Progressive Muscular Strength Protocol for the Functionality of Upper
Limbs in Individuals with Parkinson’s disease: Protocol Study
Thais Vianna Correa
1
, Vera Lúcia Santos de Britto
2
and Clynton Lourenço Correa
1,2*
1
Program of Physical Education, Universidade Federal do Rio de Janeiro, Brazil
2
Physical Therapy Course, Universidade Federal do Rio de Janeiro, Brazil
*
Corresponding author: Dr. Clynton Lourenço Correa, Laboratório de Neurobiologia Comparativa e do Desenvolvimento, Instituto de Biofísica Carlos Chagas Filho,
Universidade Federal do Rio de Janeiro, Brazil, Tel: 55-21-995226017; E-mail: clyntoncorrea@hucff.ufrj.br
Received date: October 31, 2017; Accepted date: November 16, 2017; Published date: November 22, 2017
Copyright: © 2017 Correa TV, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: There is a lack understanding between the possible effects of physical intervention in motor
function of the upper limbs and quality of life in patients with PD.
Objective: To present a progressive muscular strengthening protocol of the upper limbs with focus on the
functional capacity.
Methods: The sample has been chosen for convenience. The patients have been divided into two groups:
Intervention and Control which have not been distributed randomly. The following instruments have been chosen to
be evaluating results: Unified Parkinson Disease Rate Scale, Parkinson's Disease Questionnaire, Nine Hole Peg
Test, Test d'Evaluation des Membres Superieurs of Personnes Âgées and handgrip dynamometer. All these
instruments have to be applied before and after the training phase which is for 2 months, twice a week and follow up
period for one month after the last training session. For demographic characteristics of the sample, descriptive
statistics have to be used. The Shapiro-Wilk test has to examine the normality of the sample. Parametric or non-
parametric tests have to be performed to check if there is a significant statistical difference between pre- and post-
training and follow-up, as correlation tests, pre- and post-training. The significance level of 5% for all procedures
have to be adopted.
Results: The strength training has to combine isotonic and isometric exercises using elastic tubes for upper
limbs. The program has to be carried out for two months, totalizing 16 sessions. Five subjects in each group started
the program, but have not yet finished. Results are expected in 2018.
Discussion: Most studies on muscle weakness in PD focus on the evaluation aspect. Cover mainly studies of
physical rehabilitation the lower limbs, and focus on gait and balance. Therefore, it is important to carry out studies
that investigate the possible effects of a progressive muscular strengthening protocol in upper limbs in PD patients.
Keywords: Parkinson’s disease; Physical therapy (modalities); Upper
limbs; Strengthening; Rehabilitation; Disability evaluation; Exercise
therapy
Introduction
Parkinson’s disease (PD) is primarily a neurodegenerative disorder
afecting the motor control. More precisely in the substantia nigra pars
compacta compromising the nigrostriatal pathway where the motor
symptoms are caused by the degeneration of dopaminergic neurons
that participate [1-3].
Diagnosis of PD is predominantly based on clinical features and the
diagnostic criteria. Te most widely accepted in the world are those
that comprise the UK Parkinson’s Disease Society Brain Bank. Tese
are: rigidity, bradykinesia, resting tremor, postural instability and gait
disorders [4,5]. Moreover, the Movement Disorders Society has
included non-motor symptoms as clinical manifestations of PD [5]. In
the literature, some authors have been discussing the presence of
muscle weakness as an intrinsic symptom of PD or a secondary
symptom due to disuse [6-8].
PD produces deterioration of the motor function over the course of
the disease, which results in an increase in the number, and severity of
symptoms. Te motor symptoms progressively produce more
restrictions and reduction in dependency of activities of daily living
(ADLs). Tus causing a worsening in quality of life [9-12].
Some authors have been pointing out the possible origin of the
muscle weakness in PD in comparative studies with control group
matched with age and gender [13-16].
Studies on physical rehabilitation in PD mostly highlight lower
limbs, gait and balance impairments [17-22]. Tose that focus on
upper limbs are, in its majority, evaluate mostly aspects in either
coordination, strength, power, bradykinesia or functionality
[6,14,16,23-25]. Tere are only three studies focused on the efects of
some type of muscle strengthening in the upper limbs. None, however,
about functionality [26-28]. Terefore, there is a lack of understanding
between possible efects of the physical rehabilitation in upper limbs of
PD patients.
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ISSN: 2329-9096
International Journal of Physical
Medicine & Rehabilitation
Correa et al., Int J Phys Med Rehabil 2017, 5:6
DOI: 10.4172/2329-9096.1000436
Protocol Article Open Access
Int J Phys Med Rehabil, an open access journal
ISSN:2329-9096
Volume 5 • Issue 6 • 1000436