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Inicio Revista Iberoamericana de Fisioterapia y Kinesiología Programa de fisioterapia mejora a largo plazo las habilidades motoras en pacient...
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Vol. 11. Núm. 2.
Páginas 81-92 (diciembre 2008)
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Vol. 11. Núm. 2.
Páginas 81-92 (diciembre 2008)
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Programa de fisioterapia mejora a largo plazo las habilidades motoras en pacientes con enfermedad de Parkinson
Physical therapy program improves motor skills in the long term in patients with Parkinson's disease
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11772
Inés Gago Fernández, Jesús Seco Calvo
Autor para correspondencia
jesus.seco@unileon.es

Correspondencia: Dr. J. Seco Calvo. Departamento de Enfermería, y Fisioterapia.Universidad de León, (Campus de Ponferrada).
Escuela Universitaria de Ciencias, de la Salud. Universidad de León, (Campus de Ponferrada)
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Resumen

El objetivo es reflejar la influencia que tiene el tratamiento fisioterapéutico en pacientes con enfermedad de Parkinson (EP). Se evaluó a 19 pacientes aplicando la Unified Parkinson's Disease Rating Scale (UPDRS). La UPDRS es una escala multidimensional con 4 secciones: estado mental, comportamiento y estado de ánimo; actividades de la vida diaria; examen motor; complicaciones de la terapia. También se aplicó la escala Hoehn-Yahr modificada. Las complicaciones motoras de la EP sobre la capacidad física y funcional son notables.

Los resultados relativos al examen motor en la etapa preintervención y postintervención se presentan mediante regresión lineal, utilizando la herramienta informática SPSS versión 14.0. Las medidas de tendencia central de la puntuación global alcanzada en la etapa preintervención y postintervención son: en el estadio on la media ± desviación estándar pasa de 64,22±16,383 antes de la intervención fisioterapéutica a 50,89±19,499 tras la intervención; en el estadio off el valor de la media ± desviación estándar pasa de 85,78±12,549 a 75,78±17,745.

La reducción cuantitativa de fuerza muscular en la espalda, la cadera y el tobillo, con daño en la propiocepción y el sentido visual, y una menor base de apoyo, son las causas principales para la inestabilidad postural en los pacientes con EP. Observamos que, al incrementar hasta un rango de 7-12 el número de sesiones (grupos 3 y 4), las puntuaciones en la subescala motor son mayores, lo que indica que la rigidez de cuello, la postura, el equilibrio y la marcha mejoran, y esta mejoría es más duradera.

Palabras clave:
Enfermedad de Parkinson
Fisioterapia
Escala de valoración UPDRS
Abstract

The objective of this study is to examine the effect physical therapy on patients with Parkinson's Disease (PD).

Nineteen patients were evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS). UPDRS is a multidimensional scale composed of four sections: 1) mental state, behavior and attitude; 2) daily activities; 3) motor examination; 4) therapeutic complications and modified Hoehn-Yahr scale. The motor complications caused by the PD have an important effect on physical and functional capacity.

The results relative to motor examination in the stage pre-intervention and post-intervention are shown with the linear regression, using SPSS software version 14.0®.

Measurements of central trend of the global punctuation reached in the pre-intervention and post-intervention stages are: in the on stage, the average goes from 64.22±16.383 before physical therapy intervention to 50.89±19.499 after the intervention; in the off stage, the value of the average goes from 85.78±12.549 to 75.78±17.745.

Quantitative reduction of muscular strength in the back, hips, ankles, with damage in propioception, visual sense and the lowest support base, are the main causes of instability in patients with Parkinson's Disease.

If the number of sessions (groups 3 and 4) are increased to a range of 7-12, the scores on the motor examination are higher. This indicates that neck stiffness, body posture, balance and gait improve, and this improvement is longer-lasting.

