Comparison of strength training, aerobic training, and additional physical therapy as supplementary treatments for Parkinson’s disease: pilot study Alessandro Carvalho1,2
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OBJECTIVE: To compare verbal fluency among Alzheimer’s disease, Parkinson’s disease, and major depression and to assess the sociodemographic and clinical factors associated with the disease severity. METHODS: Patients from an outpatient... more
OBJECTIVE: To compare verbal fluency among Alzheimer’s disease, Parkinson’s disease, and major depression and to assess the sociodemographic and clinical factors associated with the disease severity. METHODS: Patients from an outpatient university center with a clinical diagnosis of Alzheimer’s disease, Parkinson’s disease or major depression were studied. Severity was staged using the Hoehn & Yahr scale, the Hamilton Depression scale and the Clinical Dementia Rating for Parkinson’s disease, major depression, and Alzheimer’s disease, respectively. All subjects were tested with the Mini-Mental State Examination, the digit span test, and the verbal fluency test (animals). We fit four types of regression models for the count variable: Poisson model, negative binomial model, zero-inflated Poisson model, and zero-inflated negative binomial model. RESULTS: The mean digit span and verbal fluency scores were lower in patients with Alzheimer’s disease (n = 34) than in patients with major dep...
La practica regular de ejercicio fisico puede ayudar a prevenir la enfermedad de Alzheimer (EA) [1] y la demencia vascular [2]. Es mas, el ejercicio ofrece resultados esperanzadores como tratamiento complementario de la demencia [3,4]. No... more
La practica regular de ejercicio fisico puede ayudar a prevenir la enfermedad de Alzheimer (EA) [1] y la demencia vascular [2]. Es mas, el ejercicio ofrece resultados esperanzadores como tratamiento complementario de la demencia [3,4]. No obstante, en determinadas circunstancias, el ejercicio podria afectar negativamente la capacidad cognitiva de los pacientes con EA que presentan un factor de riesgo cardiovascular [5]. Tal podria ser el caso de la demencia mixta, un trastorno mental caracterizado por la presencia de lesiones vasculares, ademas del cuadro clinico tipico de la EA. Segun los estudios neuropatologicos, se calcula que mas de un tercio de los pacientes afectados por la EA presenta esas lesiones [6]. A dia de hoy, pocos estudios han investigado los efectos del ejercicio sobre la cognicion en los pacientes aquejados unicamente de demencia mixta [7]. Por consiguiente, este estudio investigo los efectos del ejercicio fisico en los aspectos cognitivos y funcionales de una pac...
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Objective Evaluate the accuracy of two semantic categories of the verbal fluency test (supermarket and animal categories) to separate healthy elderly individuals and lower educated Alzheimer’s disease patients. Methods We evaluated 69... more
Objective Evaluate the accuracy of two semantic categories of the verbal fluency test (supermarket and animal categories) to separate healthy elderly individuals and lower educated Alzheimer’s disease patients. Methods We evaluated 69 older adults with less than 5 years of schooling, consisting of 31 healthy elderly, and 38 patients diagnosed with Alzheimer’s disease. Semantic verbal fluency was evaluated using the animal and supermarket categories. Mann-Whitney U and Independent t Tests were used to compare the two groups, and the diagnostic accuracy of the tests was analyzed by sensitivity, specificity, likelihood ratio’s, and the Area Under the Curve (AUC). Results We found a significant difference between the healthy older and Alzheimer’s disease groups, in both, animal (p = 0.014) and supermarket verbal fluency (p < 0.001). The supermarket category showed better overall diagnostic accuracy (AUC = 0.840, 95% CI = 0.746-0.933; p < 0.001) compared to the animal category (AUC...
