Yamaguchi B1, Iucksch D1, Silva A1, Siega J2, Israel V1
1Universidade Federal do Paraná, Curitiba, Brazil, 2UFPR, Curitiba, Brazil
Background: Aquatic physical therapy (APT) has been increasingly used for kinetic-functional recovery of patients with Parkinson´s Disease (PD). APT is safe and motivating for this population and has shown to be able to assist motor features, mainly postural instability, bradykinesia and PD rigidity. For assessment in APT, the Assessment Functional Aquatic Scale (AFAS), initially developed for subjects with spinal cord injury, is used to assess the motor skills and the adaptation the patient with PD. It presented reliable reproducibility between the different observers (ICC inter-raters: 0.887 good), as well as repeatability (ICC intra-raters: 0.959 excellent).
Purpose: To verify the performance in the AFAS evaluation in its phases, of subjects adapted and not adapted to the aquatic environment and correlate it the Hoehn and Yahr (HY) staging scale.
Methods: Participants were invited to join in the research, which took place in a southern capital of Brazil. The patients were assessed by AFAS by a team of physiotherapists. The assessment was taped and then scored in the 31 AFAS items, composed by Adaptation (A); Mastering of Liquid Environment (D); Specialized Therapeutic Exercise (E) and Global Organic Fitness (Cd). Other AFAS trained physiotherapist performed a separate score (5 being fully motor skill achieved and 1 when he/she was unable to perform aquatic motor skill). Previous experience in the aquatic environment and HY scale was also evaluated.
Results: 34 participated in the research (17 = male; 17 = female). Age 64.5 ± 1.88 years. 15 reported having previous experience in Aquatic Environment. The mean AFAS score was 101 ± 3.65 The HY score showed a significant correlation of the A (p = 0.05 rô = -0.774), D (p = 0.03 rô = -0.854) and Cd (p = 0.014 r = -0.939). When comparing the participants with previous experience in water, it was observed that they did not have a higher overall score (p = 0.071). But in the A (p = 0.01) and Cd (p = 0.004) phases there was a difference between the participants with previous experience in Aquatic Environment, indicating a benefit.
Conclusion(s): In addition to assessment in Land environment, APT performance should be evaluated on a scale appropriate to the environment. AFAS demonstrates greater influence of the subjects previous experience in APT than in the severity of the disease, being possible to apply it at any HY level. In literature searches it was not possible to find other Assessment scales in APT.
Implications: Knowing the performance in APT helps to define the correct exercises, whilst making its application safer.
Keywords: Parkinson's Disease, Physical therapy, Hydrotherapy
Funding acknowledgements: Scholarship Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Brazil
Purpose: To verify the performance in the AFAS evaluation in its phases, of subjects adapted and not adapted to the aquatic environment and correlate it the Hoehn and Yahr (HY) staging scale.
Methods: Participants were invited to join in the research, which took place in a southern capital of Brazil. The patients were assessed by AFAS by a team of physiotherapists. The assessment was taped and then scored in the 31 AFAS items, composed by Adaptation (A); Mastering of Liquid Environment (D); Specialized Therapeutic Exercise (E) and Global Organic Fitness (Cd). Other AFAS trained physiotherapist performed a separate score (5 being fully motor skill achieved and 1 when he/she was unable to perform aquatic motor skill). Previous experience in the aquatic environment and HY scale was also evaluated.
Results: 34 participated in the research (17 = male; 17 = female). Age 64.5 ± 1.88 years. 15 reported having previous experience in Aquatic Environment. The mean AFAS score was 101 ± 3.65 The HY score showed a significant correlation of the A (p = 0.05 rô = -0.774), D (p = 0.03 rô = -0.854) and Cd (p = 0.014 r = -0.939). When comparing the participants with previous experience in water, it was observed that they did not have a higher overall score (p = 0.071). But in the A (p = 0.01) and Cd (p = 0.004) phases there was a difference between the participants with previous experience in Aquatic Environment, indicating a benefit.
Conclusion(s): In addition to assessment in Land environment, APT performance should be evaluated on a scale appropriate to the environment. AFAS demonstrates greater influence of the subjects previous experience in APT than in the severity of the disease, being possible to apply it at any HY level. In literature searches it was not possible to find other Assessment scales in APT.
Implications: Knowing the performance in APT helps to define the correct exercises, whilst making its application safer.
Keywords: Parkinson's Disease, Physical therapy, Hydrotherapy
Funding acknowledgements: Scholarship Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Brazil
Topic: Neurology: Parkinson's disease; Outcome measurement
Ethics approval required: Yes
Institution: Federal University of Parana - Brazil
Ethics committee: Ethics Committee of Research Universidade Federal do Paraná, Brazil
Ethics number: CAAE: 66781417.4.0000.0102, number: 2.200.372.
All authors, affiliations and abstracts have been published as submitted.
