Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UCB |
Texto Completo: | https://bdtd.ucb.br:8443/jspui/handle/tede/2039 |
Resumo: | The reduced dopamine production in Parkinson's disease (PD) substantially affects the motor skills and other primary bodily functions, including mood, cognition and functional performance. At the same time, losses occur in the autonomic nervous system. It is unknown how the autonomic function is related to these losses and whether a walking program can modify the heart rate variability (HRV) in this population. The aim of this study was to assess HRV in patients with PD and its relationship with anxiety and depression symptons, functional performance and severity of disease, and also the effect of a walking program in autonomic modulation and functional capacity. In cross- sectional phase were evaluated 26 patients (16 men / 10 women, 57.4 ?? 9.2 years) using the scales of anxiety, depression (HADS-A and HADS-D) and disease severity (UPDRS motorexamination and Hoehn and Yahrd scales). Functional performance was evaluated by the Timed Up and Go test (TUG) and three tests from the Senior Fitness Tests. These results were correlated with HRV indexes of time (RMSSD, SDNN) and frequency domain (HF, LF, LF / HF, TP, HF / TP, LF / TP) and nonlinear analysis (SampEn and DFA1) measured in sitting and standing position. The HRV variation from sitting to standing position (??? analysis) was also considered. In longitudinal phase a walking group (WG, n = 13) and a control group (CG n = 6) were formed through a randomized controlled trial. The home-based walking program had a duration of six weeks. The patients in the WG group were reassessed after 12 weeks of training. Were observed high levels of anxiety (30.7%) and depression (34.6%) in the patients evaluated. Depressive symptoms were associated to the parasympathetic activity: RMSSD (r = - 0.382; p ??? 0.05), as the activity in the both sympathetic and parasympathetic branches: LFseated (r = -0383; p ??? 0.05), LFstanding (r = -0.411; p ??? 0.05), TPstanding (r = -0, 504, p ??? 0.05) and ??? SampEn (r = -0384, p ??? 0.05). The severity and duration of illness also were negatively associated with autonomic function. RMSSDseated (r = -0.438; p ??? 0.05), SDNNseated (r = -0.452; p ??? 0.05) SDNNstanding (r = -0.602, p ??? 0.01); LFstanding (r = -0.603; p ??? 0.01); TPstanding (r = -0.504; p ??? 0.05) and LF/ TPstanding (r = -0.504; p ??? 0.05) were negatively associated with time to perform the TUG test. Other significant correlations (p ??? 0.05) of physical and functional tests and age HRV were observed . The six-weeks walking program have promoted significant changes in SampEn index (which measures the irregularity of HR data) in WG group compared to the CG group (20.47 vs -22.81%; CA and CO, respectively; p = 0.033) as well as ???SampEn measure (-22.83% vs. 18.46; WG and CG, respectively; p = 0.022), suggesting positive changes in autonomic function. At week 12, the WG group patients exhibited increased ratios of HF/TPstanding (7.0%; p = 0.017) and SampEn-standing (20.5%; p = 0.008; respectively), and reduction of the LF/HFstanding index (-10.65%; p = 0.012 ) compared to the first week, suggesting improvements in autonomic balance. There was an increase in sit-to-stand repetitions (10.50 ?? 1.93 to 13.25 ?? 1.58 repetitions; p = 0.021) and reduced time to perform the TUG test (7.34"?? 0.67 to 6.91" ?? 0.83, p = 0.002). Several HRV indices measured before walking program (SDNN, RMSSD, LF, HF, LF / TP) have shown correlations with the functional gain (r2 ranging from 0.62 to 0.81), suggesting a role of autonomic function in neuromuscular adaptation to training. It follows that HRV may work as an integrative measure and also as a peripheral marker of body's adaptability and its self-regulatory capacity, besides a practical and sensitive tool e to the disease progression. The home-based walking program have improved autonomic function of participants, often hampered by the disease. This is particularly interesting in that many bodily functions impaired in PD are mediated by autonomic function. |
