECVAB on the gait of elderly people
with Parkinson's. Eighteen people with Parkinson's grades 2 to 4 participated in this
study, on the scale of Hoehn and Yahr, aged between 55 and 75 years. They were
allocated to an Experimental Group (GE), treated with ECVAB and Walking Training
on the Track (TM); and Control Group (CG), treated with Placebo Cerebral Stimulation
(ECP) and TM. Initially, the subjects were evaluated using the Hoehn and Yahr staging
protocol; the Functional Gait Assessment and the Freezing Of Gait Questionnaire;
then, randomized in the corresponding groups for the intervention, being treated during
the on time, where the EG was treated with 5 minutes of warm-up on the manual cycle
ergometer without load, at baseline speed, followed by 20 minutes of ECVAB, 30
minutes of TM at training speed, ending with 5 minutes of cool-down with TM at
minimum speed, and the CG following a similar protocol to the previous group, differing
only by replacing the ECVAB by 20 minutes of ECP. 16 sessions were carried out,
during 8 weeks. 48 hours after the last session, the patients were reassessed.
Statistical analysis was performed by assigning a significance level of 5%. The KruskalWallis test with pos hoc was used to compare the values of the control and
experimental groups before and after the intervention. As a result, in the control group,
an improvement in FGA was observed only in the gait criterion with eyes closed (X2:
4.07; P: 0.043). There were no significant results regarding the FOG-Q criteria. As for
the experimental group, there was an improvement for both the FGA: gait speed (X2:
3.92; P: 0.048) and the ability to overcome obstacles (X2: 4.13; P: 0.042), and for the
FOG -Q: freezing during gait (X2: 3.92; P: 0.048), freezing and the ADLs (X2: 6.97; P:
0.008), glued feet (X2: 4.98; P: 0.026), and freezing time (X2: 6.12; P: 0.013). In view of the above, it can be suggested that the intervention protocol with ECVAB associated
with the treadmill was better for the treatment of gait fluency when compared to the
isolated treadmill protocol.