Dados do Trabalho

Título

Analysis of upper limb strength in patients with Parkinson's disease: a descriptive cross-sectional study.

Resumo

INTRODUCTION: Parkinson’s disease (PD) is a neurodegenerative disorder caused by disruption of the dopaminergic system. The muscle weakness is one of the main complaints reported by patients with PD, given the impacts on day-to-day activities. The clinical diagnosis of PD is based primarily on motor features, that usually starts in the upper limbs. The involvement of handgrip strength can be considered as an intrinsic characteristic of PD, besides being correlated with the motor symptom severity of the disorder. OBJECTIVE: Correlate upper limb strength to the disability in patients with PD. METHOD: Descriptive cross-sectional study with PD patients from the Movement Disorders outpatient clinic of a tertiary hospital carried out from September/2020 to May/2022. Demographic, clinical data and upper limb strength measurements were collected using the SAEHAN handgrip test with dynamometer according to the Southampton protocol and the cutoff suggested by the Revised European Consensus on Sarcopenia (2019) of <27kg for men and <16kg for women as determinants of weakness. PD staging was assessed using the modified Hoehn&Yahr (HY) scale and functionality using the Schwab-England (SE) scale. Eligibility criteria were mild to moderate PD (HY 1-3), no other neurological diseases with motor impairment, no chronic diseases with acute instability and no health conditions that compromise mobility. RESULTS: The sample consisted of 125 patients, of which 72 (57.6%) were men and 53 (42.4%), women; 56.8% had a family history of PD, 53.6% had dyskinesia, 43.2% reported FOG, 20.8% needed walking aids and 41.6% were physically active. The comorbidities were: SAH (47.2%), depression (17%), PLD (16%) and DM2 (11.2%). Twenty-five patients (20%) had reduced palm strength, with an average age of 64.4 years in the group with normal examination and 71.1 years in the group with alterations. Of these, 12 were women and 13, men; 12 patients (48%) had SAH, 2 (8%) DM2, 3 (12%) PLD, and 9 (36%) depression. In the group with weakness in the upper limbs, the prevalent HY was 3, in 13 patients (52%); 3 (12%) had HY=2 and 9 (36%) had HY=2.5. CONCLUSION: Study carried out with Brazilian elderly had 28.2% dynapenic, compared to the 20% recorded in this analysis in patients with PD and a mean age of 71.1 years. Despite the correlation between the decreased upper limb strength in PD and a greater impairment of manual dexterity, it is important that further studies are carried out in this area.

Palavras Chave

Parkinson's Disease; Sarcopenia; Upper limb