Author(s): MONTEIRO, E., RODRIGUES, J., FRANZONI, L., GOMEÑUKA, N., ARCILA, D., PEYRÉ-TARTARUGA, L., Institution: FEDERAL UNIVERSITY OF SCIENCE OF HEALTH OF PORTO ALEGRE, Country: BRAZIL, Abstract-ID: 2311

INTRODUCTION:
Gait disturbance is a relevant component of motor disability in people with Parkinson’s disease (PwP). Recovery, a mechanism for exchanging energy of Center of Mass (CoM), is less effective in PwP than in healthy age-matched people. Rehabilitation with Nordic walking (NW) can promote changes in the CoM movement parameters, increasing energy reconversion. Therefore, the study aimed to evaluate the effects of NW compared to free walking (FW) on recovery in PwP.
METHODS:
This study is a randomized controlled clinical trial (Number: NCT03355521) composed of two groups, NW and FW, with the following eligibility criteria: Parkinson’s disease diagnosis, both sexes, age over 50 years, with stages between 1 to 4 on the Hoehn & Yahr (H&Y) scale. The recovery assessment took place before and after the intervention program, using the VICON® kinematics system (100Hz), 36 reflective markers, a sphere shape 14mm in diameter, and both sides of the body at anatomical points. For data treatment, we used a mathematical routine in Matlab® software. The training program was conducted for nine weeks, with two alternating weekly sessions ranging from 35 to 50 minutes daily in the last training cycle, totaling 18 sessions. Generalized Estimating Equations were used to compare groups. We used H&Y and Froud number values as covariates (appearing are fixed values – H&Y: 1.69; Froude number: 0.07). We used Bonferroni post-hoc to identify differences between means for all outcomes. Data were analyzed using SPSS® software (v.20.0) with an a =0.05.
RESULTS:
The final sample consisted of 20 PwP (NW: 13 and FW: 7), age (NW: 64.23±10.52 and FW: 69.71±6.82 years), body mass (NW: 80.07±14.79 and FW: 65.42±9.05 kg), height (NW: 1,68 ± 0,07 and FW: 1,68 ± 0,06 m), H&Y (Median: 1.5) and time since diagnosis (NW: 5.54±3.75 and FW: 3.29±1.97 years). For Recovery, significant differences were found for Group and Time (both P<0.01), with increased value for the NW group (NW pre: 51.12±7.95 to NW post: 66.07±7.63). In addition, we found significant differences in Time and interaction between Time*Group (P=0.0014 and P=0.010, respectively) for horizontal mechanical work. Internal mechanical work from arms showed significance for Time and Time*Group (P=0.02 and P<0.01, respectively), and the trunk showed Time*Group interaction (P=0.01). Vertical external work also presented significance for Time (P<0.01). Rint also showed significance for Time, Group, and Time*Group (P<0.01, P<0.01, and P=0.02, respectively). For maximum trunk flexion, we found significance for Time and Group (both P=0.001). Finally, we found significant differences for Time (P=0.006).
CONCLUSION:
We conclude that the NW group carried out the reconversion process more effectively. Thus, aged PwP, who walked with poles, had a more optimized pendular mechanism and, therefore, a more efficient gait than the FW group. This finding concludes that the reconversion process was carried out more effectively by the NW group.