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Campbell, Carmen S??lvia Gruberthttp://lattes.cnpq.br/2410015141212165Lopes, Daniel de Paula Lima e Oliveirahttp://lattes.cnpq.br/2271160970010055http://lattes.cnpq.br/9929015287806466Rodrigues, Fabio Barreto2017-04-07T20:44:08Z2015-07-16RODRIGUES, Fabio Barreto. Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional. 2015. 135 f. Tese (Programa Strictu Sensu em Educa????o F??sica) - Universidade Cat??lica de Bras??lia, Bras??lia, 2015.https://bdtd.ucb.br:8443/jspui/handle/tede/2039The reduced dopamine production in Parkinson's disease (PD) substantially affects the motor skills and other primary bodily functions, including mood, cognition and functional performance. At the same time, losses occur in the autonomic nervous system. It is unknown how the autonomic function is related to these losses and whether a walking program can modify the heart rate variability (HRV) in this population. The aim of this study was to assess HRV in patients with PD and its relationship with anxiety and depression symptons, functional performance and severity of disease, and also the effect of a walking program in autonomic modulation and functional capacity. In cross- sectional phase were evaluated 26 patients (16 men / 10 women, 57.4 ?? 9.2 years) using the scales of anxiety, depression (HADS-A and HADS-D) and disease severity (UPDRS motorexamination and Hoehn and Yahrd scales). Functional performance was evaluated by the Timed Up and Go test (TUG) and three tests from the Senior Fitness Tests. These results were correlated with HRV indexes of time (RMSSD, SDNN) and frequency domain (HF, LF, LF / HF, TP, HF / TP, LF / TP) and nonlinear analysis (SampEn and DFA1) measured in sitting and standing position. The HRV variation from sitting to standing position (??? analysis) was also considered. In longitudinal phase a walking group (WG, n = 13) and a control group (CG n = 6) were formed through a randomized controlled trial. The home-based walking program had a duration of six weeks. The patients in the WG group were reassessed after 12 weeks of training. Were observed high levels of anxiety (30.7%) and depression (34.6%) in the patients evaluated. Depressive symptoms were associated to the parasympathetic activity: RMSSD (r = - 0.382; p ??? 0.05), as the activity in the both sympathetic and parasympathetic branches: LFseated (r = -0383; p ??? 0.05), LFstanding (r = -0.411; p ??? 0.05), TPstanding (r = -0, 504, p ??? 0.05) and ??? SampEn (r = -0384, p ??? 0.05). The severity and duration of illness also were negatively associated with autonomic function. RMSSDseated (r = -0.438; p ??? 0.05), SDNNseated (r = -0.452; p ??? 0.05) SDNNstanding (r = -0.602, p ??? 0.01); LFstanding (r = -0.603; p ??? 0.01); TPstanding (r = -0.504; p ??? 0.05) and LF/ TPstanding (r = -0.504; p ??? 0.05) were negatively associated with time to perform the TUG test. Other significant correlations (p ??? 0.05) of physical and functional tests and age HRV were observed . The six-weeks walking program have promoted significant changes in SampEn index (which measures the irregularity of HR data) in WG group compared to the CG group (20.47 vs -22.81%; CA and CO, respectively; p = 0.033) as well as ???SampEn measure (-22.83% vs. 18.46; WG and CG, respectively; p = 0.022), suggesting positive changes in autonomic function. At week 12, the WG group patients exhibited increased ratios of HF/TPstanding (7.0%; p = 0.017) and SampEn-standing (20.5%; p = 0.008; respectively), and reduction of the LF/HFstanding index (-10.65%; p = 0.012 ) compared to the first week, suggesting improvements in autonomic balance. There was an increase in sit-to-stand repetitions (10.50 ?? 1.93 to 13.25 ?? 1.58 repetitions; p = 0.021) and reduced time to perform the TUG test (7.34"?? 0.67 to 6.91" ?? 