L. Gobbi | Universidade Estadual Paulista "Júlio de Mesquita Filho" (original) (raw)

Papers by L. Gobbi

Research paper thumbnail of Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

Motriz: Revista de Educação Física, 2014

Research paper thumbnail of Effect of muscle fatigue and physical activity level in motor control of the gait of young adults

Research paper thumbnail of Functional capacity of Brazilian patients with Parkinson's disease (PD): Relationship between clinical characteristics and disease severity

Archives of Gerontology and Geriatrics, 2012

Research paper thumbnail of The role of vision in Parkinson's disease locomotion control: Free walking task

Research paper thumbnail of Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

Motriz: Revista de Educação Física, 2014

This study investigated the effect of a multimodal exercise program on executive functions and me... more This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson's disease, taking into account disease severity and gender. Twenty-three patients with Parkinson's disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observed the effects of the intervention on executive functions (ability to abstract: p = .01), immediate memory (p = .04) and declarative episodic memory (p < .001). Women showed higher scores on declarative episodic memory (p = .03) than men, however there was no interaction between gender and the intervention. Regardless of sex and disease severity, these preliminary results indicate that the multimodal exercise seems to be effective in improving cognitive functions in patients with PD, suggesting that this program can be indicated as a preventive strategy to mitigate progressive cognitive deficits in the later stages of the disease.

Research paper thumbnail of Effects of physical exercise on articular range of motion of the lower limb in the Parkinson's disease individuals

Fisioterapia e Pesquisa, 2014

| The aim of this study was to investigate the effect of eight months of a multimodal program of ... more | The aim of this study was to investigate the effect of eight months of a multimodal program of physical exercise on articular range of motion of the lower limb of patients with Parkinson disease (PD), considering gender and disease stage. Seventeen individuals with PD participated in this study. Participants were assessed before of multimodal program of the physical exercise and after four and eight months of physical exercise. In these periods were evaluated the clinical aspects and articular range of motion of the lower limb. For statistical analysis, patients were distributed according to gender and disease stage. A MANOVA considering exercise, gender and stage of disease, with repeated measures for the first factor, was performed. The clinical results showed regression of disease progression, indicating cognitive decline for women. The articular range of motion improved after four and eight months of physical exercise, especially for the hip and ankle, independent of gender and stage of PD. It was concluded that the multimodal exercise program of the eight months was effective in improving articular range of motion in patients with PD. The benefits of exercise for this physical capacity were independent of gender and severity of PD.

Research paper thumbnail of Obstacle crossing with dual tasking is a danger for individuals with Alzheimer's disease and for healthy older people

Journal of Alzheimer's disease : JAD, 2015

The aim of this study was to analyze the effects of dual tasking on obstacle crossing during walk... more The aim of this study was to analyze the effects of dual tasking on obstacle crossing during walking by individuals with Alzheimer's disease (AD) and by healthy older people. Thirty four elderly individuals (16 healthy subjects and 18 individuals with AD) were recruited to participate in this study. Three AD individuals and one control participant were excluded due to exclusion criteria. The participants were instructed to walk barefoot at their own speed along an 8 m long pathway. Each participant performed five trials for each condition (unobstructed walking, unobstructed walking with dual tasking, and obstacle crossing during walking with dual tasking). The trials were completely randomized for each participant. The mid-pathway stride was measured in the unobstructed walking trials and the stride that occurred during the obstacle avoidance was measured in the trials that involved obstacle crossing. The behavior of the healthy elderly subjects and individuals with AD was simil...

Research paper thumbnail of Adaptive Walking in Alzheimer's Disease

International Journal of Alzheimer's Disease, 2012

The aim of this study is to analyze dual-task effects on free and adaptive gait in Alzheimer's di... more The aim of this study is to analyze dual-task effects on free and adaptive gait in Alzheimer's disease (AD) patients. Nineteen elders with AD participated in the study. A veteran neuropsychiatrist established the degree of AD in the sample. To determine dual-task effects on free and adaptive gait, patients performed five trials for each experimental condition: free and adaptive gait with and without a dual-task (regressive countdown). Spatial and temporal parameters were collected through an optoelectronic tridimensional system. The central stride was analyzed in free gait, and the steps immediately before (approaching phase) and during the obstacle crossing were analyzed in adaptive gait. Results indicated that AD patients walked more slowly during adaptive gait and free gait , using conservative strategies when confronted either with an obstacle or a secondary task. Furthermore, patients sought for stability to perform the tasks, particularly for adaptive gait with dual task, who used anticipatory and online adjustments to perform the task. Therefore, the increase of task complexity enhances cognitive load and risk of falls for AD patients.

