Aquatic Dual-Task Training and Its Relation to Motor Functions, Activities of Daily Living, and Quality of Life of Individuals With Parkinson's Disease: A Randomized Clinical Trial.

Objectives: Parkinson's disease (PD) is a neurodegenerative disorder that impacts the dopaminergic neurons of the substantia nigra, leading to motor and non-motor symptoms, as well as changes in activities of daily living (ADL) and quality of life (QoL). Aquatic physical exercises and dual-task physical exercises have been used to manage PD symptoms. The aim of this study was to investigate the effects of a dual-task aquatic exercise program on the ADL, motor symptoms, and QoL of individuals with PD. Methods: A randomized controlled trial with a parallel group design was employed, and participants were randomized into 2 groups: a control group and an experimental group. The intervention was a 10-week program consisting of twice-weekly 40-minute aquatic dual-task exercises. Pre-intervention evaluations of ADL, motor function, and QoL were conducted at baseline (AS1), immediately after the intervention (AS2), and 3 months post-intervention (follow-up-AS3). The Unified Parkinson's Disease Rating Scale (UPDRS) II and III sections and the Parkinson's Disease Questionnaire 39 (PDQ-39) were utilized for outcome measures. Results: A total of 25 individuals completed the study. The experimental group showed significant improvements in both the UPDRS II (ADL) and III (motor function) sections (P's < .05), but there was no significant difference in PDQ-39 scores. Additionally, significant differences were observed in the experimental group between the AS2 and AS3 time periods (P < .05) for both UPDRS II and III scores (P < .05). Conclusions: Aquatic dual-task training may be effective in improving both ADL and motor functions in individuals with PD. Furthermore, the combination of aquatic environment and dual-task exercises may represent a promising approach to maintaining and improving the functionality of individuals with PD.

Aquatic physical therapy effects on cardiorespiratory variables in Parkinson's disease / Efeitos da fisioterapia aquática sobre variáveis cardiorrespiratórias na doença de Parkinson

Abstract Introduction Parkinson's (PD) is a neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra. It has motor and non-motor symptoms which is directly related to these people's decreased autonomy and quality of life. Aquatic physical therapy (APT) is a non-drug treatment option that is a resource to complement functional rehabilitation and/or prevention. Objective To analyze the effects of an APT program on cardiovascular and fatigue conditions in individuals with PD. Methods The cardiorespiratory conditions were assessed with vital signs - heart rate (HR) and blood pressure (BP), measured before and after each intervention. The double product (DP) and the Fatigue Severity Scale (FSS), measured pre- and post-intervention, were also used as variables. The intervention had eight 40- minute biweekly sessions over 4 weeks, with immersion in a heated swimming pool at 33 ºC on average. The statistical analysis was made with the paired t-test (to analyze the FSS) and the repeated measures ANOVA test (for DP, BP and HR); significance was set at p < 0.05. Results Fatigue perception with FSS improved significantly (p = 0.037), from 4.7 ± 1.6 (pre-intervention) to 4.3 ± 1.6 (post-intervention). There were no statistically significant differences in DP, BP and HR (p = 1). Conclusion HR and BP remained at appropriate values for older people, and DP remained within a safe submaximal training range. Furthermore, the proposed APT program statistically decreased fatigue in this specific group of people with PD.

