Felipe Augusto dos Santos Mendes

Background and Purpose: Cognitive impairment manifests early in Parkinson’s disease (PD), adversely affecting patients’ daily activities and mental health. Utilizing exergames via the Xbox 360 Kinect (XBK) console presents a promising therapeutic avenue to mitigate cognitive decline in PD. This study aimed to assess the efficacy of the XBK system in enhancing cognitive performance and reducing anxiety levels among individuals with PD. Method: A non‐randomized controlled trial, controlled, single‐blind clinical trial was conducted. Forty‐three PD participants were selected through convenience sampling and non‐randomly assigned to either the XBK experimental group ( n = 23) or the Control Group ( n = 23). Participants underwent pre, post, and 30‐day post‐intervention evaluations using the Digit Span Tests, Semantics, Verbal Fluency Test, and Beck Anxiety Inventory. The control group received no intervention, while the experimental group underwent 10 sessions employing four XBK games. This study was approved by the Institutional Ethics Committee of the University of Brasília (Approval No. 2.109.826). Analysis of variance (ANOVA 2 × 3) with Sidak post hoc test and Bonferroni correction was utilized to examine intergroup outcomes. Results: The XBK‐trained group exhibited enhancements in short‐term memory post‐intervention ( p = 0.04) and at follow‐up ( p = 0.01), as well as operational memory post‐intervention ( p = 0.006) and at follow‐up ( p = 0.001), although without significant between‐group differences. Although no significant interaction effect was observed ( p = 0.126), a reduction in anxiety levels was verified up to 30 days post‐training ( p = 0.03), exclusively within the XBK group, accompanied by a significant between‐group difference ( p = 0.01), also in follow‐up. Discussion: Although the intervention did not demonstrate a superior effect compared with the control group, our findings suggest that training with the Xbox 360 Kinect may have the potential to reduce anxiety in individuals with Parkinson's disease. Further research through randomized clinical trials is necessary to validate these findings and evaluate the long‐term benefits of this intervention. Trail Registration: University of Brasília, CAAE: 12248513.9.0000.0030. N°: 2.109.826 https://ensaiosclinicos.gov.br/rg/RBR‐7h6b8mg .

Introdução. A Doença de Parkinson é uma condição neurodegenerativa progressiva associada a sintomas motores e não motores, além de maior risco de sarcopenia, que agrava perdas funcionais e reduz a qualidade de vida. Método. Estudo observacional transversal realizado em 2025 com pacientes com Doença de Parkinson ≥50 anos, avaliados quanto à sarcopenia (força de preensão, bioimpedância e velocidade da marcha) e qualidade de vida (PDQ-8 e EQ-5D-3L). Resultados. A amostra de 47 pacientes com DP apresentou maior prevalência de sarcopenia e sedentarismo entre os homens, além de maior índice de massa muscular apendicular em comparação às mulheres. A sarcopenia associou-se à maior gravidade da doença (Hoehn e Yahr), mas não à qualidade de vida global, exceto no domínio dor do EQ-5D-3L. Os achados sugerem que, embora a sarcopenia não comprometa a percepção global de qualidade de vida, ela afeta dimensões funcionais relevantes, como dor e mobilidade. Estratégias preventivas e terapêuticas, incluindo exercícios resistidos, fisioterapia e suporte nutricional, são recomendadas para preservar a função e reduzir complicações em pacientes com DP. Conclusão. A sarcopenia em pacientes com Doença de Parkinson associou-se à maior gravidade clínica e ao aumento da dor, mas não afetou os escores globais de qualidade de vida.

Currently, the management of Parkinson’s disease (PD), the second most common neurodegenerative disease, is challenging due to the lack of consensus on blood biomarkers for diagnostic, prognostic, and outcome purposes. The identification of specific and sensitive biomarkers could contribute to an early diagnosis and, consequently, facilitate management and improve prognosis. Several molecules are emerging as potential biomarkers, although current data seem preliminary and need further validation. Further, their combination in a panel seems to strengthen their diagnostic power, allowing them to identify PD cases with greater specificity and sensitivity. In this study, we evaluated the association of a panel of molecules, including shed syndecans, ELA peptides, CD141, VEGF, BDNF, and systemic inflammatory indices, in 30 PD cases and 30 matched healthy controls. Significant differences in the systemic levels of all the molecules studied were detected in the PD group when compared to the healthy participants. Univariate and multivariate regression analyses, as well as correlations with clinical indicators, including PD severity expressed by the Hoehn and Yahr (H&Y) scale, highlighted the key role of the studied molecules as independent risk factors. Finally, the use of receiver operating characteristic (ROC) curves demonstrated the diagnostic value of hs-CRP, NLR, BDNF, shed syndecans (1–3), and ELA-32 in PD. Interestingly, their diagnostic performance significantly improved when combined in a panel. Overall, our results suggest that hs-CRP, NLR, BDNF, shed syndecans (1–3), and ELA-32 are significantly associated with PD and could likely serve as appropriate diagnostic and prognostic biomarkers, especially if combined in a panel.