Research paper thumbnail of Interactions of age and leg muscle fatigue on unobstructed walking and obstacle crossing

Gait & Posture, 2014

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.

Research paper thumbnail of Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia

Research paper thumbnail of Benefits of Multimodal Exercise Intervention for Postural Control and Frontal Cognitive Functions in Individuals with Alzheimer's Disease: A Controlled Trial

Journal of the American Geriatrics Society, 2013

To verify the effects of a systematized multimodal exercise intervention program on frontal cogni... more To verify the effects of a systematized multimodal exercise intervention program on frontal cognitive function, postural control, and functional capacity components of individuals with Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (AD). Nonrandomized controlled trial with pre- and posttraining tests in a training group and a control group. Kinesiotherapy program for seniors with AD, São Paulo State University. Convenience sample of older adults with AD (n = 30) were assigned to a training (n = 14; aged 78.6 ± 7.1) and a control (n = 16; aged 77.0 ± 6.3) group. The intervention program was structured with the aim of simultaneously promoting better balance and frontal cognitive capacity. The participants attended a 1-hour session three times a week for 16 weeks, whereas the control group did not participate in any activity during the same period. Frontal cognitive function was evaluated using the Montreal Cognitive Assessment, the Clock Drawing Test, the Frontal Assessment Battery, and the Symbol Search Subtest. Postural control (center of pressure area) was analyzed under four dual-task conditions. Functional capacity components were analyzed using the Timed Up and Go Test, the 30-second sit-to-stand test, the sit-and-reach test, and the Berg Functional Balance Scale. Intervention group participants showed a significant increase in frontal cognitive function (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001, partial η(2) = 0.838), with less body sway (P = .04, partial η(2) = 0.04) during the dual tasks, and greater functional capacity (P = .001, partial η(2) = 0.676) after the 16-week period. Intervention participants performed better on dual-task activities and had better postural balance and greater functional capacity than controls.

Research paper thumbnail of Mobilidade funcional em indivíduos com paralisia cerebral espástica de acordo com o tipo e a idade

Functional mobility in spastic cerebral palsy individuals according to the type and age Functiona... more Functional mobility in spastic cerebral palsy
individuals according to the type and age
Functional mobility refers to the ability to move independently in the environment. Spastic cerebral palsy individuals show mobility needs according with the type (diplegia, hemiplegia and tetraplegia). With the age advance, spastic cerebral palsy individuals show deterioration on gait kinematics’ parameters. The purpose of this study was to compare functional mobility among spastic cerebral palsy individuals according to the type and the age. Sixty eight individuals with spastic cerebral palsy, 30 with diplegia, 23 with hemiplegia and 15 with tetraplegia, participated in this study. They were also distributed in 3 age groups: children group (from 4 to 12 years old); young group (from 13 to 19 years old) and adult group (from 20 to 45 years old).
The functional mobility was assessed by the Functional Mobility Scale. The spent time and the scale classification were treated by non-parametric ANOVA, by type and age group, in three distances: 5m, 50m, and 500m. The results did not reveal age group differences and they showed that spastic cerebral palsy individuals with hemiplegia had better results for all distances. The segmental involvement and motor repertoire affect the functional mobility.

Research paper thumbnail of Locomoção, distúrbios neuropsiquiátricos e alterações do sono de pacientes com demência e seus cuidadores

Fisioterapia em Movimento, 2013

Research paper thumbnail of SQUARE STEPPING EXERCISE E EXERCÍCIOS BÁSICOS NA COGNIÇÃO DE IDOSOS

Kinesis, 2012

RESUMO O objetivo do presente estudo foi comparar as funções cognitivas de idosos antes e após do... more RESUMO O objetivo do presente estudo foi comparar as funções cognitivas de idosos antes e após dois protocolos de intervenção: exercícios básicos combinados com o Square SteppingExercise (COM) e apenas exercícios básicos (EB). Todos foram avaliados antes e depois dos 4 meses de intervenção por meio do Montreal CognitiveAssessment (MoCA) e do Teste Winsconsin de Classificação de Cartas (TWCC). Os resultados mostraram que ambos os grupos melhoraram o estado cognitivo global, mas que apenas o COM apresentou melhora específica em abstração e flexibilidade mental. Assim, o treinamento combinado de exercícios básicos e SSE parece ser mais efetivo para a cognição quando comparado com um treinamento exclusivamente com exercícios básicos. Palavras-Chave: Idosos. Cognição. Exercício físico.