Resumo Introdução A Doença de Parkinson (DP) é uma doença neurodegenerativa caracterizada pela perda de neurônios dopaminérgicos na substância negra. Apresenta sintomas motores e não motores ligados à diminuição da autonomia e qualidade de vida. Entre os tratamentos prescritos está a fisioterapia aquática (FA), sendo um recurso na reabilitação e/ou prevenção de alterações funcionais. Objetivo Analisar os efeitos de um programa de FA nas condições cardiovasculares e fadiga em indivíduos com DP. Métodos Foram utilizados os sinais vitais frequência cardíaca (FC) e pressão arterial (PA), mensurados antes e depois de cada intervenção, e o duplo-produto (DPr) e Escala de Severidade da Fadiga (ESF) pré e pós-intervenção. A intervenção consistiu em oito encontros, durante quatro semanas, duas vezes por semana, com 40 minutos de imersão em piscina aquecida com média de 33 ºC. A análise estatística deu-se pelo test T pareado para a ESF e teste Anova para medidas repetidas do DPr, PA e FC, adotando p < 0,05. Resultados Houve melhora significativa na percepção de fadiga pela ESF (p = 0,037) de 4,7 ± 1,6 (pré-intervenção) para 4,3 ± 1,6 (pós-intervenção). DPr, PA e FC não apresentaram diferença significativa (p = 1). Conclusão Os sinais vitais de FC e PA se mantiveram em valores apropriados para idosos, bem como o DPr se manteve dentro de uma faixa segura de treinamento submáximo. Assim, o programa de FA proposto foi capaz de diminuir de forma significativa a fadiga nesta amostra de pessoas com DP.

Parkinson's disease and multicomponent aquatic exercise: Effects on motor aspects, functional mobility, muscle function and aquatic motor skills.

OBJECTIVE: Analyze the effects of a multicomponent aquatic exercise program on motor aspects, functional mobility, muscle function and aquatic motor skills of people with PD. METHODS: Eighteen people with a PD diagnosis were assessed before and after a 12-week multicomponent aquatic exercise program, twice a week, with each session lasting 50 min. The terrestrial variables analyzed were motor aspects, through the Unified Parkinson Disease Rating Scale (UPDRS); functional mobility, through the Five Times Sit to Stand Test (FTSST); Peak Torque (PT) and Mean Power (MP) of hip, knee and ankle flexors and extensors, assessed using an isokinetic dynamometer. In water, aquatic motor skill levels were assessed by means of the Aquatic Functional Assessment Scale (AFAS). RESULTS: Significant improvements were found after the intervention in the following outcomes: motor aspects (p = 0.038, Δ = 5-61); MP of knee flexors at 90°/s on the most affected side (p = 0.026, Δ = 5.14), MP of knee extensors at 90°/s on the most affected side (p = 0.008, Δ = 8.69), MP of knee extensors at 120°/s on the most affected side (p = 0.005, Δ = 8.35), and AFAS in the domain of specialized therapeutic exercises (p = 0.014, Δ = 1.28). CONCLUSIONS: The completed multicomponent aquatic exercise program promoted changes in muscle function and terrestrial and aquatic functional outcomes in people with PD.

Efeitos de exercícios físicos aquáticos na flexibilidade e alcance funcional de indivíduos com Doença de Parkinson / Effects of aquatic physical exercises on the flexibility and functional reach in individuals with Parkinson's Disease

O objetivo deste estudo foi analisar os efeitos de um programa de exercícios físicos aquáticos na flexibilidade e no alcance funcional de pacientes com Doença de Parkinson (DP). Para avaliar a flexibilidade foi utilizado o Teste de Flexibilidade da bateria AAHPERD (adaptado), enquanto que para verificar o alcance funcional, utilizou-se o Functional Reach Test (FRT). As variáveis foram analisadas pré e pós-intervenção. O programa de intervenção consistiu em 20 atendimentos, duas vezes por semana, 40 minutos de imersão em piscina aquecida a 33ºC, com exercícios aquáticos envolvendo Dupla Tarefa (DT) com uma progressão gradual de complexidade. A análise estatística consistiu no Teste T pareado para o comparativo pré e pós-intervenção. Os resultados encontrados mostraram melhora significativa nas variáveis analisadas no Teste de Flexibilidade da bateria AAHPERD (p<0,0001) e FRT (p<0,001) após a FA. Assim, conclui-se que o programa de exercícios aquáticos proposto foi capaz de promover melhora no alcance funcional e flexibilidade dos indivíduos com DP participantes da pesquisa...(AU)

