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|Título:||Effects of a intensive multitask gait training program on spatiotemporal gait parameters in parkinson disease : a case study|
|Orientador:||Caldas, Alexandra Castro|
|Data de Defesa:||Abr-2010|
|Resumo:||BACKGROUND: The performance of an additional task during walking alters gait stability, speed and step length, representing therefore a major fall risk factor in PD (Parkinson disease). Hence, improvement of this capacity to divide attention while walking can allow us to improve the specificity of the fall interventions for PD patients that have a longer lasting effect in reducing risk of falling. PURPOSE and DESIGN: The purpose of the present study was to investigate the effect of a four week intensive multitask gait training program on spatiotemporal gait parameters in one individual with Parkinson's disease. A pretest-post test case study example will therefore be presented. METHODS: A 73 year old woman was recruited from the Portuguese Parkinson Association. She was a suitable medically stable candidate followed by a PD neurologist specialist, diagnosed with idiopathic PD in stage 4 of the Hoehn and Yahr staging with no significant cognitive impairment. She had a history of falling in the last 6 months (minimum 3 falls per week) but was able to stand ( 1 minute) and walk ( 10 m) independently without significant assistance. The participant undertook a four week intensive multitask gait training program that looked to enhance safety and functional independence of gait in day to day situations. The participant was tested in 3 evaluation periods (baseline, pos-test and follow-up evaluation). The participant had to walk at comfortable speed on a force platform under 3 baseline conditions: (i) walking, (ii) walking carrying a glass of water; and (iii) walking saying words that began with a specific letter as instructed. Secondary outcome measures included the frequency of falls per week (falls diary), balance (Berg Scale), gait (UPDRS 30 score) and freezing (UPDRS 14 score). RESULTS: At the end of the 4 week training period, the participant walked faster and with longer strides in all conditions when compared to baseline, showing that it was possible to improve gait parameters under dual and multitask conditions in this patient with moderate PD with intensive practice. The participant also significantly improved on the Berg scores and freezing, and this was maintained after a 4-week washout training. These improvements in walking were achieved without any significant adverse effect such as falls during training and evaluation. CONCLUSIONS This study provides preliminary information in support of the development of a future innovating fall prevention program in PD that tackles complex everyday situations by training dual and multitask activities.|
|Aparece nas colecções:||ICS(L) - Dissertações de Mestrado / Master Dissertations|
R - Dissertações de Mestrado / Master Dissertations
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