Research paper thumbnail of EFEITOS DA PRÁTICA REGULAR DE DANÇA NA CAPACIDADE FUNCIONAL DE MULHERES ACIMA DE 50 ANOS

Revista da Educação Física/UEM, 2008

O processo de envelhecimento e os fatores a ele associados caracterizam-se por um declínio da cap... more O processo de envelhecimento e os fatores a ele associados caracterizam-se por um declínio da capacidade funcional (CF). O objetivo do presente estudo foi analisar os efeitos da prática de dança na CF de mulheres com idade acima de 50 anos. Participaram do estudo 21 mulheres, 61±7,12 anos, engajadas na modalidade dança do Programa de Atividade Física para Terceira Idade -(PROFIT) UNESP -Rio Claro. O tempo de intervenção foi de quatro meses e a CF foi avaliada por meio da bateria de testes da American Aliance for Health, Physical Education, Recreation and Dance. Os dados foram analisados por meio do teste t de Student pareado, com p<0,05. Melhoras significativas foram observadas apenas na resistência de força (30,14±3,49; 33,42±4,3 repetições) e na coordenação motora (10,40±2,15; 9,75±1,68 segundos). Conclui-se que quatro meses de prática de dança foram suficientes para melhorar dois componentes da CF e manter os níveis dos demais.

Research paper thumbnail of Comportamento e barreiras

Psicologia: Teoria e Pesquisa, 2008

RESUMO -Este estudo analisa as barreiras percebidas à prática de atividade física e os estágios d... more RESUMO -Este estudo analisa as barreiras percebidas à prática de atividade física e os estágios de mudança de comportamento de idosos institucionalizados preservados cognitivamente. Trinta participantes responderam ao Mini-Exame do Estado Mental, ao Questionário sobre Estágios de Mudança de Comportamento e ao Questionário sobre Barreiras à Prática de Atividade Física. Os resultados mostraram que poucos idosos institucionalizados apresentam uma alta percepção de descrença nos benefícios da atividade física. Entretanto, muito poucos praticam atividades físicas e a maioria não pretende incluí-las em seu estilo de vida. O estágio de comportamento no qual se encontram pode estar sendo mediado pela percepção de barreiras. Conclui-se, coerentemente com as principais barreiras reportadas, que a promoção de atividade física para o idoso institucionalizado deve, prioritariamente, enfatizar a conscientização sobre os riscos do sedentarismo e os benefícios da prática mesmo na presença de doenças, bem como preparar um ambiente seguro e sem gasto financeiro individual.

Research paper thumbnail of Risco de quedas em idosos com doença de Parkinson e demência de Alzheimer: um estudo transversal

Revista Brasileira de Fisioterapia, 2006

Objetivo: Comparar o risco de quedas entre idosos com doença de Parkinson (DP), demência de Alzhe... more Objetivo: Comparar o risco de quedas entre idosos com doença de Parkinson (DP), demência de Alzheimer (DA) e saudáveis (controle). Além disso, pretendeu-se analisar as relações do risco de quedas com declínio cognitivo e com nível de atividade física. Método: vinte idosos, sendo sete com DP (69,57 ± 2,40 anos), seis com DA (77,5 ± 2,32 anos) e sete saudáveis (74,71 ± 2,58 anos), foram avaliados por meio dos seguintes instrumentos: Escala de Equilíbrio Funcional de Berg (EEFB), Timed Up and Go test (TUG), Mini-Exame do Estado Mental (MEEM) e Questionário Baecke Modificado para Idosos (QBMI). Resultados: O teste de Kruskal-Wallis apontou diferença significativa entre os grupos, tanto em relação à EEFB (KW=9,67, p<0,01), quanto em relação ao TUG (KW=9,14, p<0,01, para tempo despendido, e KW=10,04, p<0,01, para número de passos). A "análise aos pares" do teste post-hoc de Bonferroni apontou comprometimento maior do equilíbrio no grupo DA, no qual também foram observados menores valores no MEEM. O grupo DP foi caracterizado por apresentar um maior nível de atividade física. A análise de correlação de Spearman apontou correlação baixa entre MEEM e EEFB (r s =0,59); entre MEEM e TUG (r s =-0,62 e r s =-0,52); entre QBMI e EEFB (r s =0,54); e entre QBMI e TUG (r s =-0,39 e r s =-0,42). Conclusões: As baixas correlações observadas devem ser analisadas com cautela, pois tais variáveis sofrem influência de múltiplos fatores. No grupo DA, o declínio cognitivo pode estar relacionado ao maior risco de quedas e, no grupo DP, a atividade física pode ter auxiliado a manter um risco de quedas próximo ao grupo controle.