0.83, p = 0.002). Several HRV indices measured before walking program (SDNN, RMSSD, LF, HF, LF / TP) have shown correlations with the functional gain (r2 ranging from 0.62 to 0.81), suggesting a role of autonomic function in neuromuscular adaptation to training. It follows that HRV may work as an integrative measure and also as a peripheral marker of body's adaptability and its self-regulatory capacity, besides a practical and sensitive tool e to the disease progression. The home-based walking program have improved autonomic function of participants, often hampered by the disease. This is particularly interesting in that many bodily functions impaired in PD are mediated by autonomic function.A redu????o da produ????o de dopamina na Doen??a de Parkinson (DP) afeta substancialmente a motricidade e outras fun????es org??nicas primordiais, como humor e a cogni????o, bem como o desempenho funcional. Paralelamente, ocorrem preju??zos no sistema nervoso aut??nomo. N??o se sabe como a fun????o auton??mica se relaciona com estes preju??zos e se um programa de caminhada pode modificar a variabilidade da frequ??ncia card??aca (VFC) desta popula????o. O objetivo deste estudo foi avaliar a VFC de pacientes com DP e a sua rela????o com os sintomas de ansiedade, depress??o, desempenho funcional e gravidade da doen??a, e tamb??m o efeito de um programa de caminhada na modula????o auton??mica e na capacidade funcional. Na etapa transversal foram avaliados 26 pacientes (16 homens/ 10 mulheres; 57,4 ?? 9,2 anos) pelas escalas de ansiedade, depress??o (HADS-A e HADS-D) e gravidade da doen??a (UPDRSexame motor e Hoehn e Yahrd). O desempenho funcional foi avaliado pelos testes Timed up and Go (TUG) e tr??s testes da bateria Senior Fitness Test. Estes resultados foram correlacionados com ??ndices da VFC no dom??nio do tempo (RMSSD, SDNN) e da frequ??ncia (HF, LF, LF/HF, TP, HF/TP, LF/TP), e an??lise n??o linear (SampEn e DFA1) aferidos na posi????o sentado e em p??. A varia????o da VFC da posi????o sentada para em p?? (valores em ??) tamb??m foi considerada. Na etapa longitudinal foram formados um grupo de caminhada (CA; n=13) e um grupo controle (CO; n=6), a partir de um ensaio cl??nico randomizado. O programa de caminhada home-based teve dura????o de seis semanas. Os pacientes do grupo CA foram reavaliados ap??s 12 semanas de treinamento. Foram observados elevados n??veis de ansiedade (30,7%) e depress??o (34,6%) nos pacientes avaliados. Os sintomas depressivos associaram-se tanto ?? atividade parassimp??tica: RMSSD (r= - 0,382; p ??? 0,05), quanto ?? atividade conjunta nos ramos simp??tico e parassimp??tico: LFsent (r= -0.383; p ??? 0,05), LFem p?? (r= -0,411; p ??? 0,05), TPemp?? (r= -0, 504; p ??? 0,05) e ?? SampEn (r= -0.384; p ??? 0,05). A gravidade e tempo da doen??a tamb??m se associaram negativamente ?? fun????o auton??mica. RMSSDsentado (r= -0,438; p ??? 0,05), SDNNsentado (r= -0,452; p ??? 0,05) e SDNNemp?? (r= -0,602; p ??? 0,01); LFemp?? (r= -0,603; p ??? 0,01); TPemp?? (r= -0,504; p ??? 0,05) e LF/TPemp?? (r= -0,504; p ??? 0,05) foram negativamente associados ao tempo no teste TUG. Outras correla????es significativas dos testes f??sico-funcionais e da idade com a VFC foram observadas. O programa de seis semanas de caminhada promoveu varia????es significativas do ??ndice SampEn (que mede a irregularidade dos dados de FC) no grupo CA em rela????o ao grupo CO (20,47 vs ???22,81%; CA e CO, respectivamente; p=0,033), assim como o ??ndice ??SampEn (-22,83 vs 18,46%; CA e CO, respectivamente; p=0,022), sugerindo mudan??as positivas na fun????o auton??mica. Na 12?? semana, os pacientes do grupo CA exibiram aumento dos ??ndices HF/TPemp?? (7,0%; p=0,017) e SampEn-em p?? (20,5%, p= 0,008), respectivamente) e redu????o do ??ndice LF/HFemp?? (-10,65 %; p=0,012) em rela????o ?? 1?? semana, sugerindo melhoras no equil??brio auton??mico. Houve aumento no n??mero de agachamentos (de 10,50 ?? 1,93 para 13,25 ?? 1,58 repeti????es; p= 0,021) e redu????o no tempo para realizar o TUG ( de 7,34??? ?? 0,67 para 6,91 ?? 