Função pulmonar e força muscular respiratória de idosos com Doença de Parkinson em estágio inicial: estudo observacional

Abstract

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in the world. It is a disorder of the non-contagious and nonfatal movement caused by the progressive loss of the ventrolateral cells of the compact part of the black substance of the midbrain, which leads to three cardinal signs: rest tremor, stiffness and bradykinesia. Although the scientific research mainly addresses neuromotor signs, there are other functional damages, and the consequences of ventilatory dysfunction are the main cause of death in this population. Objective: To analyze pulmonary function and respiratory muscle strength (FMR) of elderly patients with PD at an early stage. Method: An observational study evaluating the degree of dysfunction related to the disease through the modified Hoehn & Yahr scale, FMR by manovacuometry, and pulmonary volumes and capacities by spirometry. FMR and lung function were evaluated in the on and off period of levodopa (L-Dopa). The results were presented through graphs and tables, with simple absolute frequencies and relative to the categorical data. For the analysis of the quantitative data, when the normality hypothesis was accepted using the Shapiro-Wilk test, the mean and the standard deviation (SD) were calculated. When the normality hypothesis was rejected, it was decided to calculate the median and the interquartile range (IIQ). In the comparison of means, the t-student test was applied, and in the case of the dependent variables the paired t-student test. In the comparison of medians, the Mann-Whitney test for the independent variables was applied, and Wilcoxon for dependent variables. The Minitab version 17 program was used for Windows and the level of significance in the statistical tests was 5%. Results: Elderly patients with early-stage PD had a higher prevalence of ventilatory disorder than their controls, mainly the restrictive disorder. There was no respiratory muscle weakness and no difference between the respiratory muscle strength of the elderly with PD in relation to their controls, matched by gender, age and body mass index. The on-off period of L-Dopa didn’t change the analyzed variables. Conclusion: Elderly patients with PD present ventilatory disorders, even in the early stages of the disease, being the restrictive disorder the most prevalent. L-Dopa does not change the analyzed variables.