Research paper thumbnail of Effects of postural threat on walking features of Parkinson's disease patients

Neuroscience Letters, 2009

This study investigated whether or not gait kinematics among healthy older individuals and Parkin... more This study investigated whether or not gait kinematics among healthy older individuals and Parkinson's disease (PD) patients are influenced by postural threat. Eight healthy older individuals and eight PD patients were examined while walking at self-selected velocities, under three conditions of postural threat: unconstrained floor; constrained floor (19 cm wide); constrained and elevated floor (19 cm wide by 10 cm high). Independent of the surface conditions, due to motor disturbances caused by the PD these patients walked slower, with shorter strides, and spent more time in the double support phase and less time in the swing phase than did their matched controls. Increases in postural threat resulted in altered gait kinematics for all subjects. Specifically, stride length, stride velocity, cadence, and heel contact velocity decreased, and stride duration and double support duration increased relative to increases in postural threat. All gait alterations were the result of participants' attempts to facilitate locomotion control and maintain stability. The results of this study reveal that width and height constraints effectively perturbed the balance of all of the walking older individuals. The PD patients were able to modulate gait parameters when faced by a postural threat task.

Research paper thumbnail of Early impairment of cognitive functions in Parkinson's disease

Arquivos de Neuro-Psiquiatria, 2007

Besides the classical symptoms of Parkinson's disease (PD) such as rest tremor, rigidity, bradyki... more Besides the classical symptoms of Parkinson's disease (PD) such as rest tremor, rigidity, bradykinesia and postural instability and its high prevalence in Brazilian clinical settings 1 impaired non-motor functions such as cognitive disorders are also common events 2 . At the disease onset, 24% of patients present cognitive decay, especially memory disorders and disturbances of some executive functions such as impaired selective attention, thinking flexibility, and planning difficulty 3 . In dementia, the patient with PD also reveals deterioration of declarative memory (but with relative preserved recognition), visuoconstructive skills, and nominating ability 4 . These distur-bances depend on mostly frontal-striatum connections 5 and involve other areas of the brain such as the parietal regions and subcortical structures 6 .

Research paper thumbnail of Serum homocysteine and physical exercise in patients with Parkinson's disease

Psychogeriatrics, 2011

Hyperhomocysteinemia is a major risk factor for cerebral and peripheral vascular diseases, as wel... more Hyperhomocysteinemia is a major risk factor for cerebral and peripheral vascular diseases, as well as cortical and hippocampal injury, including an increased risk of dementia and cognitive impairment. Elevated serum homocysteine (Hcy) concentrations are common in patients with Parkinson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (PD) who have been treated with levodopa; however, physical exercises can help reduce Hcy concentrations. The aim of the present study was to compare serum Hcy levels in patients with PD who partook in regular physical exercises, sedentary PD patients, and healthy controls. Sixty individuals were enrolled in the present study across three groups: (i) 17 patients who did not partake of any type of exercise; (ii) 24 PD patients who exercised regularly; and (iii) 19 healthy individuals who did not exercise regularly. All participants were evaluated by Hoehn and Yahr scale, the Unified Parkinson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Disease Rating Scale (UPDRS) and Schwab and England scale (measure daily functionality). The serum levels of Hcy were analyzed by blood samples collected of each participant. An analysis of variance and a Tukey&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s post hoc test were applied to compare and to verify differences between groups. Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s correlation and stepwise multiple regression analyses were used to consider the association between several variables. Mean plasma Hcy concentrations in individuals who exercised regularly were similar to those in the healthy controls and significantly lower than those in the group that did not exercise at all (P= 0.000). In addition, patients who did not exercise were receiving significantly higher doses of levodopa than those patients who exercised regularly (P= 0.001). A positive relationship between levodopa dose and Hcy concentrations (R(2) = 0.27; P= 0.03) was observed in patients who did not exercise, but not in those patients who exercised regularly (R(2) = 0.023; P= 0.15). The results of the present study suggest that, even with regular levodopa therapy, Hcy concentrations in PD patients who exercise regularly are significantly lower than in patients who do not exercise and are similar Hcy concentrations in healthy controls.

