BJMB! ! ! ! ! ! ! ! !
Brazilian(Journal(of(Motor(Behavior(
(
https://doi.org/10.20338/bjmb.v17i4.367
Special issue:
“Control of Gait and Posture: a tribute to Professor Lilian T. B. Gobbi”
PD is the second most common neurodegenerative disease in the world
12
, ranging from 57 (0.057%) to 230 (0.23%) cases for
each group of 100,000 people
13
, mainly affecting the population over 50 years of age
14
. PD is a pathology that affects the central
nervous system (CNS), caused by progressive and asymmetrical degeneration of dopaminergic neurons in the substantia nigra pars
compacta
15
. These neurons are responsible for the production of dopamine – a neurotransmitter that regulates cortex activity
16
. Such
degeneration causes abnormalities in the neurotransmission from the basal ganglia to the different cortical and subcortical areas, such as
the motor cortex
17
. As a result, people with Parkinson’s Disease (PwPD) present motor symptoms, which include tremor, rigidity,
bradykinesia, hypometria, and postural instability
18
. In addition, previous studies have reported gait impairments in PwPD – for example,
a decrease in step length and gait speed, and a longer double support time
19-22
.
Due to the progressive nature of the disease, it is expected that walking impairments in PwPD become worse over time.
Although SI was necessary as a public health measure, this may reduce the physical activity level in PwPD, which may contribute to the
disease progression and lead to negative motor behavior outcomes, including in the gait parameters. In fact, previous studies have
revealed that physical inactivity/sedentary behavior are associated with slower gait speed
23,24
. In addition, the analysis of walking under
different conditions has shown promising results. For example, an analysis of preferred walking speed may estimate physical function,
risk for adverse events (e.g., hospitalization, falls, fractures, or death), and chronic diseases
25-27
, while an analysis of fast walking speed
may estimate the individual’s overall health, skeletal muscle mass quantity, and risk of falls
25
. Thus, studies that verify the effects of SI on
the gait parameters, especially under different conditions, are necessary to deepen the knowledge of this type of situation (lockdown) and
to prevent the worsening of some motor deficits. In this context, the present study aimed at analyzing the effect of SI on the gait
parameters during preferred and fast waking speed in PwPD. Furthermore, in order to identify the factors such as clinical/cognitive
characteristics and physical activity levels that may influence the decline in gait parameters, we also investigated the association between
the change in gait parameters and clinical, cognitive, and physical activity levels characteristics of PwPD. We expected that PwPD with
worse clinical and cognitive characteristics as well as a lower level of physical activity would present a higher decline in gait parameters.
METHODS
Participants
Thirty-three individuals diagnosed with PD who regularly attended the Physical Activity Program for Patients with Parkinson’s
Disease (PROPARKI) prior to the COVID-19 pandemic were selected for this study. For inclusion criteria, the individuals should have a
PD diagnosis based on UK Brain Bank criteria, be of age >50 years, take their PD medication, and have independent locomotion. The
exclusion criteria were: to present musculoskeletal, vestibular, or visual impairments that could affect the performance in the experimental
protocol; to present a score above III in the adapted Hoehn & Yahr scale (H&Y); and cognitive decline indicated by a score <24 in Mini-
Mental State Examination (MMSE)
28
. Seventeen PwPD did not participate in the experimental protocol after the SI. Thus, 16 participants
were analyzed before and after SI (Figure 1). Study approval was obtained from the research ethics committee at São Paulo State
University (n. 3936). All participants gave their signed informed consent before their participation.
Figure 1. Study flowchart.