Análise do alinhamento e controle postural do paciente com doença de Parkinson através do software de avaliação postural (SAPO)

Abstract

Introduction: Parkinson's disease (PD), a degenerative nature, idiopathic, features: resting tremor, muscle rigidity, weakness of spontaneous movements, gait, posture flexor, impaired balance, postural changes and instabilities, disability alignment body changes and postural control. For postural assessment we can make use of photogrammetry through Software postural assessment (SAPO). It consists of record photographs of the whole body in different postures plans and providing analysis of the position of anatomical landmarks of the body segments. The present study used the SAPO, understanding be another tool for everyday in the field of postural analysis combining thus the scientific and clinical environments. Objectives: To evaluate the alignment of posture and postural control in patients with Parkinson's disease, aged between 60 and 80 years; identify and quantify the positioning of body segments in the upright posture in frontal, rear, right side and left side. Methods: in this study, 50 individuals with PD, aged 60 to 80 years, 35 men and 15 women. They were divided into groups classified according to the stage of the disease, according to the Rating Scale Unified Parkinson's Disease (UPDRS), and the on-off phase of the medication "levodopa" for DP: Group early-intermediate DP and Group stage intermediate-advanced PD; Group on stage, off stage Group. The pictures analyzed in order anterior, posterior, right lateral and left lateral. Statistical analysis: normality test Kolmogorov-Smirnov (KS), the Gaussian distribution. Used non-parametric statistics between groups, the Mann-Whitney test and descriptive statistics, median and interquartile range with significance level of 5%. View previous deviations were in the initial stage the intermediate without statistical significance. In the intermediate stage to the advanced, there was a significant deviation in the variables of acromions Horizontal Alignment, Horizontal Alignment of the anterior superior iliac spines and the angle between the acromial Two and Two anterior superior iliac spines. Rear view, changes found not demonstrated significant deviation in both stages of PD. Side view of right and left lateral relations were statistically significant for all variables. Median values and interquartile range of the phase groups on and off stage for the views anterior, posterior, right side and left side, showed no significant deviation in both phases of symptoms. The center of gravity shifted to the right with adduction, stages "on" and "off". The correlation between the center of gravity in the frontal and sagittal plane with the dominant hand and the side of symptom onset showed no statistical significance. Discussion: The DP provides pronounced postural change: increased cervical lordosis, kyphosis dorsal; anterioriza head; decreases lumbar curvature, and increases the valgus angle of knee flexion; decreases the support base, step zero, reduces postural stability , flexibility; anteriori the center of gravity, changes the base of support. Conclusion: manifestations and postural sway in PA were present in all profiles photographed.