Physical Fitness and Parkinson's Disease in Advanced Stages: Systematic Review
DOI:
https://doi.org/10.21527/2176-7114.2023.47.13424Keywords:
Parkinson´s disease; Physical exercise; Physical FitnessAbstract
Introduction: Among the diversity of therapeutic interventions available to improve the physical fitness of patients with Parkinson's Disease (PD), little is evidenced about patients at an advanced stage of the disease and among the findings, many studies bring heterogeneous and imprecise results about this group. Objective: To carry out a systematic review with the question: What interventions impact the physical fitness of individuals with PD in advanced stages? Method: systematic review of the literature, which was designed, conducted and recorded (PROSPERO: CRD42020189453). A bibliographic search of articles published between 2015 and 2020 was carried out in the main databases. Randomized controlled trials were included, with individuals with PD of idiopathic origin, in the advanced stage of the disease (Hoehn & Yahr scale 4 and/or 5) and that performed physical exercises as an intervention, under the physical fitness outcome. Results: Three studies were included in the final review, which highlighted aquatic exercises with dual-task activities, treadmill training with body weight support, and activities in the home context. The benefits referred to increased walking distance, improved sitting and standing task, and improved balance during daily activities. Conclusion: There are physical exercises that impact physical fitness, even in advanced stages, but there are few studies with the population of individuals with PD in advanced stages.
References
Rizzo G, Copetti M, Arcuti S, Martino D, Fontana A, Logroscino G. Accuracy of clinical diagnosis of Parkinson disease. Neurology. 2016;86:566-576. DOI: 10.1212/WNL.0000000000002350
Allen N. E., Canning C. G., Sherrington C., et al. The effects of an exercise program on fall risk factors in people with Parkinson’s disease: a randomized controlled trial. Movement Disorders. 2010;25(9):1.217-1.225. DOI: 10.1002/mds.23082
Cholewa J., Boczarska-Jedynak M., Opala G. Influence of physiotherapy on severity of motor symptoms and quality of life in patients with Parkinson’s disease. Neurologia I Neurochirurgia Polska. 2013;47(3):256-262. DOI: 10.5114/ninp.2013.35774
Johnell O, Melton LJ, 3rd, Atkinson EJ, O’Fallon WM, Kurland LT. Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing. 1992;21:32-38. DOI: 10.1093/ageing/21.1.32
Samoudi G, Jivegard M, Mulavara AP, Bergquist F. Effects of stochastic vestibular galvanic stimulation and LDOPA on balance and motor symptoms in patients with Parkinson’s disease. Brain Stimul. 2015;8:474-480. DOI: doi.org/10.1016/j.brs.2014.11.019
Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. Lancet Neurology. 2013;12:716-726. DOI: doi.org/10.1016/S1474-4422(13)70123-6
Oliveira de Carvalho A, Filho ASS, Murillo-Rodriguez E, Rocha NB, Carta MG, Machado S. Exercício físico para a doença de Parkinson: evidências clínicas e experimentais. Clinical Practice Epidemiology Mental Health. 2018;14:89-98. DOI: 10.2174/1745017901814010089
Bouça-Machado R, Rosário A, Ferreira JJ. Physical Activity, Exercise and Physiotherapy in Parkinson`s Disease: Definiting the Concepts. Moviment Disorder Clinical Practice. 2020;7(1):7-15. DOI: 10.1002/mdc3.12849
Organização Mundial de Saúde. CIF: Classificação Internacional de Funcionalidade, Incapacidade e Saúde. [Centro Colaborador da Organização Mundial da Saúde para a Família de Classificações Internacionais, org.; coordenação da tradução Cassia Maria Buchalla]. São Paulo: Editora da Universidade de São Paulo – Edusp; 2020.
Santos PC, Gobbi LT, Orcioli-Silva D, Simieli L, van Dieen JH et al. Effects of leg muscle fatigue on gait in patients with Parkinson’s disease and controls with high and low levels of daily physical activity. Gait & Posture 2016;47:86-91.
Kanegusuku H, Peçanha T, Silva-Batista C, Myasarato RS, da Silva Júnior ND, de melo MT et al. Efeitos do treinamento resistido sobre as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo na Doença de Parkinson. Einstein. 2021;19:1-7. DOI: 10.31744/Einstein_jorunal/2021AO5940
Filippi M, Elisabetta S, Piramide N, Agosta F. Functional MRI in Idiopathic Parkinson’s Disease. International Review of Neurobiology. 2018;141:439-467.
