Alterações posturais em idosos com doença de Parkinson em estágio leve a moderado: frequência e fatores correlacionados

Abstract

Introduction: Parkinson's Disease (PD) is the second most common neurodegenerative disease in the world, with a global prevalence of more than 6 million of people. Axial symptoms, including gait impairment, postural instability and postural changes, are common disorders in advanced PD. Among the most common postural alterations, camptocormia and antecolis stand out. These postural changes have been studied, showing a relationship with important functional repercussions, however changes in incipient stages are still little studied, although they could already functionally impact the individual with PD. This information may be important for clinical practice, as it would help guide rehabilitation treatment, as it would allow earlier intervention on the functional repercussions of postural changes present in individuals with PD. Objective: To verify the relationship between postural changes associated with PD

and functionality, postural balance, walking ability and quality of life. Method: This cross- sectional study included elderly people from a specialized public outpatient clinic, with a diagnosis of mild to moderate idiopathic PD according to the modified Hoehn and Yahr classification (HY). Participants were submitted to a postural evaluation with measurement of the upper trunk flexion angles (upper camptocormia - UC), total trunk flexion (total camptocormia - TC) and cervical anterior flexion (antecollis - AC). Assessments were also performed as: functional level using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), balance using the Balance Evaluation Systems Test (BESTest), walking ability using the 6-minute walk test (6MWT), quality of life by the Parkinson's Disease Questionnaire (PDQ-39), disease progression by the Unified Parkinson's Disease Rating Scale (UPDRS) and executive function by the Frontal Assessment Battery (FAB). Results: There was a positive correlation between the angles of cervical flexion and total trunk flexion. Individuals with more than 12o of total trunk flexion, even without formal diagnosis criteria of CT, presented significantly worse performance in the 6MWT (p=0.007), in BESTest (p=0.002) and in PDQ-39 ( p=0.006), mainly in domains related to mobility (p<0.001) and posture (p<0.001). Conclusion: The findings of this study showed that individuals with PD and AC had a direct relationship with patients with greater degrees of anterior trunk flexion, and this, even in the early stages, represented a significant correlation with mobility and balance, with an impact on the quality of life. Other data found refer to the fact that participants with higher degrees of total camptocormia also showed greater impairment in functional performance, since they showed deficits in postural balance and gait.