Caracterização dos estágios da doença de Parkinson através de variáveis biomecânicas do equilíbrio

Abstract

Introduction: Parkinson’s disease is a progressive and neurodegenerative disease which is characterized by a decrease in dopaminergic neurons in substantia nigra (pars compacta). Its motor symptoms are dykinesia, postural instability, resting tremor and muscle rigidity which manifest when 60 -70% of brain cells die. Scales that evaluate the evolution of the disease are Hoehn and Yahr scale (HY) and Unified Parkinson’s Disease Rating Scale (UPDRS). Descriptive statistics measures are not always able to measure and describe the dynamics of balance task data, so nonlinear measures were used in order to analyze postural control. Objectives: To characterize changes in biomechanical properties related to the stages of Parkinson’s disease by using classical measures (velocity and trajectory), Decomposition of movements, Hurst’s Exponent and Fourier Index. Methodology: It is a cross-sectional observational study, which analyze a sample composed of subjects with Parkinson’s disease from Sensory-Motor Learning Laboratory in the Faculty of Medicine of the University of São Paulo, as well as elderly people without Parkinson’s disease which made up the control group. All possible biomechanical variables of detection through CvMob and Decomposition of movements were analyzed and from the analyzed variables some biomechanical indices were created: all in simple task condition. Non-parametric Kruskal-Wallis Test was used for statistical analysis because the variables did not present normal distribution. Results: 53 individuals participated in the study, 17 from the control group and 36 from the experimental group. It was observed that individuals with Parkinson’s disease, especially in HY2, oscillate more laterally and faster. Tremor was higher in HY3 group. Conclusion: Amount of movements in stage 2 of the disease showed high oscillation level which can be influenced by tremor mainly in stage 3. Therefore, in this study, it was possible to characterize biomechanical changes through the analysis of balance in patients with Parkinson’s disease, especially in stage 2 of Hoehn Yahr scale.