Aquatic exercise program-modulated oxidative stress markers in patients with Parkinson's disease.

Parkinson's disease is a neurodegenerative disease. Oxidative stress, i.e., the imbalance between the generation of reactive oxygen species and the antioxidant defense capacity of the body, plays an important role in the pathogenesis of this disease. Physical exercise can regulate oxidative stress. The purpose of this study was to analyze the short- and long-term effects of an aquatic exercise program on oxidative stress levels in patients with Parkinson's disease. The aquatic exercise program was carried out during 1 month with two sessions per week (1 hour/session). Blood samples were collected at four different time points: pre-intervention, immediately, 48 hours, and 30 days after the first session of aquatic exercise program. Our results revealed that water-based programs modulated antioxidant enzyme activity, increased superoxide dismutase activity, reduced catalase activity, and increased the ratio of superoxide dismutase activity to catalase activity in patients with Parkinson's disease. Compared with pre-intervention and 48 hours after the first session of aquatic exercise program, superoxide dismutase activity was higher and catalase activity was lower immediately and 30 days after the first session. Our results demonstrated that aquatic exercise program could modulate oxidative stress, mainly by the effect of antioxidant enzyme activity. These results could better help understand the target of oxidative stress in Parkinson's disease. This study was approved by the Ethics Committee of Centro Universitário Metodista IPA (approval No. 1.373.911) on August 9, 2019 and registered with REBEC (registration number: RBR-6NJ4MK).

The impact of an aquatic exercise program on BDNF levels in Parkinson's disease patients: short-and long-term outcomes.

The present study aimed to analyze the short-and long-term effects of an aquatic exercise program on plasma brain-derived neurotrophic factor (BDNF) levels in individuals with Parkinson's disease (PD). The aquatic exercise program lasted one month, and consisted of two sessions per week (1 hour per session). Blood samples were collected at four different timepoints: pre-intervention (T0), immediately after the first session (T1), 48 hours after the first session (T2), and 1 month after the intervention (T3). We found a significant decrease in BDNF levels at T2 vs T1 (p<0.05). However, no changes were observed at the other time-points. Our results demonstrated that the intervention reduced plasma BDNF levels in PD individuals in a time-dependent manner: specifically, we observed acute effects, but no delayed effects.

Cytokine modulation in response to acute and chronic aquatic therapy intervention in Parkinson disease individuals: A pilot study.

The study aimed to compare the basal plasma levels of inflammatory markers (MCP-1, IL-1ra and IL-1ß) in Parkinson Disease group (PDG) with control healthy subjects (control group, CG), as well to investigate the acute and chronic effects of an aquatic physiotherapy program on these biomarkers in PDG. Firstly, a rest blood sampling was taken from antecubital vein of the PD and CG. After, the PD individuals were submitted to a supervisioned aquatic physiotherapy program during 1 month, twice a week (60 min/session). In order to evaluate the acute and chronic effects of the intervention on the biomarkers, blood samples were in 4 times: before the exercise program (pre), immediately after the first session, 48 h after the exercise session and 1 month after the intervention. It was observed higher levels of the pro-inflammatory cytokines IL-1ß and MCP-1 and reduced levels IL-1ra in PDG compared to the CG. Regarding the intervention effects in PDG, a remarkable reduction on IL-1ß and MCP-1 levels at 48 h when compared to the basal were found. Furthermore, after 1 month, it was observed diminished levels of MCP-1 in combination to an increase on IL-1ra. Our data support the idea that an inflammatory status is linked to PD and that MCP-1 and IL-1ra could be taken as promising biomarkers in this condition. We also demonstrated that an aquatic physiotherapy program may offer a potential intervention able to attenuate immune responses in PD individuals in a short and long-term perspective.