The aim of this study is to analyze the effects of an aquatic physical exercise program on the flexibility and functional range of patients with Parkinson's disease (PD). To evaluate flexibility, the Flexibility Test of the AAHPERD (adapted) battery was used, while the Functional Reach Test (FRT) was used to verify the functional range. The variables were analyzed before and after intervention. The intervention program consisted of 20 visits, twice a week, 40 minutes of immersion in a heated pool at 33ºC, with aquatic exercises involving dual task (DT) conditions with a gradual progression of complexity. tatistical analysis consisted of paired T-test for the pre and post-intervention comparative. The results showed a significant improvement in the variables analyzed in the Flexibility Test of AAHPERD (p<0.0001) and FRT (p <0.001) after aquatic physical exercise program. Thus, it is concluded that the proposed aquatic exercise program was able to promote improvement in the functional scope and flexibility of individuals with PD participating in the research...(AU)

Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease: A randomized clinical trial with a 3-month follow-up.

OBJECTIVE: To evaluate the effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease (PD). DESIGN: A randomized, single-blind trial was used. Twenty-eight (28) individuals met the inclusion criteria and were randomized in the Experimental Group (EG) and Control Group (CG). EG was subjected to a dual-task aquatic exercise program, twice a week for 10 weeks. Each session lasted 40 min, in a heated pool (33 °C). The individuals were assessed at the beginning (AS1), after an exercise program (AS2), and after a three-month follow-up (AS3). Functional mobility ("Timed Up & Go" Test, and "Five Times Sit to Stand" Test), balance (Berg Balance Scale) and gait (Dynamic Gait Index) were verified. RESULTS: 25 individuals were analyzed (14 EG and 11 CG). There was a time-group effect of the EG when compared to the CG: TUG (p = 0.03 and p = 0.015 to AS2 and AS3), FTSST (p = 0.001 and p = 0.004, for AS2 and AS3), BBS (p = 0.002 and p = 0.002, for AS2 and AS3), DGI (p = 0.001 and p = 0.003, for AS2 and AS3). CONCLUSIONS: The suggested dual-task aquatic exercise program was able to improve functional mobility, balance and gait of individuals with PD, which shows that such type of exercise is a promising possibility of therapy.

Exercícios físicos aquáticos e equilíbrio em idosos: uma revisão sistemática / Aquatic physical exercises and balance in the elderly: a systematic review / Ejercicios físicos acuáticos y el equilibrio en los ancianos: una revisión sistemática

O objetivo foi verificar os efeitos de exercícios aquáticos no equilíbrio de idosos. Os artigos foram identificados por busca sistemática no Pubmed, SciELO e Lilacs, descritores "elderly", "exercise" e "water"; "elderly", "water" e "balance"; "elderly", "water" e "gait"; "elderly", "water" e "balance". A fase inicial totalizou 545 artigos e, afinal, ficaram 9 artigos para análise na revisão sistemática. Conclui-se que o exercício aquático é capaz de promover melhoras e manutenção no equilíbrio de idosos.

The objective was to verify the effects of aquatic exercises on the balance of the elderly. The articles were identified by systematic search in Pubmed, SciELO and Lilacs, descriptors "elderly", "exercise" and "water"; "Elderly", "water" and "balance"; "Elderly", "water" and "gait"; "Elderly", "water" and "balance". The initial phase totaled 545 articles and the final one was 9 articles for analysis in the systematic review. It is concluded that aquatic exercise is capable of promoting improvements and maintenance in the balance of the elderly.

El objetivo fue verificar los efectos de los ejercicios acuáticos sobre el equilibrio de los ancianos. Los artículos fueron identificados por búsqueda sistemática en Pubmed, SciELO y Lilacs, descriptores "ancianos", "ejercicio" y "agua"; "Ancianos", "agua" y "equilibrio"; "Ancianos", "agua" y "marcha"; "Ancianos", "agua" y "equilibrio". La fase inicial totalizó 545 artículos y la última fue de 9 artículos para su análisis en la revisión sistemática. Se concluye que el ejercicio acuático es capaz de promover mejoras y mantenimiento en el equilibrio de los ancianos.