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Research Interests: Psychology and Medicine
Objective To investigate whether the DT performance can be affected by the diagnosis of major depressive disorder (MDD) and Alzheimer’s disease (AD). Methods Cross-sectional data with 108 individuals [Healthy (HE) = 56, MDD =19, AD = 33]... more
Objective To investigate whether the DT performance can be affected by the diagnosis of major depressive disorder (MDD) and Alzheimer’s disease (AD). Methods Cross-sectional data with 108 individuals [Healthy (HE) = 56, MDD =19, AD = 33] aged 60 and older of both sexes diagnosis with AD, MDD, and HE without a clinical diagnosis of mental disorders, residents of the city of Rio de Janeiro. DT performance, was measured by mean velocity (m/s), DT cost and the number of evoked words (DTanimals). One-way ANOVA was used to compare groups. In addition, a logistic regression was used to verify the association between the performance in the DT variables and the risk of MD and AD, controlled by age and scholarity. Results There was a significant difference between the HE and AD groups in the DT variables. The worst performance in the DTC and DTanimals variables increased risk of AD, regardless of age and scholarity (DTC, OR = 5.6, 95% CI = 1.4-22.2, p = 0.01 and DTanimals, OR = 3.6, 95% CI = ...
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To validate the Rowland Universal Dementia Assessment Scale for use in Brazil (RUDAS-BR). We first completed an English-Brazilian Portuguese translation and back-translation of the RUDAS. A total of 135 subjects over 60 years of age were... more
To validate the Rowland Universal Dementia Assessment Scale for use in Brazil (RUDAS-BR). We first completed an English-Brazilian Portuguese translation and back-translation of the RUDAS. A total of 135 subjects over 60 years of age were included: 65 cognitively healthy and 70 with Alzheimer's disease (AD) according to the DSM-IV and Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. All participants completed an interview and were screened for depression. The receiver operating characteristic curves of the RUDAS were compared with those of the Mini Mental State Examination (MMSE) regarding the sensitivity and specificity of cutoffs, taking education into consideration. The areas under the curve were similar for the RUDAS-BR (0.87 [95%CI 0.82-0.93]) and the MMSE (0.84 [95%CI 0.7-0.90]). RUDAS-BR scores < 23 indicated dementia, with sensitivity of 81.5% and specificity of 76.1%. MMSE < 24 in...
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Physical rehabilitation is commonly used in patients with Parkinson's disease (PD) to improve their health and alleviate the symptoms. We compared the effects of three programs, strength training (ST), aerobic training (AT), and... more
Physical rehabilitation is commonly used in patients with Parkinson's disease (PD) to improve their health and alleviate the symptoms. We compared the effects of three programs, strength training (ST), aerobic training (AT), and physiotherapy, on motor symptoms, functional capacity, and electroencephalographic (EEG) activity in PD patients. Twenty-two patients were recruited and randomized into three groups: AT (70% of maximum heart rate), ST (80% of one repetition maximum), and physiotherapy (in groups). Subjects participated in their respective interventions twice a week for 12 weeks. The assessments included measures of disease symptoms (Unified Parkinson's Disease Rating Scale [UPDRS]), functional capacity (Senior Fitness Test), and EEG before and after 12 weeks of intervention. The PD motor symptoms (UPDRS-III) in the group of patients who performed ST and AT improved by 27.5% (effect size [ES]=1.25, confidence interval [CI]=-0.11, 2.25) and 35% (ES=1.34, CI=-0.16, 2.58...
Research Interests: Quality of life, Electroencephalography, Treatment Outcome, Medicine, Physical Therapy, and 15 moreActivities of Daily Living, Gait, Humans, Walking, Female, Male, Resistance Training, Exercise, Clinical Sciences, Aged, Middle Aged, Pilot Projects, Parkinson Disease, Aerobic Exercise, and Severity of Illness Index
Objective To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimer’s disease (AD) patients. Method Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group... more
Objective To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimer’s disease (AD) patients. Method Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group (EG) on a treadmill (30 minutes, twice a week and moderate intensity of 60% VO2max) and control group (GC) 10 patients. The primary outcome measure was the cognitive function using Cambridge Cognitive Examination (CAMCOG). Specifics instruments were also applied to evaluate executive function, memory, attention and concentration, cognitive flexibility, inhibitory control and functional capacity. Results After 16 weeks, the EG showed improvement in cognition CAMCOG whereas the CG declined. Compared to the CG, the EG presented significant improvement on the functional capacity. The analysis of the effect size has shown a favorable response to the physical exercise in all dependent variables. Conclusion Walking on treadmill may be recommended as an augmen...
