Parkinson's Disease Clinical Trial
Official title:
Continuous Behavior Assessment of the Effects of a Physical Therapy Program for Patients With Parkinson's Disease
Introduction: Parkinson's disease (PD) results from dysfunction of the dopaminergic system
of degenerative and progressive, with changes in the nigrostriatal pathway, and decreased
concentration of dopamine. Has as clinical signs, symptoms called cardinal engines: resting
tremor, bradykinesia, rigidity and postural instability. In addition to drug therapy,
physical therapy is also considered a useful tool for the treatment of motor disorders of
the disease. The role of physiotherapy aims to stimulate the security and independence of
patients with PD in carrying out activities and to preserve and improve physical function.
Some studies have shown the negative effect of the disease on quality of life and functional
mobility. Few studies have been conducted to evaluate the effects of long-term therapy in
PD, but many report the beneficial effects of a rehabilitation program in a short period of
time.
Objective: To continually assess the effects after the completion of a physical therapy
program in patients with Parkinson's disease.
Methods: Type study randomized double blind clinical trial in Parkinson Pro Program Hospital
of the Federal University of Pernambuco. Will be recruited subjects with PD, both sexes, in
stages 1 to 3 on the scale of Hoehn Yahr and score greater than 18 on the Mini-Mental.
Patients who are recruited will undergo an assessment using the scales of assessment of
functional mobility, quality of life and motor examination before starting physical therapy
at the end of treatment and two months after completion of treatment, and the intervals
assessments of a month.
The Parkinson's disease results from dysfunction of the dopaminergic systems, cholinergic,
serotonergic and noradrenergic, though the neuropathological basic pattern is the change of
the nigrostriatal pathway, with decreased concentration of dopamine at the level of dopamine
receptors in the body striatum.
With still little known etiology in most instances, the Parkinson's disease has as clinical
signs, symptoms called cardinal engines: resting tremor, bradykinesia, rigidity and postural
instability. Additionally, patients may exhibit cognitive deficits and emotional changes
with the progression of the disease.
The clinical diagnosis is primarily based on the identification of the cardinal motor
symptoms plus the initial response to levodopa therapy . The literature is unanimous in
admitting that the use of Levodopa (L-dopa) is the most effective drug for the treatment,
and its administration the most recommended in satisfactory symptom control.
In addition to drug therapy, physical therapy is also considered a useful tool for the
treatment of motor disorders associated disease. Although the speed of the motor of the
patient learningParkinson's disease is lower than their control group of the same age,
rehabilitation, these individuals may also acquire motor skills as well as improve their
performance through practice repetition.
Although a physical rehabilitation program to be beneficial to improve the activities of
daily living (ADL) and mobility in patients with Parkinson's disease , it is not yet clear
how long its effect is sustained. Most clinical trials of physiotherapy in PD were based on
short-term rehabilitation programs.
Few studies have been conducted to evaluate the effects of long-term physical therapy in
Parkinson's disease, but many report the beneficial effects of a short-term rehabilitation
program, without having to concern monitoring after the physical therapy.
Thus this study aims to continuously evaluate the behavior of the effects of a physical
therapy program in patients with Parkinson's disease.
Knowledge of the time interval which is the decline of the gains from physiotherapy is a
guiding point to guide the patient regarding their return to service for revaluation, also
considering the fact that the disease have progressive.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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