Efeito do exercício aeróbico comparado a um treino de força na capacidade funcional e qualidade de vida de indivíduos com doença de Parkinson: ensaio clínico randomizado tipo crossover

Abstract

Introduction: Parkinson's disease (PD) is a progressive neurodegenerative condition that affects the functional capacity and quality of life of patients due to its motor and non-motor symptoms. Given the increasing relevance of non-pharmacological interventions, physical exercise has shown promise in managing these symptoms. This master's work resulted in the preparation of two scientific articles: the first describes the protocol of a randomized clinical trial that evaluates the effects of aerobic training and multimodal training in individuals with PD; the second presents the results of a randomized crossover clinical trial that compared the effects of aerobic training and strength training. Objectives: Develop a protocol to evaluate the effects of different types of physical exercise (aerobic and multimodal) in patients with PD and analyze the impacts of aerobic training and strength training on the functional capacity and quality of life of patients with the disease. Methods: The first article describes a randomized, double-blind clinical trial protocol, which will be applied to patients with idiopathic PD in stages I, II and III of the Hoehn & Yahr scale, randomly allocated into two intervention groups: Aerobic Training and Multimodal Training. The interventions will last 12 weeks, with 60-minute sessions, three times a week. The second article details a randomized clinical trial, crossover type, involving 16 patients with PD in the same stages, undergoing Aerobic Training and Strength Training, also for 12 weeks. Both studies used instruments such as the Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (UPDRS), Dynamic Gait Index (DGI), 6-Minute Walk Test (6MWT) and Parkinson Disease Questionnaire 39 (PDQ-39) to evaluation of outcomes. Results: The protocol described in the first article establishes a robust design to investigate the effects of aerobic and multimodal training, contributing to the planning of future interventions in patients with PD. In the second study, the results demonstrated that strength training promoted a significant improvement in global cognition (p = 0.004), while aerobic training improved social support (p = 0.026) and significantly reduced stigma related to PD. Despite these specific differences, no significant interactions were observed for other outcomes, such as balance and gait. Conclusion: The protocol developed in the first study ensures the transparency of the research process, allowing the reproducibility of the methods and minimizing possible biases. The second study highlights the relevance of physical training as a non-pharmacological intervention, highlighting that aerobic and strength modalities offer specific benefits. The individualization of interventions is essential to meet the particular demands of patients and enhance the results achieved.