Banca de DEFESA: THIAGO KENZO FUJIOKA SHIDA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : THIAGO KENZO FUJIOKA SHIDA
DATA : 27/04/2022
HORA: 18:00
LOCAL: videoconferência
TÍTULO:

Effect of freezing of gait and antiparkinsonian medication on the gait in individuals with Parkinson's disease

PÁGINAS: 48
GRANDE ÁREA: Engenharias
ÁREA: Engenharia Biomédica
SUBÁREA: Bioengenharia
ESPECIALIDADE: Modelagem de Sistemas Biológicos
RESUMO:

Individuals with Parkinson's disease (PD) present changes in gait due to complications of the pathology, such as greater muscle rigidity, bradykinesia, less automaticity of movements, and postural balance problems. The standard gold treatment for PD is pharmacological therapy with dopaminergic medication, which improves motor and non-motor issues of the disease. Studies report the effects of dopaminergic medication on spatiotemporal gait parameters, but few studies have evaluated the effects on kinematic and kinetic parameters. A factor that changes the gait parameters of these individuals is the presence of freezing of gait (FoG). However, the interaction between FoG and antiparkinsonian medication on PD gait is not documented. Thus, this study aims to evaluate the effects of antiparkinsonian medication and the presence of freezing of gait on the kinematic and kinetic parameters of gait in individuals with PD. Twenty-two individuals with a clinical diagnosis of idiopathic PD (17 men and 5 women; mean age = 64.1 years, SD = 10.5; mean height = 166.8 cm, SD = 7.1; mean weight = 71.4) participated in this study kg, SD = 12.3), being 11 with freezing of gait (FoG +) and 11 without freezing of gait (FoG-). Participants with PD were evaluated in the ON and OFF medication periods. For the control group, 18 healthy age-matched participants were selected from an open database (FUKUCHI et al., 2018). All participants walked on the floor on a 10-meter-long walkway at a comfortable, self-selected speed. The kinematic and kinetic variables of gait and the clinical characteristics of the groups in each condition were compared in the following analyses: Group PD FoG+ and PD FoG- both in the ON condition and control group; Group PD FoG+ and PD FoG- both in the OFF condition and control group; Group (PD FoG+ and PD FoG-) and condition (ON and OFF). Linear mixed-effects models were fitted, controlling for differences between demographic characteristics and clinical scales of PD groups. To compare the PD and control group, analysis of variance (ANOVA) was used. The level of significance for all analyzes was set at p < 0.05, and for the analysis of interactions, the post hoc of Bonferroni was used. The kinematic differences presented between the FoG+ and FoG- groups were mainly in distal joints (greater knee flexion at initial contact; greater minimal knee flexion in terminal stance; lower ankle plantar flexion peak in load response, and higher ankle dorsiflexion during the swing phase compared to the FoG- group). Regarding the effect of medication, both groups had ON state changes in the range of motion of both distal and proximal joints (higher peak knee flexion during the swing phase, a greater range of pelvic rotation, and a greater range of hip adduction/abduction compared to the OFF state). No differences were observed in the analysis of the Group*Condition interaction, the antiparkinsonian medication, it showed improvements in the kinematic and kinetic gait parameters in the groups FoG+ and FoG- equally. The analysis between the PD and control groups resulted in a greater amount of differences in kinematic parameters in the FoG+ group; and both PD groups, regardless of medication state, showed a lower second peak of vertical ground reaction force than the control group. This study concluded that FoG mainly affects lower limb distal joints and that antiparkinsonian medication affects the range of motion of both distal and proximal joints in the gait of individuals with PD. The effects of medication on the kinematic and kinetic gait parameters act similarly between the groups with and without FoG. Compared to healthy individuals, the FoG+ group showed greater differences in gait than the FoG- group; and in general, individuals with PD present lower force applications during the impulse period.

MEMBROS DA BANCA:
Presidente - Interno ao Programa - 2418537 - DANIEL BOARI COELHO
Membro Titular - Examinador(a) Interno ao Programa - 2090962 - REGINALDO KISHO FUKUCHI
Membro Titular - Examinador(a) Externo à Instituição - ANDREA CRISTINA DE LIMA
Membro Suplente - Examinador(a) Interno ao Programa - 2352005 - RENATO NAVILLE WATANABE
Membro Suplente - Examinador(a) Externo ao Programa - 1957691 - RONNY CALIXTO CARBONARI
Membro Suplente - Examinador(a) Externo à Instituição - LUIS MOCHIZUKI