TY - JOUR
T1 - Balance and fear of falling in subjects with Parkinson's disease is improved after exercises with motor complexity
AU - Silva-Batista, Carla
AU - Corcos, Daniel M.
AU - Kanegusuku, Hélcio
AU - Piemonte, Maria Elisa Pimentel
AU - Gobbi, Lilian Teresa Bucken
AU - de Lima-Pardini, Andrea C.
AU - de Mello, Marco Túlio
AU - Forjaz, Claudia L.M.
AU - Ugrinowitsch, Carlos
N1 - Funding Information:
The authors thank the subjects for their commitment to study, Associação Brasil Parkinson’s staff, Center for Psychobiology and Exercise Studies, FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), and Prêmio Pembertom Coca-Cola Brasil. This study was supported by a grant from the FAPESP ( 2011/042423 , 2012/03056-4 , and 2013/04970-4 ), CAPES ( 3095/2015-00 ), and CNPQ ( 406609/2015-2 ).
Publisher Copyright:
© 2017
PY - 2018/3
Y1 - 2018/3
N2 - Resistance training with instability (RTI) uses exercises with high motor complexity that impose high postural control and cognitive demands that may be important for improving postural instability and fear of falling in subjects with Parkinson's disease (PD). Here, we hypothesized that: 1) RTI will be more effective than resistance training (RT) in improving balance (Balance Evaluation Systems Test [BESTest] and overall stability index [Biodex Balance System®]) and fear of falling (Falls Efficacy Scale-International [FES-I] score) of subjects with Parkinson's disease (PD); and 2) changes in BESTest and FES-I after RTI will be associated with changes in cognitive function (Montreal Cognitive Assessment [MoCA] score – previously published) induced by RTI. Thirty-nine subjects with moderate PD were randomly assigned to a nonexercising control, RT, and RTI groups. While RT and RTI groups performed progressive RT twice a week for 12 weeks, the RTI group added progressive unstable devices to increase motor complexity of the resistance exercises. There were significant group × time interactions for BESTest, overall stability index, and FES-I scores (P < 0.05). Only RTI improved BESTest, overall stability index and FES-I scores, and RTI was more effective than RT in improving biomechanical constraints and stability in gait (BESTest sections) at post-training (P < 0.05). There were strong correlations between relative changes in BESTest and MoCA (r = 0.72, P = 0.005), and FES-I and MoCA (r = −0.75, P = 0.003) after RTI. Due to the increased motor complexity in RTI, RTI is recommended for improving balance and fear of falling, which are associated with improvement in cognitive function of PD.
AB - Resistance training with instability (RTI) uses exercises with high motor complexity that impose high postural control and cognitive demands that may be important for improving postural instability and fear of falling in subjects with Parkinson's disease (PD). Here, we hypothesized that: 1) RTI will be more effective than resistance training (RT) in improving balance (Balance Evaluation Systems Test [BESTest] and overall stability index [Biodex Balance System®]) and fear of falling (Falls Efficacy Scale-International [FES-I] score) of subjects with Parkinson's disease (PD); and 2) changes in BESTest and FES-I after RTI will be associated with changes in cognitive function (Montreal Cognitive Assessment [MoCA] score – previously published) induced by RTI. Thirty-nine subjects with moderate PD were randomly assigned to a nonexercising control, RT, and RTI groups. While RT and RTI groups performed progressive RT twice a week for 12 weeks, the RTI group added progressive unstable devices to increase motor complexity of the resistance exercises. There were significant group × time interactions for BESTest, overall stability index, and FES-I scores (P < 0.05). Only RTI improved BESTest, overall stability index and FES-I scores, and RTI was more effective than RT in improving biomechanical constraints and stability in gait (BESTest sections) at post-training (P < 0.05). There were strong correlations between relative changes in BESTest and MoCA (r = 0.72, P = 0.005), and FES-I and MoCA (r = −0.75, P = 0.003) after RTI. Due to the increased motor complexity in RTI, RTI is recommended for improving balance and fear of falling, which are associated with improvement in cognitive function of PD.
KW - Cognitive impairment
KW - Fall
KW - Muscle strength
KW - Postural instability
KW - Resistance training
KW - Unstable device
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U2 - 10.1016/j.gaitpost.2017.12.027
DO - 10.1016/j.gaitpost.2017.12.027
M3 - Article
C2 - 29310015
AN - SCOPUS:85039994748
SN - 0966-6362
VL - 61
SP - 90
EP - 97
JO - Gait and Posture
JF - Gait and Posture
ER -