Funções executivas, atividades da vida diária e habilidade motora de idosos com doenças neurodegenerativas

Risks of Accidents Caused by the Use of Smartphone by Pedestrians Are Task- and Environment-Dependent

Using smartphones during a task that requires an upright posture can be detrimental for the overall motor performance. The aim of this study was to determine the risks of accidents caused by the use of smartphones by pedestrians while walking in a controlled (laboratory) and a non-controlled (public street) environment. Two hundred and one participants, 100 men and 101 women, all young adults, were submitted to walking activities while texting messages and talking on the phone. The risk of accident was measured by the time and the number of steps necessary to walk a 20 ft distance. Assessments were performed with no external distractors (laboratory) and on a public street with vehicles, pedestrians, lights, and noises. Multivariate analysis of variance tests provided the main effect of task (using × not using smartphone), environment (laboratory × street), sex (men × women), and interactions. Significance was set at 5%. The results showed that using a smartphone while walking demanded a greater number of steps and time to perform the task (main effect of task: 0.84; p = 0.001). The risk of accident was higher on the streets where, due to traffic hazards, pedestrians performed the task faster and with a lower number of steps (the main effect of environment: 0.82; p = 0.001). There was no difference of risks between men and women (main effect of sex: 0.01; p = 0.225), whether in the laboratory or on the street (main effect of sex × environment: 0.01; p = 0.905). The task × environment interaction showed that using a smartphone on the street potentiates risks of accidents of pedestrians (main effect of task × environment: 0.41; p = 0.001). In conclusion, using a smartphone while walking can be risky for pedestrians, especially in a traffic environment. People should avoid using their smartphone while crossing streets.

Dual-task intervention based on trail making test: Effects on Parkinson's disease

OBJECTIVE

To evaluate the effectiveness of an intervention with dual task based on trail making test on gait, cognition and daily activities execution in individuals with Parkinson's disease.

DESIGN

Randomized controlled trial.

METHODOLOGY

10 individuals with Parkinson's Disease (PD) were divided into dual task group (DTG) and control group (CG). Were realized 16 dual task (DT) training sessions based on the Trail Making Test (TMT) for DTG and a conventional training protocol for CG. Pre and post intervention assessments used the 6 minute walk test (T6), TMT, Katz Index and Falls Efficacy Scale (FES).

RESULTS

Comparing the difference between pre and post intervention values between groups, there was no significant difference for T6 (p=0,36). In TMT there was a significant difference (p=0,03), showing shorter times for DTG. The tests used for time values in the Katz index tasks showed an important difference for the DTG (P=0,02). As for the results of the FES, they did not show pre and post changes in the DTG (0,45) and in the CG (p= 0,29) and not even between the groups (p=0,45).

CONCLUSION

The proposed intervention was able to promote improvements in the performance of daily life activities, learning adaptations and retention of motor and cognitive aspects, which may reflect positively in the daily lives of patients with PD and, consequently, greater autonomy to perform these types of activities.

An Exploration of Equine-Assisted Therapy to Improve Balance, Functional Capacity, and Cognition in Older Adults With Alzheimer Disease

BACKGROUND AND PURPOSE

Alzheimer disease (AD) is a chronic, progressive dementia syndrome that features cognitive and behavioral symptoms, as well as physical and functional limitations that develop over the course of the disease. As an activity that involves physical and cognitive aspects, equine-assisted therapy (EAT) could be a useful therapeutic approach in conditions that involve physical and cognitive decline. However, to date, there are no reports of the use of this therapy in participants with AD. Within this context, the objective of this case series was to describe the effects of EAT on balance, functional capacity, and cognition in older adults diagnosed with AD.

METHODS

We enrolled 9 participants, of both sexes, with a mean age of 79.7 (7.8) years and a diagnosis of AD. The study intervention comprised 20 sessions of EAT. We evaluated participants at baseline and at the end of the intervention. Outcome measures were balance (force plate), functional capacity (Timed Up and Go test and 30-second chair stand test), and cognition (verbal fluency and Mini-Mental State Examination).