Research Interests: Psychology, Cognitive Science, Nonparametric Statistics, Cognition, Exercise therapy, and 15 moreMedicine, Physical Therapy, Executive Function, Activities of Daily Living, Memory, Humans, Female, Male, Clinical Sciences, Aged, Middle Aged, Pilot Projects, Alzheimer Disease, Exercise Test, and Neuropsychological Tests
Objective To evaluate the relationship between the quantitative results of functional and cognitive performance of patients with Parkinson's disease (PD) and disease severity; and to study the relationship between patients'... more
Objective To evaluate the relationship between the quantitative results of functional and cognitive performance of patients with Parkinson's disease (PD) and disease severity; and to study the relationship between patients' functional and cognitive capacity and motor impairment (Unified Parkinson's Disease Rating Scale - UPDRS III). Method Twenty-nine subjects clinically diagnosed with PD were classified into three groups according to disease severity using the modified Hoehn and Yahr Scale (H&Y). They were submitted to functional (Senior Fitness Test) and neuropsychological tests. Stepwise regression analysis showed a significant association between H&Y and upper limb strength (r 2 =0.30; p=0.005) and executive function (r 2 =0.37; p=0.004). In relation to UPDRS III, there was a significant association between lower limb strength (r 2 =0.27; p=0.010) and global cognitive status (r 2 =0.24; p=0.024). Conclusion The implementation of simple tests of functional capacity as...
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O objetivo deste trabalho foi realizar um estudo transversal dos pacientes atendidos pelo Serviço Integrado de Atendimento Domiciliar, vinculado ao Hospital Naval Marcílio Dias e a necessidade que eles apresentam de tratamento... more
O objetivo deste trabalho foi realizar um estudo transversal dos pacientes atendidos pelo Serviço Integrado de Atendimento Domiciliar, vinculado ao Hospital Naval Marcílio Dias e a necessidade que eles apresentam de tratamento endodôntico. Foram avaliados através de exame clínico (visual-tátil) 275 pacientes. Os resultados mostram um índice alto de edêntulismo (39%). Dos pacientes que possuíam dentes, 51% apresentavam necessidade de intervenção. Esses pacientes foram separados em três grupos de acordo com a intervenção indicada, 64% foi indicada extração, em 25% indicou-se endodontia e posterior restauração e em 11% foi indicada extração e endodontia em elementos dentários diferentes. Dessa forma, cerca de 36% dos pacientes apresentavam indicação para endodontia. Verifica-se assim, um aumento da demanda de tratamento endodôntico para os idosos.
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To assess cognition in major depressed (MD), Alzheimer's disease (AD), and depression in AD elderly. Subjects were evaluated by Mini Mental, Rey Auditory Verbal Learning Test, Rey Complex Figure, Digit Span, Similarities, Trail Making... more
To assess cognition in major depressed (MD), Alzheimer's disease (AD), and depression in AD elderly. Subjects were evaluated by Mini Mental, Rey Auditory Verbal Learning Test, Rey Complex Figure, Digit Span, Similarities, Trail Making A/B, Verbal Fluency and Stroop. One-way ANOVA and multivariate models were used to compare the performance of each group on neuropsychological tests. We evaluated 212 subjects. Compared to MD, attention, working memory, processing speed and recall showed significantly better in controls. Controls showed significantly higher performance in all cognitive measures, except in attention compared to AD. Verbal fluency, memory, processing speed and abstract reasoning in MD was significantly higher compared to AD. AD was significantly better in general cognitive state than depression in AD. All other cognitive domains were similar. A decreasing gradient in cognition appeared from the control to depression in AD, with MD and AD in an intermediate position.