0,83, p=0,002). V??rios ??ndices de VFC aferidos na tes do programa de caminhada (SDNN, RMSSD, LF, HF, LF/TP) mostraram correla????es com o ganho funcional (r2 variando de 0,62 a 0,81), sugerindo papel da fun????o auton??mica na adapta????o neuromuscular ao treinamento. Conclui-se que a VFC pode funcionar como medida integrativa e marcador perif??rico da adaptabilidade do organismo e da sua capacidade autoregulat??ria, al??m de recurso de avalia????o pr??tico e sens??vel ?? progress??o da doen??a. O programa de caminhada home-based melhorou a fun????o auton??mica dos participantes, frequentemente prejudicada pela doen??a. Isto ?? particularmente interessante na medida em que v??rias fun????es org??nicas debilitadas na DP s??o mediadas pela fun????o auton??mica.Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-07T20:43:48Z No. of bitstreams: 1 FabioBarretoRodriguesDissertacao2015.pdf: 3967415 bytes, checksum: f7cf99ba46734ee5644ff6b6f3b44749 (MD5)Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-07T20:44:08Z (GMT) No. of bitstreams: 1 FabioBarretoRodriguesDissertacao2015.pdf: 3967415 bytes, checksum: f7cf99ba46734ee5644ff6b6f3b44749 (MD5)Made available in DSpace on 2017-04-07T20:44:08Z (GMT). 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dc.title.por.fl_str_mv |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
title |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
spellingShingle |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional Rodrigues, Fabio Barreto Educa????o f??sica Doen??a de Parkinson Ansiedade Depress??o Sistema nervoso aut??nomo Envelhecimento Atividade motora Caminhada CIENCIAS DA SAUDE::EDUCACAO FISICA |
title_short |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
title_full |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
title_fullStr |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
title_full_unstemmed |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
title_sort |
Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional |
author |
Rodrigues, Fabio Barreto |
author_facet |
Rodrigues, Fabio Barreto |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Campbell, Carmen S??lvia Grubert |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/2410015141212165 |
dc.contributor.advisor-co1.fl_str_mv |
Lopes, Daniel de Paula Lima e Oliveira |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/2271160970010055 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9929015287806466 |
dc.contributor.author.fl_str_mv |
Rodrigues, Fabio Barreto |
contributor_str_mv |
Campbell, Carmen S??lvia Grubert Lopes, Daniel de Paula Lima e Oliveira |
dc.subject.por.fl_str_mv |
Educa????o f??sica Doen??a de Parkinson Ansiedade Depress??o Sistema nervoso aut??nomo Envelhecimento Atividade motora Caminhada |
topic |
Educa????o f??sica Doen??a de Parkinson Ansiedade Depress??o Sistema nervoso aut??nomo Envelhecimento Atividade motora Caminhada CIENCIAS DA SAUDE::EDUCACAO FISICA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::EDUCACAO FISICA |
dc.description.abstract.eng.fl_txt_mv |
The reduced dopamine production in Parkinson's disease (PD) substantially affects the motor skills and other primary bodily functions, including mood, cognition and functional performance. At the same time, losses occur in the autonomic nervous system. It is unknown how the autonomic function is related to these losses and whether a walking program can modify the heart rate variability (HRV) in this population. The aim of this study was to assess HRV in patients with PD and its relationship with anxiety and depression symptons, functional performance and severity of disease, and also the effect of a walking program in autonomic modulation and functional capacity. In cross- sectional phase were evaluated 26 patients (16 men / 10 women, 57.4 ?? 9.2 years) using the scales of anxiety, depression (HADS-A and HADS-D) and disease severity (UPDRS motorexamination and Hoehn and Yahrd scales). Functional performance was evaluated by the Timed Up and Go test (TUG) and three tests from the Senior Fitness Tests. These results were correlated with HRV indexes of time (RMSSD, SDNN) and frequency domain (HF, LF, LF / HF, TP, HF / TP, LF / TP) and nonlinear analysis (SampEn and DFA1) measured in sitting and standing position. The HRV variation from sitting to standing position (??? analysis) was also considered. In longitudinal phase a walking group (WG, n = 13) and a control group (CG n = 6) were formed through a randomized controlled trial. The home-based walking program had a duration of six weeks. The patients in the WG group were reassessed after 12 weeks of training. Were observed high levels of anxiety (30.7%) and depression (34.6%) in the patients evaluated. Depressive symptoms were associated to the parasympathetic activity: RMSSD (r = - 0.382; p ??? 