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Israel V.1, Yamaguchi B.2, Silva A.Z.2
1Universidade Federal do Paraná, Physical Therapy, Curitiba, Brazil, 2Universidade Federal do Paraná, Programa de Pós Graduação em Educação Física, Curitiba, Brazil
Background: The Parkinson's disease (PD) is nowadays one of the world's most incident neurodegenerative diseases, which brings motor and non-motor consequences caused due to the reduction on the capabilities of many neurotransmitters, mainly Dopamine. During the health's interdisciplinary management of the PD patients, the physiotherapy operates on patient's health with physical-functional exercises as a mechanism of neuroplasticity and neuroprotection. One of the Physiotherapy's strategies to intervene is hydrotherapy, which allies, in a warm pool, the kinetics and the functional activities to physical and thermic properties. In order to do that, specific physiotherapeutic evaluation methods are necessary.
Purpose: Using an Aquatic Functional Assessment Scale (AFAS) on patients with PD and correlate it with the PD scales of terrestrial evaluation.
Methods: Approved by Ethics Committee of Hospital do Trabalhador (CAAE: 05271512.7.0000.5225), Curitiba, Brazil.** Cross-sectional study in which were evaluated patients with PD on age, sex, time of diagnose, Hoehn and Yahr Degree of Disability Scale (HY), Unified Parkinsons Disease Rating Scale (UPDRS) part II and III (daily life and motor activities respectively) and AFAS, which verifies, in the aquatic environment, the adaptation and independence of each patient over their 31 motor skills, adding to the terrestrial evaluation. The score of each test goes from 1 to 5. 5 would be the best motor capacity, varying the total score from 31 to 155. For the replicability of AFAS it was used the Interclass Correlation Coefficient (ICC), intra and inter-evaluator, through the score of videos taken during the evaluations. It was also used the Spearman and Pearson tests to determinate the shared and exclusive variation between AFAS and the other variables.
Results: 17 participants with PD were evaluated through AFAS (8 men and 9 women). The average, the Standard Deviation and the Confidence Interval of 95% (CI) of the variables were: Age 62,82±12,13 years, CI [56,59-69,06]; time since diagnose 71,65±43,6 months, CI [49,23-94,07]; AFAS 109,59±23,27, CI [97,62-121,56]; UDPRS II 11,35±6,23, CI [8,15-14,56]; UPDRS III 14,18±6,87, CI [10,64-17,71] and the HY scale, presented in an 50% median, 25-75%: 3, 1,5-3,0. The ICC intra-evaluators was of 0,887 and the inter-examinators was 0,754, and both would be indicators of good replicability. As for the correlation between the AFAS and the other variables, were of moderate inverse correlation UPDRS II (r: -0,540, IC [-0,472-0,566], p: 0,836) and age (r:0,481, CI [-0,769-0,180], p:0,131). The correlations were weak of the time of (r: 0,05, [-0,504-0,495], p:0,98); UPDRS III (r: 0,214, [-0,504-0,495], p:0,408), and HY (r:0,120, [-0,329-0,575], p: 0,645)1 (1 = Spearman test).
Conclusion(s): The AFAS permitted to measure the motor capacities of the PD patients in the aquatics environment in a ambiance phase, liquid-based domain, specialized therapeutic exercises and global organic conditioning. It presents a trustable replicability between different evaluators, such as reliability in the evaluation with the same evaluator in different periods.
Implications: It presented, during this study, moderate correlation with daily life activities and age, indicating that, the bigger the age the lower is the development during aquatic motor skills.
Funding acknowledgements: Supported by National Counsel of Technological and Scientific Development (CNPq) through masters degree research and educational scholarships.
Topic: Neurology: Parkinson's disease
Ethics approval: Approved by Comitê de Ética em Pesquisa com Seres Humanos do Hospital do Trabalhador (CAAE: 05271512.7.0000.5225), Brazil.
All authors, affiliations and abstracts have been published as submitted.
