Análise cinemática do movimento uniarticular do punho de sujeitos com e sem doença de Parkinson

Abstract

Parkinson´s disease is a chronic, neurodegenerative disorder classically characterized by four signs and motor symptoms: tremor at rest; muscle stiffness; bradykinesia and postural instability. The motor signs imply difficulties in implementing and controlling movements. Taking into consideration the importance of speed in the control of movements, in 1989 Gottlieb and colleagues, and Corcos and colleagues proposed the dual theory of motion which says that the increasing of the movement distance is accompanied with increasing of the motor neuron impulse activation duration, and the increasing of the speed or of the target diameter progresses with the increasing of the activation pulse amplitude. Thus, seeking to test the dual strategy of the movement, this dissertation will be presented three papers. The first one is a systematic review of the studies that, using electromyography, analyzed the control of single joint movements of the upper limbs of PD patients. The second and third papers are two cross-sectional studies that test in practice the pulse width and pulse height theories of the dual movement strategy. The literature review shows that the parkinsonian´s upper limb single joint movements control only obey the pulse height theory of motoneuron activation. On the second paper experiment, the subjects should perform wrist flexion at three different distances. While the activation magnitude showed inalterable to the increase of distance of motion, the impulse duration is significantly greater at longer distances in both subjects (p = 0.015) and in subjects without PD (p = 0.020). There was no difference in duration of acceleration impulse between subjects with and without DP (distance 1 (z = -, 347, p = 0.733); distance 2 (z = -, 494; p = 0.627), distance 3 (z = - 585; p = 0.577)). On the third paper experiment, the subjects should perform wrist flexion at the same distance but in three targets with three different diameters. The diameters increase caused no target modulation of the duration of the acceleration for both Group 1 (p = 0.920) and group 2 (0.939). Yet, there was no difference in duration between the two groups (diameter 1 (Z = -1.425, p = 0.162), diameter 2 (Z = -1.042; p = 0.297), diameter 3 (Z = -0.968; p = 0.339)). Only the acceleration amplitude scale with varying diameters for both the group 1 (p = 0.000) and group 2 (p = 0.004). Comparing the groups there was no difference in the pulse width to the diameter variation of the targets (diameter 1 (z = -1.461, p = 0.151), diameter 2 (z = -1.351, p = 0.186), diameter 3 (z = -1.643; p = 0.105)). Thus, the results of the second and third studies show that the subjects with and without DP obey both pulse width and pulse height theories of the dual movement theory.