0.05), as the activity in the both sympathetic and parasympathetic branches: LFseated (r = -0383; p ??? 0.05), LFstanding (r = -0.411; p ??? 0.05), TPstanding (r = -0, 504, p ??? 0.05) and ??? SampEn (r = -0384, p ??? 0.05). The severity and duration of illness also were negatively associated with autonomic function. RMSSDseated (r = -0.438; p ??? 0.05), SDNNseated (r = -0.452; p ??? 0.05) SDNNstanding (r = -0.602, p ??? 0.01); LFstanding (r = -0.603; p ??? 0.01); TPstanding (r = -0.504; p ??? 0.05) and LF/ TPstanding (r = -0.504; p ??? 0.05) were negatively associated with time to perform the TUG test. Other significant correlations (p ??? 0.05) of physical and functional tests and age HRV were observed . The six-weeks walking program have promoted significant changes in SampEn index (which measures the irregularity of HR data) in WG group compared to the CG group (20.47 vs -22.81%; CA and CO, respectively; p = 0.033) as well as ???SampEn measure (-22.83% vs. 18.46; WG and CG, respectively; p = 0.022), suggesting positive changes in autonomic function. At week 12, the WG group patients exhibited increased ratios of HF/TPstanding (7.0%; p = 0.017) and SampEn-standing (20.5%; p = 0.008; respectively), and reduction of the LF/HFstanding index (-10.65%; p = 0.012 ) compared to the first week, suggesting improvements in autonomic balance. There was an increase in sit-to-stand repetitions (10.50 ?? 1.93 to 13.25 ?? 1.58 repetitions; p = 0.021) and reduced time to perform the TUG test (7.34"?? 0.67 to 6.91" ?? 0.83, p = 0.002). Several HRV indices measured before walking program (SDNN, RMSSD, LF, HF, LF / TP) have shown correlations with the functional gain (r2 ranging from 0.62 to 0.81), suggesting a role of autonomic function in neuromuscular adaptation to training. It follows that HRV may work as an integrative measure and also as a peripheral marker of body's adaptability and its self-regulatory capacity, besides a practical and sensitive tool e to the disease progression. The home-based walking program have improved autonomic function of participants, often hampered by the disease. This is particularly interesting in that many bodily functions impaired in PD are mediated by autonomic function. |
dc.description.abstract.por.fl_txt_mv |
A redu????o da produ????o de dopamina na Doen??a de Parkinson (DP) afeta substancialmente a motricidade e outras fun????es org??nicas primordiais, como humor e a cogni????o, bem como o desempenho funcional. Paralelamente, ocorrem preju??zos no sistema nervoso aut??nomo. N??o se sabe como a fun????o auton??mica se relaciona com estes preju??zos e se um programa de caminhada pode modificar a variabilidade da frequ??ncia card??aca (VFC) desta popula????o. O objetivo deste estudo foi avaliar a VFC de pacientes com DP e a sua rela????o com os sintomas de ansiedade, depress??o, desempenho funcional e gravidade da doen??a, e tamb??m o efeito de um programa de caminhada na modula????o auton??mica e na capacidade funcional. Na etapa transversal foram avaliados 26 pacientes (16 homens/ 10 mulheres; 57,4 ?? 9,2 anos) pelas escalas de ansiedade, depress??o (HADS-A e HADS-D) e gravidade da doen??a (UPDRSexame motor e Hoehn e Yahrd). O desempenho funcional foi avaliado pelos testes Timed up and Go (TUG) e tr??s testes da bateria Senior Fitness Test. Estes resultados foram correlacionados com ??ndices da VFC no dom??nio do tempo (RMSSD, SDNN) e da frequ??ncia (HF, LF, LF/HF, TP, HF/TP, LF/TP), e an??lise n??o linear (SampEn e DFA1) aferidos na posi????o sentado e em p??. A varia????o da VFC da posi????o sentada para em p?? (valores em ??) tamb??m foi considerada. Na etapa longitudinal foram formados um grupo de caminhada (CA; n=13) e um grupo controle (CO; n=6), a partir de um ensaio cl??nico randomizado. O programa de caminhada home-based teve dura????o de seis semanas. Os pacientes do grupo CA foram reavaliados ap??s 12 semanas de treinamento. Foram observados elevados n??veis de ansiedade (30,7%) e depress??o (34,6%) nos pacientes avaliados. Os sintomas depressivos associaram-se tanto ?? atividade parassimp??tica: RMSSD (r= - 0,382; p ??? 