Implicaciones reeducativas en la funcionalidad y calidad de vida de las personas con enfermedad de parkinsonimplementación de una ortesis de tejido elastomérico dinámica

Abstract

The present doctoral thesis entitled “Effects of the implementation of a dynamic elastomeric fabric orthosis on the functionality and quality of life of the person with Parkinson's Disease (PD)” is carried out according to the thesis modality by compendium of scientific articles. The work scheme established to achieve the main objective is based on a study composed of 3 structured articles, a study protocol and two longitudinal clinical trials. Parkinson's Disease (PD) is a neurodegenerative disorder, characterized by a loss of dopamine neurons in the substantia nigra. It is characterized by the appearance of different motor and non-motor symptoms. The main motor symptoms of the disease are tremor at rest, bradykinesia, stiffness of the extremities, gait and balance problems. As the disease progresses, motor symptoms become accentuated, which leads to a decrease in the functionality of the patient's Activities of Daily Living (ADL). Current pharmacological treatment is based on dopaminergic treatments such as levodopa, dopamine agonists and reduction of dopamine degradation. The effectiveness of this treatment progressively decreases and produces other side effects such as dyskinesias and motor fluctuations. Currently, there are different types of non-pharmacological treatments that reduce the presence and intensity of motor symptoms; however, there is not enough scientific evidence about them and resources are scarce. Therefore, the main objective of this thesis is to evaluate the effects of the implementation of a dynamic elastomeric fabric orthosis (DEFO) on the functionality and quality of life of the person with PD. DEFO are a non-pharmacological and easily implemented device personalized for each patient that provides biomechanical alignment and allows freedom of movement of the body while sending sensory information to the brain, causing compression localized and stimulation of dermal and proprioceptive receptors that regulate motor activity. Goals To evaluate the effects of the implementation of DEFO on the functionality and quality of life of the person with PD. To evaluate the effectiveness of DEFO on manual dexterity in the SM of people with PD. Material and methods For the development of this project, patients diagnosed with PD, treated in the Neurology Service of the University Hospital of Burgos, participated. The intervention protocol was designed (Study I of the thesis) and two longitudinal studies (Studies II and III of the thesis). Based on them, the effectiveness of these devices on the different motor symptoms of PD has been proven, in order to find an effective treatment, without side effects and with great adherence for the patient. Thanks to this doctoral thesis, highly relevant information has been obtained about this type of devices; however, it is necessary to continue researching its effectiveness in this disease.