Avaliação do acesso à fisioterapia após a alta hospitalar em indivíduos com acidente vascular cerebral / Assessment of access to physiotherapy after hospital discharge in post-stroke patients

Introdução: O Acidente Vascular Cerebral (AVC) é a principal causa de incapacidades neurológicas em adultos jovens e a reabilitação precoce é essencial para a recuperação desses pacientes. O objetivo deste estudo foi investigar o acesso aos serviços de fisioterapia após a alta hospitalar (AH) em indivíduos com AVC. Métodos: Trata-se de um estudo de coorte incluindo indivíduos com AVC, que foram avaliados quanto à funcionalidade e incapacidade na AH e 60 dias após. Foi realizado contato telefônico após 30 e 60 dias da AH para verificar o seguimento da fisioterapia. Resultados: Trinta e seis indivíduos com sequelas motoras foram avaliados na AH, apenas 19% realizaram seguimento fisioterapêutico após 30 dias da AH e 39% após 60 dias. As principais barreiras encontradas, mesmo após 60 dias da AH, foram as dificuldades burocrática de acesso aos serviços de saúde (55%) e o tempo de espera (41%) para iniciar o tratamento. A funcionalidade, avaliada pela Medida Internacional de Funcionalidade e pela escala Rankin, apresentou melhora significativa após 60 dias da alta, tanto nos indivíduos que realizaram, como naqueles que não realizaram acompanhamento fisioterapêutico (p=0,001). Conclusão: O acesso à fisioterapia após a alta hospitalar para os indivíduos com AVC foi deficiente na amostra estudada devido principalmente às barreiras burocráticas e longo tempo de espera. (AU)

Introduction: Stroke is the leading cause of neurological damage in young adults, and early rehabilitation is essential for patient recovery. The objective of this study was to investigate the access to physiotherapy services after hospital discharge in post-stroke patients. Methods: The present study is a cohort study including post-stroke patients who were evaluated regarding ability and disability at hospital discharge and 60 days later. Patients were contacted by phone to check physiotherapy engagement, after 30 and 60 days. Results: A total of 36 individuals with mobility impairment were observed after hospital discharge, among which only 19% had started physiotherapeutic therapy after 30 days of discharge from the hospital, and 39% after 60 days. Major barriers included health care bureaucracy (55%), and the wait to start treatment (41%). Ability, measured by the Physical Abilities and Mobility Scale and the Rankin Scale, showed significant improvement 60 days after hospital discharge both in patients who underwent physical therapy and in those who did not (p=0.001). Conclusion: Access to physical therapy after hospital discharge for post-stroke patients was lacking in the sample studied, mainly due to bureaucratic barriers and long waiting time. (AU)

Evaluation of quality of life and psychological aspects of Parkinson's disease patients who participate in a support group / Avaliação da qualidade de vida e aspectos psicológicos de pacientes com doença de parkinson participantes de um grupo de apoio

ABSTRACT. Parkinson's disease (PD) is a neurodegenerative disorder that can dramatically impair patient quality of life (QoL). Objective: To analyze the QoL, motor capacity, depression, anxiety and social phobia of individuals who attended a patient support group (PSG) compared to non-participants. Methods: A cross-sectional study was performed. The sample consisted of 20 individuals with PD who attended a PSG and another 20 PD patients who did not attend a support group for PD patients, serving as the control group (nPSG). All patients answered questionnaires on motor capacity (UPDRS), QoL (Parkinson's Disease Questionnaire- PDQ-39), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory) and social phobia (Liebowitz Social Anxiety Scale). To determine data distribution, the Shapiro-Wilk test was performed. For comparison of means, Student's t-test was applied. In cases of asymmetry, the Mann-Whitney test was employed. To assess the association between the scales, Pearson's correlation coefficient (symmetric distribution) and Spearman's coefficient (asymmetric distribution) were applied. For the association between qualitative variables, Pearson's Chi-squared test was performed. A significance level of 5% (p≤0.05) was adopted. Results: Individuals in the PSG had a significantly better QoL (p=0.002), and lower depression (p=0.026), anxiety (p<0.001) and social phobia (p=0.01) scores compared to the nPSG. Conclusion: The participation of PD patients in social activities such as support groups is associated with better QoL and fewer symptoms of depression, anxiety and social phobia.

