RESUMO
We compare the effects of Nordic walking training (NW) and Free walk (FW) on functional parameters (motor symptoms, balance) and functional mobility (Timed Up and Go at Self-selected Speed - TUGSS, and at forced speed, TUGFS; Self-selected Walking Speed, SSW; locomotor rehabilitation index, LRI) of Parkinson's disease (PD) patients. The study included 33 patients with clinical diagnosis of idiopathic PD, and staging between 1 and 4 in the Hoehn and Yahr scale (H&Y) randomized into two groups: NW (N = 16) and FW (N = 17) for 6 weeks. Baseline characteristics were compared trough a one-way ANOVA. Outcomes were analyzed using the Generalized Estimation Equations (GEE) with a Bonferroni post-hoc. Data were analyzed using SPSS v.20.0. Improvements in UPDRS III (P < 0.001), balance scores (P < 0.035), TUGSS distance (P < 0.001), TUGFS distance (P < 0.001), SSW (P < 0.001), and LRI (P < 0.001) were found for both groups. However, the NW group showed significant differences (P < 0.001) when compared to the FW group for the functional mobility. We conclude the NW improves functional parameters and walking mobility demonstrating that NW is as effective as the FW, including benefits for FW on the functional mobility of people with PD.
Assuntos
Terapia por Exercício/métodos , Doença de Parkinson/reabilitação , Caminhada , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Índice de Gravidade de DoençaRESUMO
It has been observed that the optimal speed (OPT) of human walking is independent of load on level surfaces because of the unaltered trajectory of the center of mass and consequent conservation of the pendular mechanism. However, the role of the inverted pendulum mechanism that combines speed, load, and gradient during walking remains unknown. In the present study, 10 subjects walked on a treadmill, with and without loading (25% of the body mass), at different speeds and slopes (0%, +7%, and +15%). The three-dimensional motion and VO2 were simultaneously registered. The mechanical external and internal work and the cost of transport (C) changed with the speed and gradient, but the load only affected C. OPT decreased with increasing gradient, and the pendular mechanics (R) was modified mainly as a result of changes in speed and gradient. OPT and R were independent of the load in these gradients. Remarkably, R increased with increasing speed and decreased (to 30%) with an increasing gradient; moreover, R was independent of load. Therefore, the energy-saving strategy by the pendular mechanism persists, although at a diminished level, in loaded walking on gradients and partially explains the OPT in this condition.