The impact of pain and fatigue on the upper limb (UL) function of people with Multiple Sclerosis (PMS) is well-known, but the relations between them are poorly understood. This study aimed to verify the frequency of the types of pain and the relationship between pain and factors that limit UL function in PMS. This was a descriptive, cross-sectional study. Pain was evaluated by Functional Assessment of Quality of Life in PMS. UL function was evaluated by the hand grip strength and by the Test d’ Evaluation de la performance des Membres Supérieurs des Personnes Âgées (TEMPA), while the fatigue was evaluated by the Modified Fatigue Impact Scale. Correlations between pain and the other variables were analyzed with the Pearson coefficient. A simple linear regression was used to determine the influence of pain on fatigue. Sample was composed of 32 PMS diagnosed with relapsing remitting type. Muscle pain was the most common type of pain reported by participants (40%). Pain correlated strongly only with fatigue and explained 28% (R2 = 0.28) of the variance in fatigue scores. This study showed strong association between muscle pain and fatigue (r = - 0.52; p <0.01), and no association between pain and UL function. Keywords: Demyelination; symptoms; relations The impact of pain and fatigue on the upper limb (UL) function of people with Multiple Sclerosis (PMS) is well-known, but the relations between them are poorly understood. This study aimed to verify the frequency of the types of pain and the relationship between pain and factors that limit UL function in PMS. This was a descriptive, cross-sectional study. Pain was evaluated by Functional Assessment of Quality of Life in PMS. UL function was evaluated by the hand grip strength and by the Test d’ Evaluation de la performance des Membres Supérieurs des Personnes Âgées (TEMPA), while the fatigue was evaluated by the Modified Fatigue Impact Scale. Correlations between pain and the other variables were analyzed with the Pearson coefficient. A simple linear regression was used to determine the influence of pain on fatigue. Sample was composed of 32 PMS diagnosed with relapsing remitting type. Muscle pain was the most common type of pain reported by participants (40%). Pain correlated strongly only with fatigue and explained 28% (R2 = 0.28) of the variance in fatigue scores. This study showed strong association between muscle pain and fatigue (r = - 0.52; p <0.01), and no association between pain and UL function.

Postural Imbalance (PI) is a common complaint in cognitively impaired older adults. It is unknown whether the Cognitive Impairment (CI) affects the validity and interpretability of balance perception in this population when standing up or walking. This study aims to investigate the validity of self-reported PI perception to screen performance limitations related to the task proposed by the Timed Up and Go (TUG) test in older adults with CI. This is a cross-sectional study using the data collected from older people evaluated in 2019-2020 at a specialized geriatric care facility. The sample was composed of 136 older adults with CI identified by the Mini-Mental State Examination (MMSE). The participants were questioned about PI perception (test index) and were submitted to the TUG test (reference standard; cutoff point>20 seconds). The subject’s answers were confirmed by the accompanying caregiver. The Sensitivity (SE), Specificity (SP), Positive Predictive Values (PPV) and Negative Predictive Values (NPV) were estimated, measuring the agreement percentage (Cohen’s Kappa test). Out of the 136 individuals studied herein, 60.3% (n=82) had self-reported PI and 25.3% (n=35) experienced it during the TUG test. Validity estimates presented high sensitivity and NPV values (SE=85.7%, SP=48.5%, PPV=36.6%, NPV=90.7%). The agreement percentage between the two tools in the overall sample was 58.1%. Despite the low agreement between instruments, the self-reported PI showed low false-negative percentages, indicating that it could be a potential tool for screening limitations in the TUG test, favoring the identification of individuals at risk of imbalance among older adults with CI.

