Efetividade do treinamento de marcha com dupla tarefa associado à neuromodulação na mobilidade funcional e função executiva de pessoas com doença de Parkinson

Abstract

Introduction: In Parkinson's disease (PD), the presence of motor and non-motor symptoms generates repercussions on functional mobility and consequent restrictions in activities of daily living that make the person with PD more dependent and susceptible to falls. Thus, treadmill gait training associated with dual task and transcranial direct current stimulation (tDCS) appears to be an effective therapy for PD symptoms. Aim: To analyze the effectiveness of cognitive-motor training associated with anodal tDCS on functional mobility and executive function in people with PD. Methods: 28 individuals with PD were included in this randomized, double-blind clinical trial. Participants were allocated into two groups: Experimental (treadmill gait training + dual task (DT) + tDCS) and Control (single treadmill gait training + tDCS). The evaluation was carried out in three stages. For the primary outcome (functional mobility), the Timed up and go test (TUGT) was used. For secondary outcomes, the TUG dual task (TUG_DT), the UPDRS III, the 10-meter walk test, the trail building test, the verbal fluency test and the Stroop test. Interventions with and without dual-tasking were carried out in 12 sessions, over four weeks. SPSS software was used and a value of p≤0.05 was considered for the difference between variables. The multivariate test MANOVA, univariate test ANOVA of repeated measures and post hoc tests were performed for within subjects and between subjects. Results: There was a significant difference in the time factor for the outcomes functional mobility with DT (p=0,001*) and without concurrent dual tasks (p=0,001*), verbal fluency and semantic memory (p=0,004*) in both groups. Conclusion: The two training sessions carried out resulted in improvements in functional mobility with and without the interference of dual-tasking, as well as in fluency, language and semantic memory. DT training may not be an effective complement to gait training with tDCS in PD.