0,05), quanto ?? atividade conjunta nos ramos simp??tico e parassimp??tico: LFsent (r= -0.383; p ??? 0,05), LFem p?? (r= -0,411; p ??? 0,05), TPemp?? (r= -0, 504; p ??? 0,05) e ?? SampEn (r= -0.384; p ??? 0,05). A gravidade e tempo da doen??a tamb??m se associaram negativamente ?? fun????o auton??mica. RMSSDsentado (r= -0,438; p ??? 0,05), SDNNsentado (r= -0,452; p ??? 0,05) e SDNNemp?? (r= -0,602; p ??? 0,01); LFemp?? (r= -0,603; p ??? 0,01); TPemp?? (r= -0,504; p ??? 0,05) e LF/TPemp?? (r= -0,504; p ??? 0,05) foram negativamente associados ao tempo no teste TUG. Outras correla????es significativas dos testes f??sico-funcionais e da idade com a VFC foram observadas. O programa de seis semanas de caminhada promoveu varia????es significativas do ??ndice SampEn (que mede a irregularidade dos dados de FC) no grupo CA em rela????o ao grupo CO (20,47 vs ???22,81%; CA e CO, respectivamente; p=0,033), assim como o ??ndice ??SampEn (-22,83 vs 18,46%; CA e CO, respectivamente; p=0,022), sugerindo mudan??as positivas na fun????o auton??mica. Na 12?? semana, os pacientes do grupo CA exibiram aumento dos ??ndices HF/TPemp?? (7,0%; p=0,017) e SampEn-em p?? (20,5%, p= 0,008), respectivamente) e redu????o do ??ndice LF/HFemp?? (-10,65 %; p=0,012) em rela????o ?? 1?? semana, sugerindo melhoras no equil??brio auton??mico. Houve aumento no n??mero de agachamentos (de 10,50 ?? 1,93 para 13,25 ?? 1,58 repeti????es; p= 0,021) e redu????o no tempo para realizar o TUG ( de 7,34??? ?? 0,67 para 6,91 ?? 0,83, p=0,002). V??rios ??ndices de VFC aferidos na tes do programa de caminhada (SDNN, RMSSD, LF, HF, LF/TP) mostraram correla????es com o ganho funcional (r2 variando de 0,62 a 0,81), sugerindo papel da fun????o auton??mica na adapta????o neuromuscular ao treinamento. Conclui-se que a VFC pode funcionar como medida integrativa e marcador perif??rico da adaptabilidade do organismo e da sua capacidade autoregulat??ria, al??m de recurso de avalia????o pr??tico e sens??vel ?? progress??o da doen??a. O programa de caminhada home-based melhorou a fun????o auton??mica dos participantes, frequentemente prejudicada pela doen??a. Isto ?? particularmente interessante na medida em que v??rias fun????es org??nicas debilitadas na DP s??o mediadas pela fun????o auton??mica. |
description |
The reduced dopamine production in Parkinson's disease (PD) substantially affects the motor skills and other primary bodily functions, including mood, cognition and functional performance. At the same time, losses occur in the autonomic nervous system. It is unknown how the autonomic function is related to these losses and whether a walking program can modify the heart rate variability (HRV) in this population. The aim of this study was to assess HRV in patients with PD and its relationship with anxiety and depression symptons, functional performance and severity of disease, and also the effect of a walking program in autonomic modulation and functional capacity. In cross- sectional phase were evaluated 26 patients (16 men / 10 women, 57.4 ?? 9.2 years) using the scales of anxiety, depression (HADS-A and HADS-D) and disease severity (UPDRS motorexamination and Hoehn and Yahrd scales). Functional performance was evaluated by the Timed Up and Go test (TUG) and three tests from the Senior Fitness Tests. These results were correlated with HRV indexes of time (RMSSD, SDNN) and frequency domain (HF, LF, LF / HF, TP, HF / TP, LF / TP) and nonlinear analysis (SampEn and DFA1) measured in sitting and standing position. The HRV variation from sitting to standing position (??? analysis) was also considered. In longitudinal phase a walking group (WG, n = 13) and a control group (CG n = 6) were formed through a randomized controlled trial. The home-based walking program had a duration of six weeks. The patients in the WG group were reassessed after 12 weeks of training. Were observed high levels of anxiety (30.7%) and depression (34.6%) in the patients evaluated. Depressive symptoms were associated to the parasympathetic activity: RMSSD (r = - 0.382; p ??? 