There are several forms of treatment and performance evaluation existing in the rehabilitation of children with CP, but there are few studies describing performance evaluation in adults with CP. Evidence demonstrated through a systematic review points to positive effects of virtual reality on the motor function of children with CP after rehabilitation with active videogames. The objective was to verify the use of a virtual game as tool to evaluate the performance of people with CP and hemiparesis. There were selected three female young adults; one with CP and mild spasticity (CPL); one with CP and moderated spasticity and athetosis (CPM); and one as control (CRTL). Everyone played 40 moves in the virtual game Bowling, Wi Sports Resort, Nintendo Wii. Was calculate the average of the pins dropped in the attempts from 1 to 10, from 11 to 20, from 21 to 30 and from 31 to 40. The average of pins knocked down presented by CPL (7,05 hits) was higher than the CPM (5,2 hits). The average of pins knocked down presented by CRTL (7,08 hits) was higher than the CPM (5,2 hits). In the comparison between the individual with CPL (7,05 hits) and CRTL (7,08 hits) the number of pins knocked down was similar. The game used has the potential to be used as a tool to assess the performance of the non-involved side in individuals with hemiparetic CP. The performance curve showed that there are different behaviors when comparing hemiparetic people with different levels of motor impairment. São diversas as formas de tratamento e de avaliação do desempenho existentes na reabilitação de crianças com PC, porém são escassos os estudos que descrevem a avaliação de desempenho em adultos com PC. Evidências demonstradas por meio de revisão sistemática apontam para efeitos positivos da realidade virtual na função motora de crianças com PC após reabilitação com videogames ativos. O objetivo foi verificar a possibilidade do uso de um jogo virtual como ferramenta na avaliação de desempenho do lado não envolvido de hemiparéticos adultos com PC. Foram selecionados três adultos jovens do sexo feminino: uma com PC e espasticidade leve (PCL); uma com PC, espasticidade moderada e atetose (PCM); e uma sem deficiência (CRTL). Cada voluntária realizou 40 tentativas no jogo virtual Bowling, Wii Sports Resort, Nintendo Wii. Foi calculada a média de pinos derrubados nas tentativas de 1 a 10, de 11 a 20, de 21 a 30 e de 31 a 40. A média de pinos derrubados do PCL (7,05 acertos) foi maior que a do PCM (5,2 acertos). A média de pinos derrubados do CRTL (7,08 acertos) foi maior que a do PCM (5,2 acertos). Entre o indivíduo com PCL (7,05 acertos) e o CRTL (7,08 acertos) a média de pinos derrubados foi semelhante. O jogo utilizado tem potencial para ser usado como ferramenta de avaliação do desempenho do lado não envolvido em indivíduos com PC hemiparética. A curva de desempenho mostrou que há comportamentos diferentes quando se comparam pessoas hemiparéticas com diferentes níveis de comprometimento motor.

Introduction: Parkinson's disease (PD) is a progressive neurological condition resulting from the degeneration of dopaminergic neurons in the substantia nigra. Impaired manual dexterity and cognitive impairment are common symptoms and are often associated with recurrent adverse events in this population.Objective: To verify the association between cognitive performance and manual dexterity in people with PD.Methods: This is a cross‐sectional observational study, with 29 participants, who underwent cognitive and manual dexterity assessments, and the following tools were used: Trail Making Test, box and block test (BBT), Learning Test of Rey and Nine Hole Peg Test. Descriptive statistics for clinical and demographic data were performed using mean and standard deviation, and data normality was assessed using the Shapiro–Wilk test. Spearman's nonparametric test was used to determine the correlation between variables.Results: Our findings revealed significant associations between cognitive performance and manual dexterity. The nine‐hole peg test positively correlated with TMT—Part A and Part B, establishing a relationship between manual dexterity and cognitive functions such as attention and mental flexibility. On the other hand, BBT showed an inverse relationship with TMT—Part B, indicating that longer time on this task was associated with lower manual dexterity.Conclusion: Fine manual dexterity had a significant correlation with visual search skills and motor speed, while gross motor dexterity had a negative correlation with cognitive skills. No significant results were demonstrated regarding the interaction between manual dexterity and memory.

Objective: to identify sociodemographic factors, clinical conditions and sarcopenia parameters that predict hospital admission and death in older adults with cognitive impairment. Method: this is a longitudinal observational study carried out with 170 older adults with cognitive impairment assessed between 2019 and 2021. Predictor variables were sociodemographic characteristics, clinical conditions and sarcopenia parameters. Sarcopenia was operationalized through handgrip muscle strength (dynamometry), muscle mass (calf circumference) and the Timed Up and Go test. Occurrence of hospital admission and death within one year after assessment of older adults were the predicted variables. Analyzes were carried out using descriptive statistics, independent Student’ t-test, Mann-Whitney U test, chi-square test and univariate logistic regression. Results: most participants were female (±77.57 years old), with low education, sedentary, 15.9% with sarcopenia and 13% with a history of hospital admission. It was identified that education level had an effect on occurrence of hospital admission (U=1,423.5, p=0.027) and death (U=647.0, p=0.025) within one-year follow-up. Furthermore, there is an association between history of hospital admission in the last 6 months and occurrence of hospital admission [χ2(1)=4.729; p=0.030] and death [χ2(1)=3.919; p=0.048] within one year follow-up. It was identified that history of hospital admission in the last 6 months was associated with occurrence of hospital admission within one-year follow-up (OR=2.963; 95%CI 1.076-8.165, p=0.036). Conclusion: history of hospital admission in the last six months is associated with occurrence of hospital admission over a year in older adults with cognitive impairment.