Dor e função na doença de Parkinson: uma abordagem multimetodológica integrando análise clínica, neurofisiológica e intervenção associada ao forró

Abstract

Introduction: Parkinson's disease (PD) presents both motor and non-motor symptoms, such as gait impairments and pain, which are associated with alterations in cortical electrical activity identifiable via electroencephalogram (EEG). Despite the known benefits of dance, gaps persist regarding the standardization of protocols and the availability of physiological data in PD following dance interventions. Objective: To investigate the correlation between pain and function, evaluate the feasibility of an intervention protocol based on Forró (a Brazilian dance genre), and analyze the brain activity of individuals with PD. Methods: Three distinct studies were conducted to address the proposed objectives, as follows: 1) a cross-sectional observational study, following the STROBE checklist, which evaluated pain (Brief Pain Inventory [BPI]) and gait (Timed Up and Go [TUG], 6-Minute Walk Test [6MWT], and Freezing of Gait [FOG]); 2) a feasibility study, which followed the CONSORT recommendations, evaluating the feasibility and acceptability of the Forró-based dance intervention protocol through adherence, satisfaction, refusal rate, data completeness rate, consent rate, adverse events, and clinical changes before and after the intervention (BPI, FOG, 6MWT, and TUG); 3) A single-arm, before-and-after, quasi-experimental study using EEG for the analysis of cerebral activity in individuals with PD prior to and 12 weeks following a Forró-based dance protocol. Recruitment was conducted via social media and included adults and older adults with PD of both sexes, with no age limit, under neurological follow-up, on stable medication, and capable of standing and walking independently (Hoehn & Yahr stages 1 to 4). Results: 1) Positive correlations were found between PD stage and functional capacity (TUG; p < 0.05; ρ = 0.40) and freezing of gait (FOG; p < 0.05; ρ = 0.34); between freezing of gait and pain (FOG and pain interference; p < 0.05; ρ = 0.37); and between pain intensity and pain interference (p < 0.001; ρ = 0.64). Negative correlations were observed between the distance covered in the 6MWT and freezing of gait measured by the FOG (p < 0.001; ρ = -0.67), and between distance covered (6MWT) and pain interference (p < 0.01; ρ = -0.48). 2) The Forró dance protocol proved to be feasible, acceptable, and achieved high participant satisfaction. 3) a reduction in the global slowing of brain activity and alpha band asymmetry was observed. There was an increase in the absolute power of alpha, beta, and gamma bands at Cz and Oz, as well as better energy distribution at Cz. Conclusion: This research demonstrated that: 1. pain interference can compromise functionality in PD; 2. the Forró-based intervention protocol is feasible, acceptable, safe, and replicable; 3. the intervention enhanced alertness and interhemispheric communication. It is concluded that the proposed intervention has the potential to promote integrated clinical and neurophysiological benefits, establishing itself as an promising rehabilitation strategy.