Treinamento de força de potência com resistência elástica na doença de Parkinson : um ensaio clínico randomizado (PARK-BAND)

Abstract

Introduction: Parkinson’s disease (PD) is a neurodegenerative disease with symptomatic treatment. The association between medication and physical exercise, such as power strength, may improve bradykinesia, physical-functional performance, postural instability, prevent the risk of falls and life quality. Objective: To evaluate whether power strength training is more effective than a health education program in improving bradykinesia and physical-functional performance in patients with PD. Methods: A randomized clinical trial was conducted, with 19 patients in the control group and 22 in the intervention group (Hoehn & Yahr 1 to 3). PD- related themes were discussed in the control group through a booklet. Exercises were performed with elastic bands and tubes in the intervention group and the subjective perception of effort was measured. The study took place over 12 weeks, in blocks of 8 patients, from May 2022 to August 2024, at the Federal University of Ceará. The primary outcomes of bradykinesia were assessed by some items of the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part 3 and physical-functional performance was measured by the Short Physical Performance Battery (SPPB). The secondary outcomes of postural stability and risk of falls were assessed by the Biodex Balance System (BBS), the concern about falling by the Falls Efficacy Scale International (FES-I) and quality of life as measured by the 39-item Parkinson’s Disease Questionnaire (PDQ-39). Results: Significant outcomes were observed when comparing the control and intervention groups, with more pronounced reductions in scores in the intervention group. Improvements were evident in the items hand pronation and supination, related to bradykinesia of the upper limbs, as well as in the items gait and overall movement spontaneity, associated with bradykinesia of the lower limbs. In addition, significant results in the intervention group before and after training were verified with reductions in the scores of bradykinesia of the upper and lower limbs, total bradykinesia and total MDS-UPDRS part 3; reductions in the time to perform the SPPB chair stand test and reductions in oscillations in general postural stability and, anteroposterior and in the risk of falls in the BBS and improvements in quality of life in the domains of “activities of daily living,” “emotional well- being,” “stigma,” and the PDQ-39 total score. Conclusion: Power strength training was more effective than the health education program in improving hand pronation and supination, gait, and overall movement spontaneity. In the intervention group, power strength exercise promoted improvements in bradykinesia, in the total MDS-UPDRS part 3, in physical-functional performance when standing up from the chair, in postural stability, in the risk of falls, in overall quality of life and in its specific domains related to daily activities, emotional well-being, and the perception of stigma.