Efeitos da terapia de movimento MOTOmed® na função motora e principais sintomas de pacientes com doença de Parkinson: uma revisão sistemática
DOI:
https://doi.org/10.47197/retos.v47.93936Palavras-chave:
Parkinson´s disease, MOTOmed, Physical Therapy, Physical Activity, Rehabilitation., Enfermedad de Parkinson, MOTOmed, Fisioterapia, Actividad Física, Rehabilitación.Resumo
Introdução: Os achados científicos mostram melhorias imediatas após o ciclismo assistido forçado em altas velocidades de pedalada de até 90 rotações por minuto em pacientes com doença de Parkinson, portanto, esta revisão teve como objetivo estimar a eficácia da terapia de movimento MOTOmed®. para aumentar a função motora e aliviar os principais sintomas nesses pacientes. Métodos: Revisão sistemática incluindo ensaios controlados randomizados examinando as intervenções de terapia de movimento MOTOmed®, isoladamente ou como adjuvante da reabilitação, para pacientes com doença de Parkinson. A ferramenta de avaliação de risco de viés seguiu as recomendações do Cochrane Handbook 5.1.0. Todos os estudos incluídos relataram os efeitos da mobilidade como desfechos primários. Diferenças médias padronizadas ou diferenças médias com correspondentes intervalos de confiança de 95% (CI) foram calculadas. Resultados: No total, 7 estudos com um total de 206 pacientes foram incluídos na análise. Todos os estudos foram de qualidade moderada. A terapia de movimento MOTOmed® resultou em melhorias estatisticamente significativas no escore MDS-UPDRS (Movement Disorder Society-Unified Parkinson Disease Rating Scale) Motor III (p<0,05); Escore MDS-UPDRS do membro superior (p<0,05); MDS-UPDRS total (p<0,04): Função da parte superior do corpo (p<0,007); bradicinesia (p<0,044); Variáveis do ciclismo: maior cadência (p<0,001); Cronometrado e feito (p>0,05); escore de tremor (p<0,05); Tempo de caminhada (p<0,05); Passos da marcha (p<0,05); Pronação e supinação (p<0,05); Questionário da Doença de Parkinson -PQD8 (ataduras e depressões p<0,05); Análise da marcha: velocidade (p<0,000), comprimento da passada (p<0,000), postura monopedal (p<0,000), fase de balanço (p<0,000); Biodex® Balance System: Teste Clínico de Integração Sensorial do Equilíbrio-CTSIB1 (p<0,007). Conclusão: A terapia de movimento MOTOmed® isolada ou combinada com reabilitação padrão melhora a função motora e os principais sintomas em pacientes com doença de Parkinson.
Palavras-chave: Doença de Parkinson, MOTOmed®, Fisioterapia, Atividade Física, Reabilitação.
Referências
Adamovich, S. V., Berkinblit, M. B., Hening, W., Sage, J., & Poizner, H. (2001). The interaction of visual and proprioceptive inputs in pointing to actual and remembered targets in Parkinson’s disease. Neuroscience, 104(4), 1027-1041.
Ahlskog, J. E., & Muenter, M. D. (2001). Frequency of levodopa‐related dyskinesias and motor fluctuations as estimated from the cumulative literature. Movement disorders: official journal of the Movement Disorder Society, 16(3), 448-458.
Alberts, J. L., Linder, S. M., Penko, A. L., Lowe, M. J., & Phillips, M. (2011). It is not about the bike, it is about the pedaling: forced exercise and Parkinson's disease. Exercise and sport sciences reviews, 39(4), 177-186.
Berardelli, A., Rothwell, J. C., Thompson, P. D., & Hallett, M. (2001). Pathophysiology of bradykinesia in Parkinson's dis-ease. Brain, 124(11), 2131-2146.
Bilowit, D. S. (1956). Establishing physical objectives in the rehabilitation of patients with Parkinson’s disease (gymnasium activities). Physical Therapy, 36(3), 176-178.
