Efectos del entrenamiento con plataforma posturogrĂĄfica sobre el control postural en pacientes con enfermedad de parkinson en estadio I y II segĂșn la escala de Hoehn y Yahr
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2011
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Universidad Andrés Bello
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Marco teĂłrico: La Enfermedad de Parkinson (EP) es una enfermedad neurodegenerativa crĂłnica, progresiva que afecta la calidad de vida de las personas que la padecen. En la actualidad el objetivo terapĂ©utico fundamental en la EP, es reducir su progresiĂłn, controlar los sĂntomas y los efectos secundarios de los fĂĄrmacos que se usan para combatirla.
En Chile para el tratamiento de la EP se ocupa la âGuĂa clĂnica GES 2008â del Ministerio de Salud y para la rehabilitaciĂłn, la âGuĂa de rehabilitaciĂłn de la Enfermedad de Parkinsonâ que hace hincapiĂ© en un abordaje integral y multidisciplinario, desde el diagnĂłstico y durante toda la evoluciĂłn de la patologĂa, pero existen muy pocas medidas para poder disminuir o atenuar los trastornos en la estabilidad y en el control postural.
MĂ©todo: El objetivo de la investigaciĂłn fue comparar el efecto del tratamiento mĂ©dico y de rehabilitaciĂłn convencional en base a la GuĂa GES mĂĄs un entrenamiento posturogrĂĄfico con el tratamiento mĂ©dico y de rehabilitaciĂłn convencional sobre el ĂĄrea del centro de presiĂłn, la velocidad media, la energĂa total y el Ăndice de Romberg en pacientes con Enfermedad de Parkinson en estadios I y II segĂșn escala Hoehn y Yahr. Once pacientes del Grupo de Pacientes con Enfermedad de Parkinson y sus Familiares (GRUPARFA) de la ciudad de ConcepciĂłn participaron en la investigaciĂłn los cuales, fueron asignados aleatoriamente en dos grupos; uno control (nÂș5) y otro grupo experimental (nÂș6). Las variables posturogrĂĄficas evaluadas con la plataforma posturogrĂĄfica Artoficio fueron: velocidad media (m/s), ĂĄrea del centro de presiĂłn (mÂČ) y energĂa total (J) en condiciĂłn vista al frente y ojos cerrados e Ăndice de
Romberg. Los pacientes del grupo experimental recibieron tratamiento mĂ©dico y de rehabilitaciĂłn convencional en base a la GuĂa GES mĂĄs un entrenamiento posturogrĂĄfico, mientras que el grupo control solo recibiĂł tratamiento mĂ©dico y de rehabilitaciĂłn convencional.
Resultados: Al comparar los valores iniciales de ambos grupos se observa que existe igualdad de medias pre-prueba (p > 0,05) para todas las variables excepto para la variable energĂa vista al frente pre (p = 0,005) y la variable energĂa ojos cerrados pre (p = 0,009), lo que indica que estas dos Ășltimas variables no se encontraban en igualdad de condiciones en ambos grupos al inicio del estudio. Al comparar los valores medios de las variables post intervenciĂłn se observa que en todas ellas existen diferencias significativas entre el grupo experimental y el grupo control, excepto para la variable ĂĄrea CP ojos cerrados post (p = 0.164). Se dejaron afuera del anĂĄlisis las variables energĂa con vista al frente y ojos cerrados, pues tambiĂ©n presentaban respuestas promedio diferentes en la pre-prueba. Al analizar las diferencias preprueba- postprueba se comparĂł el valor medio de cada variable entre grupos, encontrĂĄndose que no existen diferencias significativas en ninguna de ellas (p>0,05) excepto en el Ăndice de Romberg (p=0,017), donde el grupo experimental aumentĂł en un 103,15% como valor medio y el grupo control disminuyĂł en un 32%.