RESUMO. A doença de Parkinson (DP) é uma doença neurodegenerativa que pode prejudicar a qualidade de vida (QV) do paciente. Objetivo: Analisar a qualidade de vida, capacidade motora, depressão, ansiedade e fobia social dos indivíduos que frequentavam um grupo de apoio a pacientes (PSG) em comparação com aqueles que não frequentavam. Métodos: Tratase de um estudo transversal. Amostra composta por 20 indivíduos com Parkinson que participavam de uma PSG e outros 20 pacientes com DP que não participavam de qualquer grupo de apoio para pacientes com DP, denominado de grupo de controle (nPSG). Os participantes responderam questionários sobre capacidade motora (UPDRS), QV (PDQ-39), depressão (Inventário de depressão de Beck), ansiedade (Inventário de ansiedade de Beck) e fobia social (Escala de Ansiedade Social de Liebowitz). Determinando a distribuição dos dados, foi realizado o teste de Shapiro-Wilk. Comparando médias, teste t de Student foi aplicado. Em assimetria, foi realizado o teste de Mann-Whitney. Avaliando a associação entre as escalas, o coeficiente de correlação de Pearson (distribuição simétrica) e o coeficiente de Spearman (distribuição assimétrica) foram aplicados. Para a associação entre as variáveis qualitativas, foi realizado o teste qui-quadrado de Pearson. Adotado o nível de significância de 5% (p≤0,05). Resultados: Os indivíduos do PSG apresentaram uma qualidade de vida significativamente melhor (p=0,002), menos depressão (p=0,026), ansiedade (p<0,001) e fobia social (p=0,01) quando comparado com o nPSG. Conclusão: A participação de pacientes com DP em atividades sociais como os grupos de apoio está associado a melhor qualidade de vida e menor presença de sintomas de depressão, ansiedade e fobia social.

Evaluation of quality of life and psychological aspects of Parkinson's disease patients who participate in a support group.

Parkinson's disease (PD) is a neurodegenerative disorder that can dramatically impair patient quality of life (QoL). OBJECTIVE: To analyze the QoL, motor capacity, depression, anxiety and social phobia of individuals who attended a patient support group (PSG) compared to non-participants. METHODS: A cross-sectional study was performed. The sample consisted of 20 individuals with PD who attended a PSG and another 20 PD patients who did not attend a support group for PD patients, serving as the control group (nPSG). All patients answered questionnaires on motor capacity (UPDRS), QoL (Parkinson's Disease Questionnaire- PDQ-39), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory) and social phobia (Liebowitz Social Anxiety Scale). To determine data distribution, the Shapiro-Wilk test was performed. For comparison of means, Student's t-test was applied. In cases of asymmetry, the Mann-Whitney test was employed. To assess the association between the scales, Pearson's correlation coefficient (symmetric distribution) and Spearman's coefficient (asymmetric distribution) were applied. For the association between qualitative variables, Pearson's Chi-squared test was performed. A significance level of 5% (p≤0.05) was adopted. RESULTS: Individuals in the PSG had a significantly better QoL (p=0.002), and lower depression (p=0.026), anxiety (p<0.001) and social phobia (p=0.01) scores compared to the nPSG. CONCLUSION: The participation of PD patients in social activities such as support groups is associated with better QoL and fewer symptoms of depression, anxiety and social phobia.

A doença de Parkinson (DP) é uma doença neurodegenerativa que pode prejudicar a qualidade de vida (QV) do paciente. OBJETIVO: Analisar a qualidade de vida, capacidade motora, depressão, ansiedade e fobia social dos indivíduos que frequentavam um grupo de apoio a pacientes (PSG) em comparação com aqueles que não frequentavam. MÉTODOS: Trata-se de um estudo transversal. Amostra composta por 20 indivíduos com Parkinson que participavam de uma PSG e outros 20 pacientes com DP que não participavam de qualquer grupo de apoio para pacientes com DP, denominado de grupo de controle (nPSG). Os participantes responderam questionários sobre capacidade motora (UPDRS), QV (PDQ-39), depressão (Inventário de depressão de Beck), ansiedade (Inventário de ansiedade de Beck) e fobia social (Escala de Ansiedade Social de Liebowitz). Determinando a distribuição dos dados, foi realizado o teste de Shapiro-Wilk. Comparando médias, teste t de Student foi aplicado. Em assimetria, foi realizado o teste de Mann-Whitney. Avaliando a associação entre as escalas, o coeficiente de correlação de Pearson (distribuição simétrica) e o coeficiente de Spearman (distribuição assimétrica) foram aplicados. Para a associação entre as variáveis qualitativas, foi realizado o teste qui-quadrado de Pearson. Adotado o nível de significância de 5% (p≤0,05). RESULTADOS: Os indivíduos do PSG apresentaram uma qualidade de vida significativamente melhor (p=0,002), menos depressão (p=0,026), ansiedade (p<0,001) e fobia social (p=0,01) quando comparado com o nPSG. CONCLUSÃO: A participação de pacientes com DP em atividades sociais como os grupos de apoio está associado a melhor qualidade de vida e menor presença de sintomas de depressão, ansiedade e fobia social.