RESULTS

Comparison between the pre- and postintervention time points (Wilcoxon test) revealed significant improvements in balance (center of pressure in the anterior-posterior direction, P = .017) and functional capacity (Timed Up and Go test, P = .036, and 30-second chair stand test, P = .012).

CONCLUSION

These findings provide evidence of an association between EAT and improved balance and functional capacity in older adults with AD, with no significant impact on cognitive performance.

Validity evidence of the Zulliger-CS in older adults with Parkinson’s disease

Abstract The ethical principles of psychological assessment include the need to use reliable tests to meet the demands of the emerging population. Therefore, the present study sought to provide evidence of validity of the Zulliger Comprehensive System (Zulliger Test in the Comprehensive System) considering the constructs: self-perception and interpersonal relationships. A total of 61 older adults of both sexes participated in the study; 30 had Parkinson’s disease (clinical group) and 31 were healthy (non-clinical group). The clinical group showed an increase in the following variables: Human detail (p = 0.02, d = 0.50); Morbid responses (p = 0.025, d = 0.62); Vista responses (p = 0.016, d = 0.72), Food Responses (p = 0.021, d = 0.61) and Decrease in human detail fictional (p = 0.012, d = -0.65) and in Personalized Responses (p = 0.003, d = -0.48). There was a positive relationship between the Zulliger Test in the Comprehensive System variables and age, income, and disease severity and a negative relationship between the Zulliger Test in the Comprehensive System variables and time since diagnosis. The results obtained confirm the validity of the Zulliger Test in the Comprehensive System and encourage further studies.

Benefits of Exercise on the Executive Functions in People with Parkinson Disease: A Controlled Clinical Trial

OBJECTIVE

We have made a 3-arm trial (group vs. individual exercise vs. no treatment) to test the effects of a 6-month exercise program upon the executive functions in participants with Parkinson disease.

METHODS

Twenty-four subjects were randomly allocated in 3 groups and undertook individualized exercises (G1, n = 8), group exercises (G2, n = 8), or monitoring (G3, n = 8). Executive functions were evaluated by means of the Wisconsin card sorting test and the Raven colored matrices, both assessed at the beginning of the program and after 6 months. The statistical analyses consisted of the application of repeated measurement tests, with a significant level of 5%.

RESULTS

The findings showed similar behavior of groups in terms of the Wisconsin card sorting test (P = 0.792), reporting no benefit of the program on such instrument. Differently, Raven colored matrices evidenced a significant benefit provided by the intervention (P = 0.032). Compared with the control group, individuals from G1 had a substantial improvement on executive functions (P = 0.031) and from G2 had a trend of significance (P = 0.072).

CONCLUSION

Findings of this study show that 6 months of exercise improved some aspects of executive functions when compared with control peers. Individual therapy seems to have a more prominent improvement than group therapy.

Cognitive processes affect the gait of subjects with Parkinson’s and Alzheimer’s disease in dual tasks

Objective To investigate the relation between gait parameters and cognitive impairments in subjects with Parkinson’s disease (PD) and Alzheimer’s disease (AD) during the performance of dual tasks. Methods This was a cross-sectional study involving 126 subjects divided into three groups: Parkinson group (n = 43), Alzheimer group (n = 38), and control group (n = 45). The subjects were evaluated using the Timed Up and Go test administered with motor and cognitive distracters. Gait analyses consisted of cadence and speed measurements, with cognitive functions being assessed by the Brief Cognitive Screening Battery and the Clock Drawing Test. Statistical procedures included mixed-design analyses of variance to observe the gait patterns between groups and tasks and the linear regression model to investigate the influence of cognitive functions in this process. A 5% significant level was adopted. Results Regarding the subjects’ speed, the data show a significant difference between group vs task interaction (p = 0.009), with worse performance of subjects with PD in motor dual task and of subjects with AD in cognitive dual task. With respect to cadence, no statistical differences was seen between group vs task interaction (p = 0.105), showing low interference of the clinical conditions on such parameter. The linear regression model showed that up to 45.79%, of the variance in gait can be explained by the interference of cognitive processes. Conclusion Dual task activities affect gait pattern in subjects with PD and AD. Differences between groups reflect peculiarities of each disease and show a direct interference of cognitive processes on complex tasks.