Theoretical Framework: Parkinson's Disease (PD) is a chronic neurodegenerative disease, progressive, that affect the quality of life of people who have it. At present the key therapeutic target in PD is to reduce its progression, control symptoms and side effects of drugs used to combat it. In Chile for the treatment of PD takes the "GES Clinical Guide 2008" the Ministry of Health and for the rehabilitation, the "Guide for the rehabilitation of Parkinson's Disease" that emphasizes a holistic and multidisciplinary approach from diagnosis and throughout the course of the condition, but there are very few measures to reduce or mitigate the disruption to the stability and postural control. Method: The research objective was to compare the effect of medical treatment and rehabilitation based on conventional GES Guide more posturography training with medical treatment and conventional rehabilitation on on the center of pressure area, average speed, total energy and Romberg index in patients with Parkinson's disease in stages I and II according to Hoehn and Yahr scale. Eleven patients in the group of patients with Parkinson's Disease and Their Families (GRUPARFA) from Concepcion City participated in the study who were randomized into two groups: one control (No. 5) and one experimental group (n 6). The variables evaluated with the posturographic platform Artoficio were: average speed (m / s), center of pressure area (mÂČ) and total energy (J) under the front sight and eyes closed and romberg index. The experimental group received medical treatment and rehabilitation based on conventional GES Guide more posturography training, while the control group only received medical treatment and conventional rehabilitation. Results: When comparing the initial values of both groups shows that there is equality of means pre-test (p> 0.05) for all variables except for variable energy with front view pre (p = 0.005) and the variable energy with eye closed pre (p = 0.009), indicating that these two variables were not equal in both groups at baseline. Comparing the mean of variables post-intervention shows that in all are significant differences between the experimental and control groups, except for the variable center of pressure area (CP) with eyes closed post (p = 0.164). They left out the analysis the energy variables overlooking the forehead and eyes closed, as they also had different mean responses in the pre-test. When analyzing pretest-posttest differences comparing the average value of each variable between groups, they found no significant differences in any of them (p> 0.05) except in the Romberg index (p = 0.017), where the group experimental increased by 103.15% as mean value and the control group decreased by 32%.
Theoretical Framework: Parkinson's Disease (PD) is a chronic neurodegenerative disease, progressive, that affect the quality of life of people who have it. At present the key therapeutic target in PD is to reduce its progression, control symptoms and side effects of drugs used to combat it. In Chile for the treatment of PD takes the "GES Clinical Guide 2008" the Ministry of Health and for the rehabilitation, the "Guide for the rehabilitation of Parkinson's Disease" that emphasizes a holistic and multidisciplinary approach from diagnosis and throughout the course of the condition, but there are very few measures to reduce or mitigate the disruption to the stability and postural control. Method: The research objective was to compare the effect of medical treatment and rehabilitation based on conventional GES Guide more posturography training with medical treatment and conventional rehabilitation on on the center of pressure area, average speed, total energy and Romberg index in patients with Parkinson's disease in stages I and II according to Hoehn and Yahr scale. Eleven patients in the group of patients with Parkinson's Disease and Their Families (GRUPARFA) from Concepcion City participated in the study who were randomized into two groups: one control (No. 5) and one experimental group (n 6). The variables evaluated with the posturographic platform Artoficio were: average speed (m / s), center of pressure area (mÂČ) and total energy (J) under the front sight and eyes closed and romberg index. The experimental group received medical treatment and rehabilitation based on conventional GES Guide more posturography training, while the control group only received medical treatment and conventional rehabilitation. Results: When comparing the initial values of both groups shows that there is equality of means pre-test (p> 0.05) for all variables except for variable energy with front view pre (p = 0.005) and the variable energy with eye closed pre (p = 0.009), indicating that these two variables were not equal in both groups at baseline. Comparing the mean of variables post-intervention shows that in all are significant differences between the experimental and control groups, except for the variable center of pressure area (CP) with eyes closed post (p = 0.164). They left out the analysis the energy variables overlooking the forehead and eyes closed, as they also had different mean responses in the pre-test. When analyzing pretest-posttest differences comparing the average value of each variable between groups, they found no significant differences in any of them (p> 0.05) except in the Romberg index (p = 0.017), where the group experimental increased by 103.15% as mean value and the control group decreased by 32%.
Notas
Tesis (MagĂster en NeurorehabilitaciĂłn)
Palabras clave
Enfermedad de Parkinson, Terapia, Postura Humana, Centro de PresiĂłn (Comportamiento)