Blumenthal, J. A., Babyak, M. A., Moore, K. A., Craighead, W. E., Herman, S., Khatri, P., ... & Krishnan, K. R. (1999). Effects of exercise training on older patients with major depression. Archives of internal medicine, 159(19), 2349-2356.
Carboncini, M. C., Manzoni, D., Strambi, S., Bonuccelli, U., Pavese, N., Andre, P., & Rossi, B. (2001). The relation between EMG activity and kinematic parameters strongly supports a role of the action tremor in parkinsonian bradykinesia. Movement disorders: official journal of the Movement Disorder Society, 16(1), 47-57.
Cheng, J., Brooke, J. D., Misiaszek, J. E., & Staines, W. R. (1995). The relationship between the kinematics of passive movement, the stretch of extensor muscles of the leg and the change induced in the gain of the soleus H reflex in humans. Brain research, 672(1-2), 89-96.
Christensen, L. O., Johannsen, P., Sinkjær, T., Petersen, N., Pyndt, H. S., & Nielsen, J. B. (2000). Cerebral activation during bicycle movements in man. Experimental Brain Research, 135(1), 66-72.
Cummings, J. L. (1999). Understanding Parkinson dis-ease. Jama, 281(4), 376-378.
Damiano, D. L., Arnold, A. S., Steele, K. M., & Delp, S. L. (2010). Can strength training predictably improve gait kinematics? A pilot study on the effects of hip and knee extensor strengthening on lower-extremity alignment in cerebral palsy. Physical therapy, 90(2), 269-279.
Davies, P. M. (2000). Steps to follow: the comprehensive treatment of patients with hemiplegia. Springer Science & Business Media.
Dibble, L. E., Hale, T. F., Marcus, R. L., Droge, J., Gerber, J. P., & LaStayo, P. C. (2006). High‐intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson's disease. Movement disorders: official journal of the Movement Disorder Society, 21(9), 1444-1452.
Dorsey, E. A., Constantinescu, R., Thompson, J. P., Biglan, K. M., Holloway, R. G., Kieburtz, K., ... & Tanner, C. M. (2007). Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology, 68(5), 384-386.
Dunn, A. L., Trivedi, M. H., Kampert, J. B., Clark, C. G., & Chambliss, H. O. (2005). Exercise treatment for depression: efficacy and dose response. American journal of preventive medi-cine, 28(1), 1-8.
Ericson, M. (1986). On the biomechanics of cycling. A study of joint and muscle load during exercise on the bicycle ergome-ter. Scandinavian journal of rehabilitation medicine. Supplement, 16, 1-43.
Farley, B. G., & Koshland, G. F. (2005). Training BIG to move faster: the application of the speed–amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Experimental brain research, 167(3), 462-467.
Fickes, E. J. (2012). Effects of interval active-assisted cycling on balance in individuals with parkinson's disease. Kent State University.
Findley, L., Aujla, M., Bain, P. G., Baker, M., Beech, C., Bowman, C., ... & Playfer, J. R. (2003). Direct economic impact of Parkinson's disease: a research survey in the United Kingdom. Movement disorders, 18(10), 1139-1145.
Gao, C. H., Xu, L. Y., Huang, J., & Xiao, F. (2013). Effect of MOTOmed intelligent training system on balance and lower limb motor function in stroke patients. Chinese Journal of Rehabilitation Theory and Practice, 19, 725-728.
Giuffrida, J. P., Riley, D. E., Maddux, B. N., & Heldman, D. A. (2009). Clinically deployable Kinesia™ technology for automated tremor assessment. Movement disorders: official journal of the Movement Disorder Society, 24(5), 723-730.
Hackney, M. E., & Earhart, G. M. (2009). Effects of dance on movement control in Parkinson’s disease: a comparison of Argentine tango and American ballroom. Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine, 41(6), 475.
Heldman, D. A., Giuffrida, J. P., Chen, R., Payne, M., Mazzella, F., Duker, A. P., ... & Espay, A. J. (2011). The modified bradykinesia rating scale for Parkinson's disease: reliability and comparison with kinematic measures. Movement Disorders, 26(10), 1859-1863.
Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., et al. (2011). The cochrane collaboration’s tool for assessing risk of bias in randomized trials. BMJ, 343
Hoehn, M. M., & Yahr, M. D. (1967). Parkinsonism: onset, progression, and mortality., v. 17, n.
Jain, S., Gourab, K., Schindler-Ivens, S., & Schmit, B. D. (2013). EEG during pedaling: evidence for cortical control of locomotor tasks. Clinical Neurophysiology, 124(2), 379-390.
Jankovic, J. (2008). Parkinson’s disease: clinical features and diagnosis. Journal of neurology, neurosurgery & psychiatry, 79(4), 368-376.
Krzeminski, K., Kruk, B., Nazar, K., Ziemba, A. W., Cybulski, G., & Niewiadomski, W. (2000). Cardiovascular, metabolic and plasma catecholamine responses to passive and active exercises. Journal of Physiology and Pharmacology, 51(2).
L.C. Triarhou. Dopamine and Parkinson's disease. In Madame Curie Bioscience Database [Internet]. Landes Bioscience. Available from: http://www.ncbi.nlm.nih.gov/books/NBK6271/. Austin, Texas: Landes Bioscience, 2013.
Latt, M. D., Lord, S. R., Morris, J. G., & Fung, V. S. (2009). Clinical and physiological assessments for elucidating falls risk in Parkinson's disease. Movement disorders: official journal of the Movement Disorder Society, 24(9), 1280-1289.
Laupheimer, M., Hartel, S., & Schmidt, S. (2011). Forced exercise effects of motomed® training on parkinson’s-typical motor dysfunctions. Neurology and Rehabilitation, 17(5/6), 239-246.
Lee, K. S., Lee, W. H., & Hwang, S. (2011). Modified constraint-induced movement therapy improves fine and gross motor performance of the upper limb in Parkinson disease. American Journal of Physical Medicine & Rehabilitation, 90(5), 380-386.
Ludyga, S., Gronwald, T., & Hottenrott, K. (2016). Effects of high vs. low cadence training on cyclists’ brain cortical activity during exercise. Journal of Science and Medicine in Sport, 19(4), 342-347.
Morris, M. E., Martin, C. L., & Schenkman, M. L. (2010). Striding out with Parkinson disease: evidence-based physical therapy for gait disorders. Physical therapy, 90(2), 280-288.
Mostile, G., Giuffrida, J. P., Adam, O. R., Davidson, A., & Jankovic, J. (2010). Correlation between Kinesia system assessments and clinical tremor scores in patients with essential tremor. Movement disorders, 25(12), 1938-1943.
Müller, T., & Muhlack, S. (2007). Impact of endurance exercise on levodopa associated cortisol release and force increase in patients with Parkinson's disease. Aktuelle Neurologie, 34(S 2), P624.
Naito, E., Nakashima, T., Kito, T., Aramaki, Y., Okada, T., & Sadato, N. (2007). Human limb‐specific and non‐limb‐specific brain representations during kinesthetic illusory movements of the upper and lower extremities. European Journal of Neuroscience, 25(11), 3476-3487.
Nobrega, A. C., Williamson, J. W., Friedman, D. B., Araujo, C. G., & Mitchell, J. H. (1994). Cardiovascular responses to active and passive cycling movements. Medicine and science in sports and exercise, 26(6), 709-714.
Peacock, C. A., Sanders, G. J., Wilson, K. A., Fickes-Ryan, E. J., Corbett, D. B., von Carlowitz, K. P. A., & Ridgel, A. L. (2014). Introducing a multifaceted exercise intervention particular to older adults diagnosed with Parkinson’s disease: a preliminary study. Aging clinical and experimental research, 26(4), 403-409.
Richards, M., Marder, K., Cote, L., & Mayeux, R. (1994). Interrater reliability of the Unified Parkinson's Disease Rating Scale motor examination. Movement Disorders, 9(1), 89-91.