Evaluation of body image and self-concept and their correlation with depressive symptoms in Parkinson's disease.

OBJECTIVE: To identify characteristics of body image and self-concept in individuals over fifty years of age with Parkinson's disease (PD). The secondary objectives are to analyze whether body image and self-concept are influenced by the severity of PD and to verify if there is correlation between depression, self-concept and body image in cases of PD. METHOD: Participating in the study were 48 individuals, being 26 with PD and 22 Controls. The instruments used were: The Mini Exam of Mental State, The My Body Image Test, The Factorial Self-concept Test, The Beck Depression Inventory, the motor section of The Unified Parkinson's Disease Rating Scale and The Modified Hoehn and Yahr Scale. RESULTS: In PD the perception of body image and self-concept demonstrated significantly reduced values p<0.001 and p=0.012 respectively, and the presence of depression symptomatology was significantly more (p=0.002). CONCLUSION: Individuals with PD present alteration of body image and self-concept and also present lower personal confidence and lower social receptivity, correlated with depressive symptoms.

Evaluation of body image and self-concept and their correlation with depressive symptoms in Parkinson's disease / Avaliação da imagem corporal, autoconceito e suas correlações com os sintomas depressivos na doença de Parkinson

OBJECTIVE: To identify characteristics of body image and self-concept in individuals over fifty years of age with Parkinson's disease (PD). The secondary objectives are to analyze whether body image and self-concept are influenced by the severity of PD and to verify if there is correlation between depression, self-concept and body image in cases of PD. METHOD: Participating in the study were 48 individuals, being 26 with PD and 22 Controls. The instruments used were: The Mini Exam of Mental State, The My Body Image Test, The Factorial Self-concept Test, The Beck Depression Inventory, the motor section of The Unified Parkinson's Disease Rating Scale and The Modified Hoehn and Yahr Scale. RESULTS: In PD the perception of body image and self-concept demonstrated significantly reduced values p<0.001 and p=0.012 respectively, and the presence of depression symptomatology was significantly more (p=0.002). CONCLUSION: Individuals with PD present alteration of body image and self-concept and also present lower personal confidence and lower social receptivity, correlated with depressive symptoms.

OBJETIVO: Identificar características de imagem corporal e autoconceito em indivíduos com doença de Parkinson (DP) acima de cinqüenta anos de idade. Os objetivos secundários são analisar se a imagem corporal e o autoconceito são influenciados pela gravidade da DP e, verificar se existe correlação entre depressão, autoconceito e imagem corporal na DP. MÉTODO: Participaram do estudo 48 indivíduos, sendo 26 com DP e 22 Controles. Os instrumentos utilizados foram: Mini-Exame do Estado Mental, Teste A Minha Imagem Corporal, Escala Fatorial de Autoconceito, Inventário de Depressão de Beck, Unified Parkinson's Disease Rating Scale parte motora e Hoehn e Yahr Modificada. RESULTADOS: Na DP a percepção da imagem corporal e do autoconceito, demonstraram valores reduzidos significativamente (p<0.001 e p=0.012) respectivamente, e a sintomatologia depressiva apresentou-se significativamente maior (p=0.002). CONCLUSÃO: Indivíduos com DP apresentam alteração da imagem corporal e do autoconceito, apresentaram também menos confiança pessoal e menor receptividade social correlacionados com sintomas depressivos.