Research paper thumbnail of Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

Motriz: Revista de Educação Física, 2014

Research paper thumbnail of Effect of muscle fatigue and physical activity level in motor control of the gait of young adults

Research paper thumbnail of Functional capacity of Brazilian patients with Parkinson's disease (PD): Relationship between clinical characteristics and disease severity

Archives of Gerontology and Geriatrics, 2012

Research paper thumbnail of The role of vision in Parkinson's disease locomotion control: Free walking task

Research paper thumbnail of Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

Motriz: Revista de Educação Física, 2014

This study investigated the effect of a multimodal exercise program on executive functions and me... more This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson's disease, taking into account disease severity and gender. Twenty-three patients with Parkinson's disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observed the effects of the intervention on executive functions (ability to abstract: p = .01), immediate memory (p = .04) and declarative episodic memory (p < .001). Women showed higher scores on declarative episodic memory (p = .03) than men, however there was no interaction between gender and the intervention. Regardless of sex and disease severity, these preliminary results indicate that the multimodal exercise seems to be effective in improving cognitive functions in patients with PD, suggesting that this program can be indicated as a preventive strategy to mitigate progressive cognitive deficits in the later stages of the disease.

Research paper thumbnail of Effects of physical exercise on articular range of motion of the lower limb in the Parkinson's disease individuals

Fisioterapia e Pesquisa, 2014

| The aim of this study was to investigate the effect of eight months of a multimodal program of ... more | The aim of this study was to investigate the effect of eight months of a multimodal program of physical exercise on articular range of motion of the lower limb of patients with Parkinson disease (PD), considering gender and disease stage. Seventeen individuals with PD participated in this study. Participants were assessed before of multimodal program of the physical exercise and after four and eight months of physical exercise. In these periods were evaluated the clinical aspects and articular range of motion of the lower limb. For statistical analysis, patients were distributed according to gender and disease stage. A MANOVA considering exercise, gender and stage of disease, with repeated measures for the first factor, was performed. The clinical results showed regression of disease progression, indicating cognitive decline for women. The articular range of motion improved after four and eight months of physical exercise, especially for the hip and ankle, independent of gender and stage of PD. It was concluded that the multimodal exercise program of the eight months was effective in improving articular range of motion in patients with PD. The benefits of exercise for this physical capacity were independent of gender and severity of PD.

Research paper thumbnail of Obstacle crossing with dual tasking is a danger for individuals with Alzheimer's disease and for healthy older people

Journal of Alzheimer's disease : JAD, 2015

The aim of this study was to analyze the effects of dual tasking on obstacle crossing during walk... more The aim of this study was to analyze the effects of dual tasking on obstacle crossing during walking by individuals with Alzheimer's disease (AD) and by healthy older people. Thirty four elderly individuals (16 healthy subjects and 18 individuals with AD) were recruited to participate in this study. Three AD individuals and one control participant were excluded due to exclusion criteria. The participants were instructed to walk barefoot at their own speed along an 8 m long pathway. Each participant performed five trials for each condition (unobstructed walking, unobstructed walking with dual tasking, and obstacle crossing during walking with dual tasking). The trials were completely randomized for each participant. The mid-pathway stride was measured in the unobstructed walking trials and the stride that occurred during the obstacle avoidance was measured in the trials that involved obstacle crossing. The behavior of the healthy elderly subjects and individuals with AD was simil...

Research paper thumbnail of Adaptive Walking in Alzheimer's Disease

International Journal of Alzheimer's Disease, 2012

The aim of this study is to analyze dual-task effects on free and adaptive gait in Alzheimer's di... more The aim of this study is to analyze dual-task effects on free and adaptive gait in Alzheimer's disease (AD) patients. Nineteen elders with AD participated in the study. A veteran neuropsychiatrist established the degree of AD in the sample. To determine dual-task effects on free and adaptive gait, patients performed five trials for each experimental condition: free and adaptive gait with and without a dual-task (regressive countdown). Spatial and temporal parameters were collected through an optoelectronic tridimensional system. The central stride was analyzed in free gait, and the steps immediately before (approaching phase) and during the obstacle crossing were analyzed in adaptive gait. Results indicated that AD patients walked more slowly during adaptive gait and free gait , using conservative strategies when confronted either with an obstacle or a secondary task. Furthermore, patients sought for stability to perform the tasks, particularly for adaptive gait with dual task, who used anticipatory and online adjustments to perform the task. Therefore, the increase of task complexity enhances cognitive load and risk of falls for AD patients.