0.05), as the activity in the both sympathetic and parasympathetic branches: LFseated (r = -0383; p ??? 0.05), LFstanding (r = -0.411; p ??? 0.05), TPstanding (r = -0, 504, p ??? 0.05) and ??? SampEn (r = -0384, p ??? 0.05). The severity and duration of illness also were negatively associated with autonomic function. RMSSDseated (r = -0.438; p ??? 0.05), SDNNseated (r = -0.452; p ??? 0.05) SDNNstanding (r = -0.602, p ??? 0.01); LFstanding (r = -0.603; p ??? 0.01); TPstanding (r = -0.504; p ??? 0.05) and LF/ TPstanding (r = -0.504; p ??? 0.05) were negatively associated with time to perform the TUG test. Other significant correlations (p ??? 0.05) of physical and functional tests and age HRV were observed . The six-weeks walking program have promoted significant changes in SampEn index (which measures the irregularity of HR data) in WG group compared to the CG group (20.47 vs -22.81%; CA and CO, respectively; p = 0.033) as well as ???SampEn measure (-22.83% vs. 18.46; WG and CG, respectively; p = 0.022), suggesting positive changes in autonomic function. At week 12, the WG group patients exhibited increased ratios of HF/TPstanding (7.0%; p = 0.017) and SampEn-standing (20.5%; p = 0.008; respectively), and reduction of the LF/HFstanding index (-10.65%; p = 0.012 ) compared to the first week, suggesting improvements in autonomic balance. There was an increase in sit-to-stand repetitions (10.50 ?? 1.93 to 13.25 ?? 1.58 repetitions; p = 0.021) and reduced time to perform the TUG test (7.34"?? 0.67 to 6.91" ?? 0.83, p = 0.002). Several HRV indices measured before walking program (SDNN, RMSSD, LF, HF, LF / TP) have shown correlations with the functional gain (r2 ranging from 0.62 to 0.81), suggesting a role of autonomic function in neuromuscular adaptation to training. It follows that HRV may work as an integrative measure and also as a peripheral marker of body's adaptability and its self-regulatory capacity, besides a practical and sensitive tool e to the disease progression. The home-based walking program have improved autonomic function of participants, often hampered by the disease. This is particularly interesting in that many bodily functions impaired in PD are mediated by autonomic function. |
publishDate |
2015 |
dc.date.issued.fl_str_mv |
2015-07-16 |
dc.date.accessioned.fl_str_mv |
2017-04-07T20:44:08Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
status_str |
publishedVersion |
format |
doctoralThesis |
dc.identifier.citation.fl_str_mv |
RODRIGUES, Fabio Barreto. Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional. 2015. 135 f. Tese (Programa Strictu Sensu em Educa????o F??sica) - Universidade Cat??lica de Bras??lia, Bras??lia, 2015. |
dc.identifier.uri.fl_str_mv |
https://bdtd.ucb.br:8443/jspui/handle/tede/2039 |
identifier_str_mv |
RODRIGUES, Fabio Barreto. Associa????es entre humor, sinais cl??nicos, desempenho funcional e a fun????o auton??mica em pacientes com Doen??a de Parkinson e o efeito de um programa de caminhada na variabilidade da frequ??ncia card??aca e no desempenho funcional. 2015. 135 f. Tese (Programa Strictu Sensu em Educa????o F??sica) - Universidade Cat??lica de Bras??lia, Bras??lia, 2015. |
url |
https://bdtd.ucb.br:8443/jspui/handle/tede/2039 |
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por |
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por |
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500 500 600 |
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openAccess |
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Programa Strictu Sensu em Educa????o F??sica |
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UCB |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Escola de Sa??de e Medicina |
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Universidade Cat??lica de Bras??lia |
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