Tollar J., Nagy F., Kovacs N., et al. A high-intensity multicomponent agility intervention improves Parkinson’s patients’ clinical and motor symptoms. Archives of Physical Medicine and Rehabilitation. 2018;99(12):2.478-2.484. DOI: 10.1016/j.apmr.2018.05.007
Bouça-Machado R, Rosário A, Caldeira D, et al. Physical Activity, Exercise,and Physiotherapy in Parkinson’s Disease:Defining the Concepts Ovement Disorders Clinical Practice. 2020;7(1):7-15. DOI: 10.1002/mdc3.12849reviewexerciseinparkinson`sdisease
Scheffer DL, Aguiar J, Silva A, Latini A. Fadiga e prática de atividade física na doença de Parkinson: revisão de literatura. Arquivos de Ciências da Saúde. 2018;25(1):13-17. DOI: https://doi.org/10.17696/2318-3691.25.1.2018.886
Cancela-Carral JM, Mollinedo-Cardalda IM, López-Rodríguez, Vila-Suárez. Exercise physical, fitness and Parkinson`s disease: an 8-years folow-up study. Journal Sports Medicine Physical Fitness. 2021;10:258-262. DOI: 10.23736/S0022-4707.21.12483-1
Ellis TD, Cavanaugh JT, DeAngelis T, et al. Comparative Effectiveness of mHealth-Supported Exercise Compared With Exercise Alone for People With Parkinson Disease: Randomized Controlled Pilot Study. Physical Therapy. 2019;99(2):203-216. DOI: 10.1093/ptj/pzy131
Silva AZ, Israel VL. 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. Complementary Therapies in Medicine. 2019;42:119-124. DOI: https://doi.org/10.1016/j.ctim.2018.10.023
Atan T, Takiran O, Tokcaer AB, Karata GK, Çaliskan K, Karaoglan B. Effects of different percentages of body weight-supported treadmill training in Parkinson’s disease: a double-blind randomized controlled trial. Turkish Journal of Medical Sciences. 2019;49:999-1.007.
Chiver KS, Pickering R, Rochester L, Roberts HC, Roberts HC, Ballinger C, Hulbert S, Kunkel D, Marian JR, Fitton C, Mcintosh E, Goodwin VA. Multicentre, randomised controlled trial of PDSAFE, a physiotherapist-delivered fall prevention programme for people with Parkinson’s. Journal Neurology Neurosurgery and Psychiatry. 2019;90:774-782. DOI: 10.1136/jnnp-2018-319448
Mantri S, Wood S, Duda JE, Morley JF. Understanding physical activity in Veterans with Parkinson disease: A mixed-methods approach. Parkinsonism & Related Disorders. 2019;61, 156-160.
Moraes Filho AV, Chaves SN, Martins WR, et al, Progressive Resistance Training Improves Bradykinesia, Motor Symptoms and Functional Performance in Patients with Parkinson’s Disease. Clinical Interview Aging. 2020;15:87-95.
Mak MKY, Wong-Yu ISK. Six-Month Community-Based Brisk Walking and Balance Exercise Alleviates Motor Symptoms and Promotes Functions in People with Parkinson's Disease: A Randomized Controlled Trial. Journal Parkinsons Disorder. 2021;11(3):1.431-1.441. DOI: 10.3233/JPD-202503
Nadeau A, Lungu O, Duchesne C, et al. A 12-Week Cycling Training Regimen Improves Gait and Executive Functions Concomitantly in People with Parkinson's Disease Frontiers in Human Neurosciense. 2017;12;10:690. DOI: 10.3389/fnhum.2016.00690.eCollection 2016
Schootemeijer S, van der Kolk NM, Ellis T, Mirelman A, Nieuwboer A, Nieuwhof F, Schwarzschild MA, de Vries NM, Bloem BR. Barriers and Motivators to Engage in Exercise for Persons with Parkinson's Disease. J Parkinsons Dis. 2020;10(4):1.293-1.299. DOI: 10.3233/JPD-202247
Schootemeijer S, van der Kolk NM, Bloem BR, et al. Correction to: Current Perspectives on Aerobic Exercise in People with Parkinson's Disease. Neurotherapeutics. 2022;19(2):683-685. DOI: 10.1007/s13311-022-01219-6
Zaman A, Ellingson L, Sunken A, Gibson E, Stegemöller EL. Determinants of exercise behaviour in persons with Parkinson's disease. Disability and Rehabilitation. 2021;43(5):696-702. DOI: 10.1080/09638288.2019.1638975
Johansson ME, Cameron IGM, Van der Kolk NM, de Vries NM, Klimars E, Toni I, Bloem BR, Helmich RC. Aerobic Exercise Alters Brain Function and Structure in Parkinson's Disease: A Randomized Controlled Trial. Ann Neurol. 2022 Feb.;91(2):203-216. DOI: 10.1002/ana.26291
Johansson H, Hagströmer M, Grooten WJA, Franzén E. Exercise-Induced Neuroplasticity in Parkinson's Disease: A Metasynthesis of the Literature. Neural Plast. 2020 Mar. 5;2020:8961493. DOI: 10.1155/2020/8961493
Bonavita S. Exercise and Parkinson’s Disease. Advances in Experimental Medicine and Biology. 2020;1.228:289-301. DOI: 10.1007/978-981-15-1792-1_19
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