Os efeitos da manipulação do sistema proprioceptivo na locomoção de pessoas com doença de Parkinson com e sem congelamento da marcha: desenvolvimento, otimização e aplicabilidade de um sistema de vibração muscular

• Autor(a) principal: Pereira, Marcelo Pinto [UNESP]
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/126517; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/22-07-2015/000841461.pdf
• topic: Motor ability; Musculos - Vibração; Capacidade motora; Parkinson, Doença de; Locomoção humana; Marcha humana

Proprioceptive processing deficits and difficulties in integrating different motor plans are pointed as the main mechanisms underlying the worse performance of people with Parkinson's disease during the execution of locomotor tasks (PD). This proprioceptive deficit also plays an important role in the occurrence of freezing of gait (FOG). Thus, the main objective of this Doctoral Thesis was to determine the effects of proprioceptive system manipulation, by means of a muscle vibration system, on the performance of locomotor tasks in people with Parkinson's disease, and on the severity FOG episodes. However, due to a number of difficulties, it was necessary to develop and optimize a homemade vibration system that could fulfill our requirements. To this, we also aimed: to describe the development of a homemade vibratory system and its reliability; to optimize the parameters of muscle vibration to promote an improvement in the performance of sit-to walk and gait initiation in healthy young adults. It had been shown that the homemade vibratory system developed here (named RCVibro System) is highly reliable and elicits similar results to those reported in the literature. The best way to apply muscle vibration is in parallel to muscle fibers and on the proximal region of muscle bellies. As a result, we observed an improvement of gait initiation performance when the vibration is applied only before the movement onset. Additionally, we observed no vibratory effects on the sit-to-walk performance in healthy young adults. On the other hand, the sit-to-walk performance of people with PD are disturbed by muscle vibration, possibly by an overstimulation of the proprioceptive system. We also found an improvement of gait initiation performance of people with PD and FOG when muscle vibration is applied before the movement onset. Postural effects elicited by the proprioceptive system manipulation are suggested to be the mechanism underlying these results...