Key words:
Parkinson's disease
Physical therapy
Unified Parkinson's Disease Rating Scale
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Bibliografía
[1.]
C.D. Marsden.
Parkinson's disease.
J Neurol Neurosurg Psychiatry, 57 (1994), pp. 672-681
[2.]
W. Carne, D.X. Cifu, P. Marcinko, M. Baron, T. Pickett, A. Qutubuddin, et al.
Efficacy of multidisciplinary treatment program on long-term outcomes of individuals with Parkinson's disease.
J Rehabil Res Dev, 42 (2005), pp. 779-786
[3.]
A. Baddeley.
Working memory: the interface between memory and cognition.
J Cogn Neurosci, 4 (1992), pp. 281-288
[4.]
S. Hiroyuki, Y. Uchiyama, S. Kakurai.
Specific effects of balance and gait exercises on physical function among the frail elderly.
Clin Rehabil, 17 (2003), pp. 472-479
[5.]
T. Herman, N. Giladi, L. Gruendlinger, J.M. Hausdorff.
Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson's disease: a pilot study.
Arch Phys Med Rehabil, 88 (2007), pp. 1154-1158
[6.]
G. Brichetto, E. Pelosin, R. Marchese, G. Abbruzzese.
Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study.
Clin Rehabil, 20 (2006), pp. 31-35
[7.]
R. Tamir, R. Dickstein, M. Huberman.
Integration of motor imagery and physical practice in group treatment applied to subjects with Parkinson's disease.
Neurorehabil Neural Repair, 21 (2007), pp. 68-75
[8.]
Quality Standards Subcommittee, American Academy of Neurology. Practice parameters: initial therapy of Parkinson's disease.
Neurology, 43 (1993), pp. 1296-1297
[9.]
W.C. Koller, D.E. Silver, A. Lieberman.
An algorithm for the management of Parkinson's disease.
Neurology, 44 (1994), pp. S1-S52
[10.]
V. Muller, B. Mohr, R. Rosin, F. Pulvermuller, F. Muller, N. Birbaumer.
Short-term effects of behavioral treatment on movement initiation and postural control in Parkinson's disease: a controlled clinical study.
Mov Disord, 12 (1997), pp. 306-314
[11.]
R. Formisano, L. Pratesi, F. Modarelli, V. Bonifanti, G. Meco.
Rehabilitation and Parkinson's disease.
Scand J Rehabil Med, 24 (1992), pp. 157-160
[12.]
J.C. Comella, G.T. Stebbins, N. Brown-Tomas, C.G. Goetz.
Physical therapy and Parkinson's disease: a controlled clinical trial.
Neurology, 44 (1994), pp. 376-378
[13.]
S. Franklyn, I.J. Kohout, G.M. Stern, M. Dunning.
Physiotherapy in Parkinson's disease.
Research progress in Parkinson's disease, pp. 397-400
[14.]
F.B. Gibberd, G.R. Page, K.M. Spencer.
A controlled trial in physiotherapy for Parkinson's disease.
Research progress in Parkinson's disease, pp. 401-413
[15.]
S.W. Pederson, B. Oberg, A. Insulander, A. Vretman.
Group training in Parkinsonism: quantitative measurements of treatment.
Scand J Rehabil Med, 22 (1990), pp. 207-211
[16.]
H. Ellgring, S. Seiler, U. Nagel, B. Perleth, T. Gassr, W.H. Oertel.
Psychosocial problems of Parkinson patients: approaches to assessment and treatment.
Adv Neurol, 53 (1990), pp. 349-353
[17.]
Movement Disorder Society Task Force on Ratio Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord. 2003; 18: 738-50.
[18.]
P. Martínez, A. Gil, L.M. Gracia, J.B. Gómez, J. Martínez, F. Bermejo.
Unified Parkinson's Disease Rating Scale characteristics and structure.
Mov Disord, 9 (1994), pp. 76-83
[19.]
M.T. Pellecchia, A. Grasso, L.G. Biancardi, M. Squillante, V. Bonavita, P. Barone.
Physical therapy in Parkinson's disease: an open long-term rehabilitation trial.
J Neurol, 251 (2004), pp. 595-598
[20.]
T. Ellis, C.J. De Goede, R.G. Feldman, E.C. Wolters, G. Kwakkel, R.C. Wagenaar.
Efficacy of a physical therapy program in patients with Parkinson's disease: a randomized controlled trial.
Arch Phys Med Rehabil, 86 (2005), pp. 626-632
[21.]
R. Cano, A.I. Macías, V. Crespo, M. Morales.
Escalas de valoración y tratamiento fisioterápico en la enfermedad de Parkinson.
Fisioterapia, 26 (2004), pp. 201-210
[22.]
M. Chouza, I. Raposo, R. Fernández, L. González, A. Martínez, M.A. Fernández.
Protocolo de fisioterapia en el paciente parkinsoniano.
Fisioterapia, 23 (2001), pp. 1911-1919
[23.]
M.E. Morris.
Movement disorders in people with Parkinson's disease: a model for physical therapy.
Phys Ther, 80 (2000), pp. 578-597
[24.]
X. Badía, M. Salamero, J. Alonso.
Guía de escalas de medición en español.
Edimac, (2002),
[25.]
J.V. Jacobs, F.B. Horak.
An alternative clinical postural stability test for patients with Parkinson's disease.
J Neurol, 253 (2006), pp. 1404-1413
[26.]
C.J. De Goede, S. Zeus, G. Kwakkel, R. Wagenaar.
The effects of physical therapy in Parkinson's disease: a research synthesis.
Arch Phys Med Rehabil, 82 (2001), pp. 509-515
[27.]
V. Lun, N. Pullan, N. Labelle, C. Adams, O. Suchowersky.
Comparison of the effects of a self-supervised home exercise program with a physiotherapist-supervised exercise program on the motor symptoms of Parkinson's disease.
Mov Disord, 20 (2005), pp. 971-975
[28.]
T. Schmitz-Hübsch, D. Pyfer, K. Kielwein, R. Fimmers, T. Klockgether, U. Wüllner.
Qigong exercise for the symptoms of Parkinson's disease: a randomized, controlled pilot study.
Mov Disord, 21 (2006), pp. 543-548
[29.]
M. Nallegowda, U. Singh, G. Handa, M. Khanna, S. Wadhwa, S.L. Yadav, et al.
Role of sensory input and muscle strength in maintenance of balance, gait and posture in Parkinson's disease: a pilot study.
Am J Phys Med Rehabil, 83 (2004), pp. 898-908
Copyright © 2008. Asociación Española de Fisioterapeutas
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