Research paper thumbnail of Interactions of age and leg muscle fatigue on unobstructed walking and obstacle crossing

Gait & Posture, 2014

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.

Research paper thumbnail of Physical activity attenuates neuropsychiatric disturbances and caregiver burden in patients with dementia

Research paper thumbnail of Benefits of Multimodal Exercise Intervention for Postural Control and Frontal Cognitive Functions in Individuals with Alzheimer's Disease: A Controlled Trial

Journal of the American Geriatrics Society, 2013

To verify the effects of a systematized multimodal exercise intervention program on frontal cogni... more To verify the effects of a systematized multimodal exercise intervention program on frontal cognitive function, postural control, and functional capacity components of individuals with Alzheimer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (AD). Nonrandomized controlled trial with pre- and posttraining tests in a training group and a control group. Kinesiotherapy program for seniors with AD, São Paulo State University. Convenience sample of older adults with AD (n = 30) were assigned to a training (n = 14; aged 78.6 ± 7.1) and a control (n = 16; aged 77.0 ± 6.3) group. The intervention program was structured with the aim of simultaneously promoting better balance and frontal cognitive capacity. The participants attended a 1-hour session three times a week for 16 weeks, whereas the control group did not participate in any activity during the same period. Frontal cognitive function was evaluated using the Montreal Cognitive Assessment, the Clock Drawing Test, the Frontal Assessment Battery, and the Symbol Search Subtest. Postural control (center of pressure area) was analyzed under four dual-task conditions. Functional capacity components were analyzed using the Timed Up and Go Test, the 30-second sit-to-stand test, the sit-and-reach test, and the Berg Functional Balance Scale. Intervention group participants showed a significant increase in frontal cognitive function (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001, partial η(2) = 0.838), with less body sway (P = .04, partial η(2) = 0.04) during the dual tasks, and greater functional capacity (P = .001, partial η(2) = 0.676) after the 16-week period. Intervention participants performed better on dual-task activities and had better postural balance and greater functional capacity than controls.

Research paper thumbnail of Mobilidade funcional em indivíduos com paralisia cerebral espástica de acordo com o tipo e a idade

Functional mobility in spastic cerebral palsy individuals according to the type and age Functiona... more Functional mobility in spastic cerebral palsy
individuals according to the type and age
Functional mobility refers to the ability to move independently in the environment. Spastic cerebral palsy individuals show mobility needs according with the type (diplegia, hemiplegia and tetraplegia). With the age advance, spastic cerebral palsy individuals show deterioration on gait kinematics’ parameters. The purpose of this study was to compare functional mobility among spastic cerebral palsy individuals according to the type and the age. Sixty eight individuals with spastic cerebral palsy, 30 with diplegia, 23 with hemiplegia and 15 with tetraplegia, participated in this study. They were also distributed in 3 age groups: children group (from 4 to 12 years old); young group (from 13 to 19 years old) and adult group (from 20 to 45 years old).
The functional mobility was assessed by the Functional Mobility Scale. The spent time and the scale classification were treated by non-parametric ANOVA, by type and age group, in three distances: 5m, 50m, and 500m. The results did not reveal age group differences and they showed that spastic cerebral palsy individuals with hemiplegia had better results for all distances. The segmental involvement and motor repertoire affect the functional mobility.

Research paper thumbnail of Locomoção, distúrbios neuropsiquiátricos e alterações do sono de pacientes com demência e seus cuidadores

Fisioterapia em Movimento, 2013

Research paper thumbnail of SQUARE STEPPING EXERCISE E EXERCÍCIOS BÁSICOS NA COGNIÇÃO DE IDOSOS

Kinesis, 2012

RESUMO O objetivo do presente estudo foi comparar as funções cognitivas de idosos antes e após do... more RESUMO O objetivo do presente estudo foi comparar as funções cognitivas de idosos antes e após dois protocolos de intervenção: exercícios básicos combinados com o Square SteppingExercise (COM) e apenas exercícios básicos (EB). Todos foram avaliados antes e depois dos 4 meses de intervenção por meio do Montreal CognitiveAssessment (MoCA) e do Teste Winsconsin de Classificação de Cartas (TWCC). Os resultados mostraram que ambos os grupos melhoraram o estado cognitivo global, mas que apenas o COM apresentou melhora específica em abstração e flexibilidade mental. Assim, o treinamento combinado de exercícios básicos e SSE parece ser mais efetivo para a cognição quando comparado com um treinamento exclusivamente com exercícios básicos. Palavras-Chave: Idosos. Cognição. Exercício físico.

