The acute effects of a stretching and conditioning exercise protocol for the lower limbs on gait performance- a proof of concept and single-blind study.

Background: Due to improvement in movement performance, post-activation performance enhancement (PAPE) may open new possibilities to improve gait performance. However, no study has attempted to translate this phenomenon into walking. Therefore, the study aimed to test whether acute stretching followed by a conditioning exercise can improve subsequent gait performance in healthy adults. Research question: Can an exercise protocol subsequently improve gait performance? Methods: Sixteen individuals walked four 10-m trials (in each period) before and after 7 min of an exercise protocol composed of stretching (focusing on the lower limb) and a conditioning exercise (standing calf-raise wearing a vest of 20 kg). Gait spatialtemporal parameters and muscle activity of tibialis anterior and gastrocnemius medialis and lateralis muscles were obtained by a 3D-motion system and wireless electromyography, respectively. Before and after the exercise protocol, kinematic and muscle activity parameters were compared by a one-way ANOVA and the Wilcoxon signed-rank test, respectively. Results: After the exercise protocol, the participants walked with a faster step velocity (p < 0.018) and with a lower step duration (p < 0.025). Also, higher peak muscle activity (p < 0.008) and low-frequency (p < 0.034) activation of the anterior tibial muscle after the exercise protocol were observed. Significance: In conclusion, the protocol improves the stability and the muscles' efficiency during gait, contributing to a new approach to enhancing gait rehabilitation programs.

Perception of COVID-19 Pandemic by Brazilian People With Parkinson's Disease and Multiple Sclerosis.

COVID-19 in Brazil is threatening, and it has forced the government to adopt partial lockdown as a strategy to stop the spread of the virus in the first wave of pandemic (March 2020). These preventive measures during the COVID-19 pandemic may affect the motor and non-motor symptoms in people with Parkinson's disease (PD) and Multiple sclerosis (MS). Thus, the purpose of this study was to investigate the perception during the first wave of COVID-19 pandemic lockdown on motor and non-motor symptoms, and also measure physical activity level, quality of life, and sleep quality in Brazilian people with PD and MS. One hundred and fifty-three participants (PD-97 and MS-56) answered an online survey to identify the perception of motor and non-motor symptoms, and characterize the physical activity level, and quality of life and sleep in these neurological Brazillian population. During the beginning of pandemic lockdown in Brazil, our results indicated that 69% of people with PD and 55% of people with MS reported worse on motor aspects and lower amount of physical activity performed. Also, 75.2% (PD) and 92.9% (MS) of our cohort were considered inactive or sedentary. Based on the perception and behavior of the population studied, people with PD and MS should be encouraged to perform more physical activity in order to reduce the effects of isolation in motor and non-motor aspects of the diseases. Teleinterventions, such as home-based exercise, should be included in the new routine of people with PD and MS to reduce the impacts of lockdown and to maintain quality of life at a good level.

Dual tasking reduces gait asymmetry of trajectory deviation during obstacle circumvention in people with Parkinson's disease.

BACKGROUND: Certain aspects of gait may depend on cognition, and the effects of dual-tasking (DT) on gait asymmetry (GA) during obstacle circumvention in people with Parkinson's disease (pwPD) may be walking phase-dependent. While the approaching phase requires allocating significant cognitive resources to perform the task, outweighing the available resources may increase GA. During the avoiding phase, the obstacle could be used as an external cue, enhancing the attention to the obstacle and, consequently, improving gait control and regulating GA. OBJECTIVE: The study investigated the effects of obstacle circumvention during gait with DT on GA in pwPD, considering the circumvention phase. METHODS: Thirty participants, 15 pwPD and 15 neurologically healthy individuals, circumvented an obstacle 20 times (in total) according to side (right and left side) and DT (presence and absence). Spatial-temporal stride parameters, medial-lateral and horizontal trajectory deviations from the original path, strategy to obstacle circumvention (lead limb away from or close to the obstacle during the crossing step), and gaze parameters were calculated during the approaching and avoiding phases. The parameters were grouped considering the side that the obstacle was circumvented during each task, and the symmetry index was calculated. RESULTS: The results showed greater asymmetry of time of fixations, width, duration, and velocity during the approaching phase (p < 0.02), whereas the avoiding phase decreased asymmetry of medial-lateral and horizontal trajectory deviations parameters (p < 0.001) during obstacle circumvention with DT, in both pwPD and control group. CONCLUSIONS: The findings offer a basis for considering that goal-directed movement control may regulate GA in pwPD.