Efeitos da observação da ação combinada à imagética motora na marcha e atividade eletroencefalográfica de indivíduos com doença de Parkinson: ensaio clínico controlado randomizado

Abstract

This study aimed to verify the effects of the action observation (AO) and the motor imagery (MI) of gait on the physical practice of patients with Parkinson's disease by evaluating the parameters of gait kinematics and mobility in conjunction with the spectral power analysis of alpha and beta oscillatory rhythms on the frontal and frontocentral bilateral cortex. For that, we conducted a randomized controlled experimental protocol with 39 individuals, who were divided into an experimental group (EG = 21) and a control group (CG = 18). The EG training consisted of 12 sessions of AO plus MI and physical gait practice, while the CG was led to observe educational videos and perform physical practices of gait during the same period. Right after the last training session, the gait kinematics and mobility of each subject were assessed, and reevaluated on the first, seventh and thirtieth following days, with electroencephalographic (EEG) data collection. The locomotor training based on the combination of AO, MI and physical practice resulted in an increase of the knee extension at initial contact, of the ankle range of motion, and of the stride length. Therefore, by promoting the improvement of the walking speed and mobility, it proved to be more effective in reducing hip maximum flexion and increasing hip range of motion than the physical practice alone. In addition, the EEG analysis revealed that the right frontal region of EG had a statistically significant increase in alpha relative spectral power, as well as a decrease in beta relative spectral power, when compared to CG, suggesting a strong correlation among the motor improvement and the lower levels of attentional demand during the gait execution after training.