Research paper thumbnail of EFEITOS DA PRÁTICA REGULAR DE DANÇA NA CAPACIDADE FUNCIONAL DE MULHERES ACIMA DE 50 ANOS

Revista da Educação Física/UEM, 2008

O processo de envelhecimento e os fatores a ele associados caracterizam-se por um declínio da cap... more O processo de envelhecimento e os fatores a ele associados caracterizam-se por um declínio da capacidade funcional (CF). O objetivo do presente estudo foi analisar os efeitos da prática de dança na CF de mulheres com idade acima de 50 anos. Participaram do estudo 21 mulheres, 61±7,12 anos, engajadas na modalidade dança do Programa de Atividade Física para Terceira Idade -(PROFIT) UNESP -Rio Claro. O tempo de intervenção foi de quatro meses e a CF foi avaliada por meio da bateria de testes da American Aliance for Health, Physical Education, Recreation and Dance. Os dados foram analisados por meio do teste t de Student pareado, com p<0,05. Melhoras significativas foram observadas apenas na resistência de força (30,14±3,49; 33,42±4,3 repetições) e na coordenação motora (10,40±2,15; 9,75±1,68 segundos). Conclui-se que quatro meses de prática de dança foram suficientes para melhorar dois componentes da CF e manter os níveis dos demais.

Research paper thumbnail of Comportamento e barreiras

Psicologia: Teoria e Pesquisa, 2008

RESUMO -Este estudo analisa as barreiras percebidas à prática de atividade física e os estágios d... more RESUMO -Este estudo analisa as barreiras percebidas à prática de atividade física e os estágios de mudança de comportamento de idosos institucionalizados preservados cognitivamente. Trinta participantes responderam ao Mini-Exame do Estado Mental, ao Questionário sobre Estágios de Mudança de Comportamento e ao Questionário sobre Barreiras à Prática de Atividade Física. Os resultados mostraram que poucos idosos institucionalizados apresentam uma alta percepção de descrença nos benefícios da atividade física. Entretanto, muito poucos praticam atividades físicas e a maioria não pretende incluí-las em seu estilo de vida. O estágio de comportamento no qual se encontram pode estar sendo mediado pela percepção de barreiras. Conclui-se, coerentemente com as principais barreiras reportadas, que a promoção de atividade física para o idoso institucionalizado deve, prioritariamente, enfatizar a conscientização sobre os riscos do sedentarismo e os benefícios da prática mesmo na presença de doenças, bem como preparar um ambiente seguro e sem gasto financeiro individual.

Research paper thumbnail of Risco de quedas em idosos com doença de Parkinson e demência de Alzheimer: um estudo transversal

Revista Brasileira de Fisioterapia, 2006

Objetivo: Comparar o risco de quedas entre idosos com doença de Parkinson (DP), demência de Alzhe... more Objetivo: Comparar o risco de quedas entre idosos com doença de Parkinson (DP), demência de Alzheimer (DA) e saudáveis (controle). Além disso, pretendeu-se analisar as relações do risco de quedas com declínio cognitivo e com nível de atividade física. Método: vinte idosos, sendo sete com DP (69,57 ± 2,40 anos), seis com DA (77,5 ± 2,32 anos) e sete saudáveis (74,71 ± 2,58 anos), foram avaliados por meio dos seguintes instrumentos: Escala de Equilíbrio Funcional de Berg (EEFB), Timed Up and Go test (TUG), Mini-Exame do Estado Mental (MEEM) e Questionário Baecke Modificado para Idosos (QBMI). Resultados: O teste de Kruskal-Wallis apontou diferença significativa entre os grupos, tanto em relação à EEFB (KW=9,67, p<0,01), quanto em relação ao TUG (KW=9,14, p<0,01, para tempo despendido, e KW=10,04, p<0,01, para número de passos). A "análise aos pares" do teste post-hoc de Bonferroni apontou comprometimento maior do equilíbrio no grupo DA, no qual também foram observados menores valores no MEEM. O grupo DP foi caracterizado por apresentar um maior nível de atividade física. A análise de correlação de Spearman apontou correlação baixa entre MEEM e EEFB (r s =0,59); entre MEEM e TUG (r s =-0,62 e r s =-0,52); entre QBMI e EEFB (r s =0,54); e entre QBMI e TUG (r s =-0,39 e r s =-0,42). Conclusões: As baixas correlações observadas devem ser analisadas com cautela, pois tais variáveis sofrem influência de múltiplos fatores. No grupo DA, o declínio cognitivo pode estar relacionado ao maior risco de quedas e, no grupo DP, a atividade física pode ter auxiliado a manter um risco de quedas próximo ao grupo controle.