Ridgel, A. L., Muller, M. D., Kim, C. H., Fickes, E. J., & Mera, T. O. (2011). Acute effects of passive leg cycling on upper extremity tremor and bradykinesia in Parkinson's disease. The Physician and sportsmedicine, 39(3), 83-93.
Ridgel, A. L., Phillips, R. S., Walter, B. L., Discenzo, F. M., & Loparo, K. A. (2015). Dynamic high-cadence cycling improves motor symptoms in Parkinson’s disease. Frontiers in neurology, 6, 194.
Ridgel, A. L., Vitek, J. L., & Alberts, J. L. (2009). Forced, not voluntary, exercise improves motor function in Parkinson's disease patients. Neurorehabilitation and neural repair, 23(6), 600-608.
Ridgel, A. L., Vitek, J. L., & Alberts, J. L. (2009). Forced, not voluntary, exercise improves motor function in Parkinson's disease patients. Neurorehabilitation and neural repair, 23(6), 600-608.
Rothwell, J. C., Obeso, J. A., Traub, M. M., & Marsden, C. D. (1983). The behaviour of the long-latency stretch reflex in patients with Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 46(1), 35-44.
Shen, C., Liu, F., Yao, L., Li, Z., Qiu, L., & Fang, S. (2018). Effects of MOTOmed movement therapy on the mobility and activities of daily living of stroke patients with hemiplegia: a systematic review and meta-analysis. Clinical rehabilitation, 32(12), 1569-1580.
Stuckenschneider, T., Helmich, I., Raabe-Oetker, A., Froböse, I., & Feodoroff, B. (2015). Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease. Gait & Posture, 42(4), 485-490.
Vitório, R., Teixeira-Arroyo, C., Lirani-Silva, E., Barbieri, F. A., Caetano, M. J. D., Gobbi, S., ... & Teresa Bucken Gobbi, L. (2011). Effects of 6-month, multimodal exercise program on clinical and gait parameters of patients with idiopathic Parkinson's disease: a pilot study. International Scholarly Research Notices, 2011.
Wilson, K. A. (2013). Interval Active-Assisted Cycling Intervention Improves Motor Function in Individuals with Parkinson's Disease (Doctoral dissertation, Kent State University).
Zhang, J. J., Hu, X. F., & Xu, X. L. (2012). Development of lower limbs rehabilitative training robot. Chin J Rehabil Theory Pract, 18(8), 728-730.
Zhang, N., Tang, Q. P., & Xiong, Y. H. (2014). Impacts on the lower limb motor function in children with spastic cerebral palsy treated by Jin three-needle therapy combined with MOTOmed intelligent motor training. Zhongguo Zhen jiu= Chinese Acupuncture & Moxibustion, 34(7), 657-660.
Zia, S., Cody, F. W., & O'Boyle, D. J. (2002). Identification of unilateral elbow‐joint position is impaired by Parkinson's disease. Clinical Anatomy, 15(1), 23-31.
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 2022 Retos
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Autores que publicam nesta revista concordam com os seguintes termos:
- Autores mantém os direitos autorais e assegurar a revista o direito de ser a primeira publicação da obra como licenciado sob a Licença Creative Commons Attribution que permite que outros para compartilhar o trabalho com o crédito de autoria do trabalho e publicação inicial nesta revista.
- Os autores podem estabelecer acordos adicionais separados para a distribuição não-exclusiva da versão do trabalho publicado na revista (por exemplo, a um repositório institucional, ou publicá-lo em um livro), com reconhecimento de autoria e publicação inicial nesta revista.
- É permitido e os autores são incentivados a divulgar o seu trabalho por via electrónica (por exemplo, em repositórios institucionais ou no seu próprio site), antes e durante o processo de envio, pois pode gerar alterações produtivas, bem como a uma intimação mais Cedo e mais do trabalho publicado (Veja O Efeito do Acesso Livre) (em Inglês).
Esta revista é a "política de acesso aberto" de Boai (1), apoiando os direitos dos usuários de "ler, baixar, copiar, distribuir, imprimir, pesquisar, ou link para os textos completos dos artigos". (1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess
