The effects of Brazilian dance, deep-water exercise and nordic walking, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD.

BACKGROUND: Motor and non-motor symptoms affect functional autonomy, mobility and daily life activities in People with Parkinson's Disease (PwPD). Brazilian Dance (BD), Deep-water exercise (DWE), and Nordic Walking (NW) are well-accepted, low-cost, and safe non-pharmacological strategies for untrained PwPD. However, no previous studies have investigated and compared the effects of these interventions on trained PwPD. OBJECTIVE: To describe and compare the effects of BD, DWE and NW, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD. METHODS: Eighty-three trained PwPD were randomly assigned into three groups: BD (n = 31), DWE (n = 21) and NW (n = 31), that participated in one of the interventions for 12 weeks. We applied Timed up and go at two speeds (self-selected and fast); 6-min and 10-meter walk test; Sit-to-Stand and handgrip test; Unified Parkinson Disease Rating Scale - III; Falls Efficacy Scale; Montreal Cognitive Assessment questionnaire; and Parkinson's Disease Questionnaire-39. The main (group and time) and interaction effects were analyzed using GEE analysis (p<0.05). RESULTS: Statistical differences were found between groups in the handgrip test (p<0.01), the time (p = 0.04), and interaction group*time (p< 0.01) in the Sit-to-stand test. While BD improved the Sit-to-stand test performance (ES=1.00; large effect size), DWE and NW remained unchanged (ES=0.16 and ES=0.14; low effect size). CONCLUSION: BD, DWE, and NW maintained most of the functional-motor and non-motor symptoms in trained PwPD. BD was shown to be more effective at improving strength in the lower limbs, when compared to NW and DWE.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

Effects of Mental Fatigue on Reaction Time in Sportsmen.

AIM: Mental fatigue (MF) has been defined as a psychobiological state commonly caused by prolonged periods of demanding cognitive activity. However, the differences between women and men in their reaction times (RTs) to visual stimuli due to mental fatigue remain largely unknown. We compare the differences in RT and heart rate after an acute intervention of mental fatigue between male and female athletes. MATERIALS AND METHODS: For this aim, 64 participants (age 31.7 ± 6.2 y) performed a routine of 15 min of the Stroop test (PsyTool), with 600 tasks and five different colors. Their heart rate (HR) was registered before, during, and one, three, and five minutes after the Stroop test. Meanwhile, the RT was evaluated before and after the Stroop test. A general linear mixed model (GLMM) and a Bonferroni post hoc test were used to compare the HR between the conditions and an ANOVA two-way analysis was used to compare the values pre-/post-Stroop test. (α = 0.05). RESULTS: The GLMM for HR showed an effect on the time (p < 0.001) and the time × group interaction (p = 0.004). The RT was significantly increased pre- to post-Stroop test (p < 0.05); however, there was no difference between the pre- and post-HR measurements (p = 1.000) and the measurements one (p = 0.559), three (p = 1.000) and five (p = 1.000) min after the Stroop test. CONCLUSION: The present findings suggest that the parasympathetic branch of the autonomous nervous system which functions as a relaxation system tends to be activated under increasing mental fatigue, with a decreased performance (RT) similarly in men and women. Therefore, athletes could use MF induced during training to improve the time delay related to motor tasks.

Samba, deep water, and poles: a framework for exercise prescription in Parkinson's disease.

Parkinson's disease is a brain disorder that leads to tremor, slowness, muscle stiffness, and other movement disorders. The benefits of exercise for reducing disability in individuals with Parkinson's disease are numerous. However, not much is known about the designing and prescription of exercise in neurodegenerative diseases. A brief review and indications for exercise prescription and evaluation are discussed throughout. In this scoping review, we specifically aimed to describe the applicability of walking tests (6-min/10-m) for the prescription of exercise in individuals with Parkinson's disease and to propose training (undulating periodized) designs in three exercise modalities, Brazilian dance rhythms (Samba and Forró), deep-water exercises, and Nordic walking. These training models and evaluation methods may assist coaches and therapists in organizing exercise programs adequate to people with Parkinson's disease, and are essential steps toward a comprehensive and more detailed understanding of the training loads in motor disorders and disease states. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-022-00894-4.

Postural Adjustments and Biomechanics During Gait Initiation and Obstacle Negotiation: A Comparison Between Akinetic-Rigid and Hyperkinetic Parkinson's Disease.

Background: Individuals with Parkinson's disease (PD) exhibit different combinations of motor symptoms. The most frequent subtypes are akinetic-rigid (AK-R) and hyperkinetic (HYP). Motor symptoms, such as rigidity and bradykinesia, can directly affect postural adjustments and performance in daily tasks, like gait initiation and obstacles negotiation, increasing the risk of falls and functional dependence. Objective: To compare postural adjustments and biomechanical parameters during the gait initiation and obstacle negotiation of people with AK-R and HYP PD and correlate with functional mobility and risk of falls. Methods: Cross-sectional study. Thirty-three volunteers with PD were divided into two groups according to clinical motor manifestations: AK-R (n = 16) and HYP (n = 17). We assessed the anticipatory (APA), compensatory (CPA) postural adjustments analyzing kinematic, kinetic and, electromyographic parameters during the gait initiation and obstacle negotiation tests. We applied independent T-tests and Pearson correlation tests for comparisons and correlations, respectively (α = 0.05). Results: In the APA phase of the gait initiation test, compared to the functional HYP group, the AK-R group showed shorter time for single support (p = 0.01), longer time for double support (p = 0.01) accompanied by a smaller first step (size, p = 0.05; height, p = 0.04), and reduced muscle activation of obliquus internus (p = 0.02). Similarly, during the first step in the obstacle negotiation test, the AK-R group showed less step height (p = 0.01) and hip excursion (p = 0.02), accompanied by a reduced mediolateral displacement of the center of pressure (p = 0.02) during APA, and activation of the gluteus medius (p = 0.02) and the anterior tibialis (p = 0.04) during CPA in comparison with HYP group. Conclusion: The findings suggest that people with AK-R present impaired postural adjustments during gait initiation and obstacles negotiation compared to hyperkinetic PD. Based on defined motor symptoms, the proposition presented here revealed consistent postural adjustments during complex tasks and, therefore, may offer new insights onto PD motor evaluation and neurorehabilitation.

