Continuous Behavior Assessment of the Effects of a Physical Therapy Program for Patients With Parkinson's Disease
Continuous Behavior Assessment of the Effects of a Physical Therapy Program for Patients With Parkinson's Disease
Introduction: Parkinson's disease (PD) results from dysfunction of the dopaminergic system of
 degenerative and progressive, with changes in the nigrostriatal pathway, and decreased
 concentration of dopamine. Has as clinical signs, symptoms called cardinal engines: resting
 tremor, bradykinesia, rigidity and postural instability. In addition to drug therapy,
 physical therapy is also considered a useful tool for the treatment of motor disorders of the
 disease. The role of physiotherapy aims to stimulate the security and independence of
 patients with PD in carrying out activities and to preserve and improve physical function.
 Some studies have shown the negative effect of the disease on quality of life and functional
 mobility. Few studies have been conducted to evaluate the effects of long-term therapy in PD,
 but many report the beneficial effects of a rehabilitation program in a short period of time.

 Objective: To continually assess the effects after the completion of a physical therapy
 program in patients with Parkinson's disease.

 Methods: Type study randomized double blind clinical trial in Parkinson Pro Program Hospital
 of the Federal University of Pernambuco. Will be recruited subjects with PD, both sexes, in
 stages 1 to 3 on the scale of Hoehn Yahr and score greater than 18 on the Mini-Mental.
 Patients who are recruited will undergo an assessment using the scales of assessment of
 functional mobility, quality of life and motor examination before starting physical therapy
 at the end of treatment and two months after completion of treatment, and the intervals
 assessments of a month.
The Parkinson's disease results from dysfunction of the dopaminergic systems, cholinergic,
 serotonergic and noradrenergic, though the neuropathological basic pattern is the change of
 the nigrostriatal pathway, with decreased concentration of dopamine at the level of dopamine
 receptors in the body striatum.

 With still little known etiology in most instances, the Parkinson's disease has as clinical
 signs, symptoms called cardinal engines: resting tremor, bradykinesia, rigidity and postural
 instability. Additionally, patients may exhibit cognitive deficits and emotional changes with
 the progression of the disease.

 The clinical diagnosis is primarily based on the identification of the cardinal motor
 symptoms plus the initial response to levodopa therapy . The literature is unanimous in
 admitting that the use of Levodopa (L-dopa) is the most effective drug for the treatment, and
 its administration the most recommended in satisfactory symptom control.

 In addition to drug therapy, physical therapy is also considered a useful tool for the
 treatment of motor disorders associated disease. Although the speed of the motor of the
 patient learningParkinson's disease is lower than their control group of the same age,
 rehabilitation, these individuals may also acquire motor skills as well as improve their
 performance through practice repetition.

 Although a physical rehabilitation program to be beneficial to improve the activities of
 daily living (ADL) and mobility in patients with Parkinson's disease , it is not yet clear
 how long its effect is sustained. Most clinical trials of physiotherapy in PD were based on
 short-term rehabilitation programs.

 Few studies have been conducted to evaluate the effects of long-term physical therapy in
 Parkinson's disease, but many report the beneficial effects of a short-term rehabilitation
 program, without having to concern monitoring after the physical therapy.

 Thus this study aims to continuously evaluate the behavior of the effects of a physical
 therapy program in patients with Parkinson's disease.

 Knowledge of the time interval which is the decline of the gains from physiotherapy is a
 guiding point to guide the patient regarding their return to service for revaluation, also
 considering the fact that the disease have progressive.
Inclusion Criteria:

 1. Patients diagnosed with Idiopathic Parkinson's disease according to the Bank of London
 Brain (Hughes et al, 1992);

 2. Both sexes;

 3. Patients in stages 1 through 3 for this modified version of the Hoehn & Yahr scale
 (HY);

 4. the patient Agreement to participate in the research after explanation and
 understanding of it and signing the Consent and Informed.

 Exclusion Criteria:

 1. cognitive disorder identified by the Mini-Mental State Examination as schooling ;

 2. Patients with other neurological diseases;

 3. initiate other rehabilitative treatment throughout and after the physical therapy
 program.