Research paper thumbnail of Effects of postural threat on walking features of Parkinson's disease patients

Neuroscience Letters, 2009

This study investigated whether or not gait kinematics among healthy older individuals and Parkin... more This study investigated whether or not gait kinematics among healthy older individuals and Parkinson's disease (PD) patients are influenced by postural threat. Eight healthy older individuals and eight PD patients were examined while walking at self-selected velocities, under three conditions of postural threat: unconstrained floor; constrained floor (19 cm wide); constrained and elevated floor (19 cm wide by 10 cm high). Independent of the surface conditions, due to motor disturbances caused by the PD these patients walked slower, with shorter strides, and spent more time in the double support phase and less time in the swing phase than did their matched controls. Increases in postural threat resulted in altered gait kinematics for all subjects. Specifically, stride length, stride velocity, cadence, and heel contact velocity decreased, and stride duration and double support duration increased relative to increases in postural threat. All gait alterations were the result of participants' attempts to facilitate locomotion control and maintain stability. The results of this study reveal that width and height constraints effectively perturbed the balance of all of the walking older individuals. The PD patients were able to modulate gait parameters when faced by a postural threat task.

Research paper thumbnail of Early impairment of cognitive functions in Parkinson's disease

Arquivos de Neuro-Psiquiatria, 2007

Besides the classical symptoms of Parkinson's disease (PD) such as rest tremor, rigidity, bradyki... more Besides the classical symptoms of Parkinson's disease (PD) such as rest tremor, rigidity, bradykinesia and postural instability and its high prevalence in Brazilian clinical settings 1 impaired non-motor functions such as cognitive disorders are also common events 2 . At the disease onset, 24% of patients present cognitive decay, especially memory disorders and disturbances of some executive functions such as impaired selective attention, thinking flexibility, and planning difficulty 3 . In dementia, the patient with PD also reveals deterioration of declarative memory (but with relative preserved recognition), visuoconstructive skills, and nominating ability 4 . These distur-bances depend on mostly frontal-striatum connections 5 and involve other areas of the brain such as the parietal regions and subcortical structures 6 .

Research paper thumbnail of Serum homocysteine and physical exercise in patients with Parkinson's disease

Psychogeriatrics, 2011

Hyperhomocysteinemia is a major risk factor for cerebral and peripheral vascular diseases, as wel... more Hyperhomocysteinemia is a major risk factor for cerebral and peripheral vascular diseases, as well as cortical and hippocampal injury, including an increased risk of dementia and cognitive impairment. Elevated serum homocysteine (Hcy) concentrations are common in patients with Parkinson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (PD) who have been treated with levodopa; however, physical exercises can help reduce Hcy concentrations. The aim of the present study was to compare serum Hcy levels in patients with PD who partook in regular physical exercises, sedentary PD patients, and healthy controls. Sixty individuals were enrolled in the present study across three groups: (i) 17 patients who did not partake of any type of exercise; (ii) 24 PD patients who exercised regularly; and (iii) 19 healthy individuals who did not exercise regularly. All participants were evaluated by Hoehn and Yahr scale, the Unified Parkinson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Disease Rating Scale (UPDRS) and Schwab and England scale (measure daily functionality). The serum levels of Hcy were analyzed by blood samples collected of each participant. An analysis of variance and a Tukey&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s post hoc test were applied to compare and to verify differences between groups. Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s correlation and stepwise multiple regression analyses were used to consider the association between several variables. Mean plasma Hcy concentrations in individuals who exercised regularly were similar to those in the healthy controls and significantly lower than those in the group that did not exercise at all (P= 0.000). In addition, patients who did not exercise were receiving significantly higher doses of levodopa than those patients who exercised regularly (P= 0.001). A positive relationship between levodopa dose and Hcy concentrations (R(2) = 0.27; P= 0.03) was observed in patients who did not exercise, but not in those patients who exercised regularly (R(2) = 0.023; P= 0.15). The results of the present study suggest that, even with regular levodopa therapy, Hcy concentrations in PD patients who exercise regularly are significantly lower than in patients who do not exercise and are similar Hcy concentrations in healthy controls.