Efeito da TENS associada ao exercício na Doença de Parkinson : ensaio clínico randomizado

• Autor(a) principal: Garcez, Priscila de Araújo
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/3782
• topic: Ciências da saúde; Doença da Parkinson; Infarto do miocárdio; Estresse oxidativo; Estimulação elétrica nervosa transcutânea; Terapia por exercício; Dor; Atividade motora; Transcutaneous Electric Nerve Stimulation - TENS; Exercise therapy.; Parkinson Disorders; Pain; Motor activity; CIENCIAS DA SAUDE

Introduction: Parkinson’s disease (PD) is a chronic, degenerative and progressive disorder, responsible for developing disabling motor and non-motor symptoms. It occurs due to a loss of dopaminergic neurons in the substantia nigra, locus coeruleus and striatum and the presence of extranigrais dysfunction. Pain is one of the most frequent non-motor features. Transcutaneous Electrical Nerve Stimulation (TENS) as well as therapeutic exercise may help the treatment of PD as both of them activate central pathways that reduce pain by releasing opioids. Aims: To evaluate the effect of TENS associated with physical exercise in the intensity of pain, temporal summation, skin sensitivity, fatigue, gait speed, sitting and standing speed, dynamic balance and psycho-emotional factors. Method: This is a randomized, placebo-controlled, double-blind clinical trial, using a crossover design. PD patients were randomly distributed into to groups: Active TENS or Placebo TENS, both associated with 20 minutes of exercise, for TENS application in the lumbar and thoracic spine. Study groups went through the following procedures: evaluation (before and after each application session TENS; before the start and after completion of each group), physical therapy intervention of 20 sessions (with 10 sessions in each group). Instruments or procedures used in the assessment and reassessment were: numerical scale of 11 points (intensity of pain and fatigue), Test Timed Up and Go (functionality of legs in displacement), accelerometry (movement speed during the act of sitting and up), figure 8 test (dynamic balance), esthesiometer (skin sensitivity), pendulum fleximeter (range of motion), temporal summation (central sensitization), Pain Catastrophizing Scale (negative expectation regarding pain), Beck Depression Inventory (depression). Results: Comparing pre- and post-treatment, there was improvement in: pain intensity in the active group (p = 0.0068), running speed in the active group (p <0.0001) skin sensitivity on the right (p = 0.0022) and left (p = 0.0410) points on the chest of the active group, dynamic balance (p = 0.0085) in the active group, temporal summation (p = 0.0044) trunk muscle flexibility in flexion movements (p = 0.0103) extension (P = 0.0104) right (p = 0.0001) and left rotation (p = 0.0001) in the active group and flexion ( p = 0.0001) extension (P = 0.0349), right slope (p = 0.0042) and left rotation (p = 0.0001) in the placebo group. Conclusion: According to the results obtained in our study, the active TENS associated with physical exercises showed effectiveness in the treatment of pain, reduced temporal summation, skin sensitivity, fatigue, gait speed, muscle flexibility and dynamic balance of individuals with PD. There was no effect of analgesic tolerance in these individuals.