Psychomotor Intervention to stimulate Motor Development in 8-10-year-old schoolchildren / Intervenção Psicomotora para estímulo do Desenvolvimento Motor de escolares de 8 a 10 anos

Abstract The human being does not have static development throughout life. From conception to death, there are physical, psychological, social transformations and modifications, being vulnerable to restrictions. Interventions seek to reduce the effects of these restrictions, as children and adolescents are influenced by impoverished motor experiences in the family and school environment. The aim of this study was to evaluate the effects of an intervention program on 8-10-year-old schoolchildren in the public school system of Matinhos/PR, Brazil. Ninety-one 8-10-year-old schoolchildren from the 3rd, 4th and 5th grades were evaluated by the Motor Development Scale (MDS). Fifty-four of them presented risk of delay. Of these, 27 who performed weekly physical education classes were randomized into Control Group (CG), and 27 (Experimental Group - EG) to a psychomotor intervention program twice a week for four weeks. After interventions, EG and CG were reassessed. In the analysis of the General Motor Quotient (GMQ), it was verified that in all grades, EG presented a significant increase compared to the moment of evaluation, which was not observed among children in the CG. There was a significant increase in the averages in the reevaluation of CG and GE, however, EG presented significant differences in the Fine Motor and Balance dimensions. Intervention improved GMQ, Fine Motor and Balance compared to traditional Physical Education class.

Resumo O ser humano não tem um desenvolvimento estático ao longo da vida. Desde a concepção à morte, são conhecidas transformações e modificações físicas, psicológicas e sociais, estando vulneráveis a restrições. As intervenções buscam reduzir efeitos destas restrições, pois crianças e adolescentes sofrem influência de vivências motoras empobrecidas no meio familiar e ambiente escolar. Objetivou-se avaliar efeitos de um programa de intervenção em escolares de oito a dez anos da rede pública de ensino do município de Matinhos/PR, Brasil. Foram avaliados 91 escolares, de oito a dez anos, do 3º, 4º e 5º ano, foram avaliadas pela Escala de Desenvolvimento Motor (EDM). Destas, 54 apresentaram risco de atraso no desenvolvimento. Das 54 crianças, 27 que realizaram semanalmente aulas de Educação Física curriculares foram randomizadas no Grupo Controle (GC), e 27 (Grupo Experimental – GE) foram submetidas a uma intervenção psicomotora, duas vezes na semana, durante quatro semanas. Após as intervenções, o GE e GC foram reavaliadas. Na análise do Quociente Motor Geral (QMG), verificou-se que em todos os anos, o GE apresentou aumento significativo comparado ao momento de avaliação, fato nãoobservado entre crianças do GC. Houve elevação significativa das médias na reavaliação no GC e no GE, contudo, o GE apresentou diferenças significativas em relação ao GC, nas dimensões Motricidade Fina e Equilíbrio. A intervenção melhorou o QMG, a Motricidade fina e Equilíbrio em comparação com a aula de Educação Física tradicional.

Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy

Abstract Aim: To assess motor abilities and functioning of institutionalized children and adolescents with cerebral palsy (CP) within a contextual model of development. Methods: Eleven institutionalized Brazilian children and adolescents aged 2-19 (14 ± 5) years, 5 males and 6 females, were evaluated through the Gross Motor Function Measure (GMFM-88 and 66) and the Functional Independence Measure (FIM), and classified according to the ICF core set. Results: The evaluated individuals have severe impairments as indicated by their GMFM scores and confirmed by their need for full assistance in basic activities of daily living according to the FIM assessment. The difficulties manifested reflected on the ICF body functions and activities and participation domains. Conclusion: Most institutionalized children and adolescents with CP had GMFM-66 scores comparable to those indicated in literature. The ICF-based assessment identified environmental barriers that might be considered for improvement in order to facilitate activities and participation.