Effect of exercise and grape juice on epigenetic modulation and functional outcomes in PD: A randomized clinical trial.

OBJECTIVE: This study aimed to investigate the impact of an aquatic physical training program associated with grape juice (Vitis labrusca) consumption on functional outcomes, Brain-Derived Neurotrophic Factor (BDNF) and global histone H4 acetylation levels in peripheral blood from individuals with Parkinson's disease. METHODS: Nineteen participants were randomized to Aquatic Exercise (AQ, n = 9) and Aquatic Exercise + Grape Juice (AQ+GJ, n = 10) groups and performed to 4 weeks of an aquatic intervention (twice a week, approximately 60 min/session). The AQ+GJ groups also consumed 400 mL of grape juice per day during this period. Functional capacity (six-min walk test, 6MWT), mobility (The Timed Up and Go, TUG) and the risk of falls (Berg Balance Scale, BBS) were evaluated before and after intervention. In addition, blood collections were carried out for biomarker analysis (e.g. BDNF and global histone H4). RESULTS: The aquatic exercise program induced functional improvement in individuals with Parkinson's disease, specifically ameliorating their mobility and functional capacity. In addition, enhanced levels of BDNF and histone H4 acetylation were found after the intervention. Grape juice consumption did not potentiate these effects, since any significant differences between the AQ and AQ+GJ groups were not found in all analysed variables. CONCLUSIONS: The present study provides important insights about aquatic exercise-modulated BDNF levels in individuals with Parkinson's disease in combination with functional improvements, suggesting that histone acetylation status may interact to dictate the molecular mechanisms involved in this response. Parkinson disease, aquatic exercise, BDNF, epigenetic, grape juice.

Avaliação da coluna lombar e torácica nas situações com salto alto e com os pés descalços com o instrumento arcômetro / Evaluation of the thoracic and lumbar spine in situations using high heels and barefoot with the arcometer instrument

O salto alto há muitos anos tem sido um grande aliado das mulheres, tornando-se uma ferramenta fundamental em seu dia a dia. Contudo, a utilização indiscriminada, seja do ponto de vista da frequência de utilização ou da altura do salto, pode trazer prejuízos para a saúde do corpo, que, a busca do melhor equilíbrio, pode desencadear alterações da postura, trazendo problemas para os pés e para a coluna vertebral. Os objetivos deste estudo foram: identificar a postura das curvaturas das colunas vertebral, torácica e lombar de estudantes universitárias, a partir do conhecimento dos ângulos destas curvaturas, e comparar esta postura nas situações com salto alto e com os pés descalços. Foram avaliadas 34 estudantes do sexo feminino, com idades médias de 20±1,9 anos, utilizando o instrumento arcômetro, nas situações com salto alto de 9 cm de altura e com pés descalços. O arcômetro foi colocado sobre os processos espinhosos das vértebras T1, T12, L1 e L5, identificados por palpação, e forneceu os ângulos das curvaturas. Para verificar as diferenças dos ângulos e da postura entre as duas situações de teste, foram utilizados o teste t pareado e o do χ2, respectivamente (a=0,05). Os resultados demonstraram que a utilização de salto alto não modificou significativamente os ângulos das curvaturas torácica e lombar da coluna vertebral, bem como não interferiu na classificação da postura das estudantes universitárias, as quais, em sua maioria, apresentaram postura normal da coluna vertebral.

For many years, high heels have been a great ally of women becoming an important tool in their everyday lives. However, its use, especially indiscriminate in the point of view of the use frequency or heel height, can bring harm to the body, which, in the search for better balance, may favor body posture changes by bringing injuries to the feet and to the spine. The aims of this study were: to identify the curvatures position of the vertebral, thoracic, and lumbar spines of university students from the knowledge of curvature angles and to compare this approach in situations with high heels and barefoot. Thirty-four female students were evaluated, and their mean age was 20±1.9 years-old, using the arcometer instrument, in situations with high heels, 9 inches tall and barefoot. The arcometer was placed on the spinous processes of T1, T12, L1 and L5 vertebrae, identified by palpation, and it provided the angles of each of the bends. For verification of differences of the angles and body posture between both test situations, the t and χ2 tests, were, respectively, used (a=0.05). The results showed that using high heels did not significantly alter the angles of curvature of the thoracic and lumbar spines and did not affect the classification of the body posture of physical therapy students, who mostly presented normal posture of the spine.