Effect of Medication and Freezing of Gait on Rambling and Trembling in Quiet Standing in Individuals With Parkinson’s Disease Layla Cupertino, Felipe Marrese Bersotti, Thayna Magalhães Novaes, Luis Mochizuki, Solaiman Shokur, et al. Motor Control, 2025 Background: Individuals with Parkinson’s disease (PD) with freezing of gait (FoG) exhibit difficulty with changes in sensory input, indicating a potential sensorimotor integration deficit. Understanding how levodopa impacts balance particularly in FoG, is critical. As traditional postural sway measures may not fully capture the complexity of balance control, rambling and trembling decomposition of the center of pressure allows a more detailed assessment of postural control by distinguishing between supraspinal and spinal contributions, offering insights into sensorimotor integration deficits. This study aims to analyze the effects of medication and FoG on rambling and trembling in quiet standing in individuals with PD. Methods: We analyzed 13 individuals with PD with FoG (PD freezers) and 19 individuals with PD without FoG (PD nonfreezers) while quiet standing on a rigid and malleable surface under (ON) and without (OFF) dopaminergic medication. Area, root mean square, and mean velocity were calculated for rambling and trembling trajectory. Results: For the rambling, all variables were significantly higher on the malleable compared with the rigid surface. For trembling, (a) all variables were higher on the malleable compared with the rigid surface (p < .001), and (b) area and medial–lateral root mean square were significantly higher ON compared with OFF medication for both groups of participants similarly. Conclusion: Our results strengthen the evidence that PD freezers have the same postural sway in quiet posture as PD nonfreezers, using similar mechanisms to control the posture. In addition, levodopa influences spinal mechanisms more than supraspinal ones in individuals with PD in quiet standing.
FREQUENCY AND MODALITY OF EXERCISE ON PAIN AND INDEPENDENCE IN ELDERLY INDIVIDUALS WITH OSTEOARTHRITIS: A CROSS-SECTIONAL STUDY Felipe Marrese Bersotti, Reniery Pereira Da Silva, Angelica Castilho Alonso, Guilherme Carlos Brech, Paula Regina Mendes da Silva Serrão, et al. Acta Ortopedica Brasileira, 2025 Background: Regular physical exercise promotes pain relief, reducing the central facilitation of pain mechanisms. Objective: Evaluate the effect of different frequencies of physical exercise (once, twice, or three times a week) on different modalities (aerobic training, stretching training, and strength training), on the pain in the knee joint, and on the level of independence on people with knee osteoarthritis. Methods: Is cross-sectional and used the STROBE-Checklist: cross-sectional studies. A total of 193 elderly people were evaluated, pain and functional independence were analyzed. Results: For the pain variable, there was a statistical difference in favor of the intervention in the comparisons control versus strength 1 and 2 times a week and stretching 3 times a week already in the Lawton variable, only the comparison control versus aerobic 1 time a week did not prove to be statistically dignified. Conclusion: The exercise modality and the weekly frequency seem to affect the perception of pain, stretching exercises performed three times a week, as well as muscle strengthening exercises, regardless of weekly frequency are efficient in joint pain analgesia. Practicing muscle strength exercises, regardless of weekly frequency and aerobic and stretching exercises at least twice a week, increases and/or maintains IADL. Level of Evidence II; Cross-sectional Study.
Virtual rehabilitation is better than conventional physical therapy to improve the functionality of the gait in elderly people? Systematic review and meta-analysis Felipe Marrese Bersotti, Reniery Pereira da Silva, Bianca Cristina Dos Santos Vieira-Yano, Amanda Orasmo Simcsik, Daniel Marques Teixeira Lima, et al. Motriz Revista De Educacao Fisica, 2024 Aim To compare the Timed Up and Go (TUG) test variables and walking speed between elderly people that carried through the training using virtual reality, sedentary (control), and those submitted to the Conventional physical therapy (exercise therapy). Systematic revision with meta-analysis of clinical essays. Methods: The recommendations of The PRISMA STATEMENT were used; having been consulted the following databases: PubMed/Medline, Exerpta Medica DataBASE Guide (IT BASES), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Physiotherapy Evidence Database (PEDro). Participants: Healthy Elderly People. Intervention: Virtual reality or Conventional physical therapy. Group control: physical inactivity. Measures of result: TUG test and walking speed. Results: 11282 generated articles of the initial search, 16 articles had entered for the meta-analysis, including 711 participants. The meta-analysis resulted the four following comparisons: [1] Virtual Reality versus Control (TUG), not significant (the IC 95% (-4,29 to 0,66) I2 = 94%) and [2] Virtual Reality versus Control (walking speed), not significant (IC 95% (-0,14 to 0,56) I2 = 98%); [3] Virtual Reality versus Conventional physical therapy (TUG), significant, in favor of Conventional physical therapy (IC 95% (-1,02 a -0,06) I2 = 20%) and [4] Virtual Reality versus Conventional physical therapy (walking speed), significant in favors of Virtual Reality (IC 95% (0,06 a 0,17) I2 = 0%).Conclusion: This demonstrates that the investigated subject needs more studies with a better methodological research design to develop more results in the literature. Register Review: PROSPERO (CRD42021247922).
FATIGUE of KNEE EXTENSOR MUSCLES DOES NOT ALTER KNEE JOINT POSITION SENSE FELIPE MARRESE BERSOTTI, TAMIRIS BARBOSA DE MELO, JERÔNIMO RAFAEL SKAU, LUIS MOCHIZUKI, ULYSSES FERNANDES ERVILHA Journal of Mechanics in Medicine and Biology, 2022 The aim of this study is to investigate the effect of knee extensors fatigue on joint position sense. Fifteen healthy participants, all males, with no history of previous musculoskeletal lesions were recruited. Evaluation of the knee joint position sense and the muscle fatigue protocol had been performed using an isokinetic dynamometer. Fatigue was considered when the maximum torque was reduced by 50%. The joint position sense was analyzed by the absolute error and the variable error. The paired t-test was used to compare the mean in pre and during muscle fatigue conditions. The level of significance was 5%. Absolute and variable errors were not significantly affected by muscle fatigue. Knee joint position sense does not seem to be affected by fatigue of knee joint extensors.
Effect of an experimental fatigue protocol applied to the quadriceps femoris muscle of physically active persons Felipe Marrese Bersotti, Tamiris Barbosa de Melo, Luis Mochizuki, Jerônimo Rafael Skau Motriz Revista De Educacao Fisica, 2019 Aims: The purpose of this study was to test an experimental fatigue protocol for the knee joint extensor muscles performed on an isokinetic dynamometer. Method: SPIRIT recommendations were applied. Participants were 40 healthy, young men and women. Protocol: The pre-fatigue quadriceps femoris peak torque during concentric maximum voluntary contractions (MVC) at 60o/s was measured. During the first protocol part, the task was to do MVC at 60°/s until a sequence of five concentric MVC was below 40% of its initial value. For the second part, intermittent quadriceps femoris muscle and hamstrings maximum voluntary isometric contractions for 30 s (ratio 2/1 seconds). Thirty seconds after the isometric MVC (post-fatigue), they did three concentric MVC. Then, after 5 minutes of absolute rest, they did two concentric MVC. Men and women showed a lower peak torque due to this protocol (p < 0.001). Conclusion: This protocol was effective for fatigue men and women’s quadriceps femoris muscle.
