Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Influence of global postural reeducation method on respiratory muscle strength and parkinsonian quality of life

Larissa Salgado de Oliveira Rocha, Larissa Natsumi Hosoda Mineshita, Luciane Lobato Sobral, Lizandra Dias Magno, Marcio Clementino de Souza Santos, Rodrigo Santiago Barbosa Rocha

Downloads: 0
Views: 476


Background: Degenerative diseases such as Parkinson’s disease can lead to postural changes and muscular strength, this generates greater impact on the individual, on his functional capacity, respiratory system, mobility and, quality of life (QOL). Objective: The aim of this study was to verify the influence of the Global Posture Reeducation (GPR) method on respiratory muscle strength and QOL in patients with Parkinson’s disease. Methods: Twenty volunteers, the average of age is 48.8 ± 6.22 years, they are diagnosed with Parkinson’s disease at level 2 to 3 by the Hoehn & Yahr Scale. They were submitted to the protocol of treatment with the GPR method in the postures of Frog in the ground and ballerina, performed regularly twice a week lasting 60 minutes each session, for 6 weeks, totaling 12 sessions, evaluated by PDQ-39 quality of life questionnaire and by inspiratory pressure measurements and Maximum expiratory value. Results: In the quantitative analysis of inspiratory and expiratory muscle pressure, there was an increase in post-treatment for maximal inspiratory pressure (MIP) (p <0.05) when compared to pre-treatment, as well as when compared with predicted values MIP and maximum expiratory pressure (MEP) presented higher values (p <0.05). In terms of QoL domains: mobility (p = 0.0009), daily life activity (p = 0.0006), emotional well-being (p = 0.001), cognition (p = 0.01) and physical discomfort were statistically significant in post-treatment. Conclusion: The use of GPR in Parkinson’s disease has shown to be effective in the treatment of respiratory muscle strength and QoL.


Parkinson’s Disease, Rehabilitation, Muscle Strength, Quality of Life.


1. Rodrigues AV, Lemes LB, Rodrigues ASR, Souza RB, Santos SMS. Evaluation of the Perceptual System in Healthy Elderly and Elderly Patients with Parkinson’s Disease. Rev Neurocienc. 2014;22(2):189-194

2. Curtze C, Nutt JG, Carlson-Kuhta P, Mancini M, Horak FB. Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People with Parkinson Disease. Phys Ther. 2016;96(11):1734-1743.

3. Blaszczyk JW. Nigrostriatal interaction in the aging brain: new therapeutic target for Parkinson’s disease. Acta Neurobiol Exp (Wars). 2017;77(1):106- 112.

4. Silva FP, Martinello M, Medeiros DL, Schwertnerd DS, Ries LGK. Global postural reeducation in an adult with cerebral palsy: a case study. Fisioter Pesq. 2015;22(1):90-96.

5. Tasca C, Schuster RC, Alvarenga LFC. Respiratory muscle strength and thoracic mobility in patients with Parkinson’s disease. Journal of Health Care. 2014;12(42):5-10.

6. Bertoldi FC, Silva JA, Faganello-Navega FR. Influence of muscle strengthening on balance and quality of life in individuals with Parkinson’s disease. Fisioter. Pesqui. 2013;20(2):117-122.

7. Gomes AVM, Lopes DC, Veloso EMC, Costa RCTS. The influence of the global postural reeducation method on the flexibility of the posterior chain muscles. Fisioter Bras. 2014;15(3):200-206.

8. Tavares GMS, Santo CCE, Parizotto P, Sperandio FF, Santos GM. Treatment for scoliosis by the global postural reeducation method (GPR) in the total visually impaired: series of cases. Sci Med. 2015;25(3):1-8.

9. Teodori RM; Negri JR; Cross MC; Marques AM. Global Postural Reeducation: a review of the literature. Rev Bras Fisioter. 2011;15(3):185-189.

10. Buated W, Lolekha P, Hidaka S, Fujinami T. Impact of cognitive loading on postural control in Parkinson’s disease with freezing of gait. Geront Geriat Med. 2016;2(1):1-8.

11. Christofoletti G, Oliani MM, Gobbi LTB, Gobbi S, Stella F. Risk of falls in the elderly with Parkinson’s disease and Alzheimer’s dementia: a crosssectional study. Rev Bras Fisioter. 2006;10(4):429-433.

12. Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2009;90(6):913- 918.

13. Santana CMF, Lins OG, Sanguinetti DCM, Silva FP, Angelo TDA, Coriolan MGWS. Effects of non-immersive virtual reality treatment on the quality jof life of individuals with Parkinson’s. Rev. Bras. Geriatr. Gerontol. 2015;18(1):49-58.

14. Oliveri M, Caltagirone C, Loriga R, Pompa MN, Versace V, Souchard P. Fast increase of motor cortical inhibition following postural changes in healthy subjects. Neurosci Lett. 2012;530(1):7-11.

15. Pinheiro IM, Santos LLS, Paula LCN, Costa ACN. Impact of Parkinson ‘s disease on the functionality and quality of life of the elderly in a geriatric reference unit in the city of Salvador - Bahia. Rev. Ciênc. Med. Biol. 2014;13(3):292-297.

16. Baptista A, Vieira RTB, Silva SM, Correa JCF, Sampaio LM, Correa FI. Immediate effect of thoracoabdominal rebalancing on the respiratory mechanics of parkinsonians. Fisioter Bras. 2014;15(2):131-135.

17. Wang CM, Shieh WY, Weng YH, Hsu YH, Wu YR. Non-invasive assessment of swallowing and respiratory dysfunction in early Parkinson’s disease. Parkinsonism Relat Disord. 2017;S1353-8020(17):30190-6.

18. Guimarães EA, Alkmim DN, Birth MC, Boaventura CM, Magazoni VS. Adaptations of the respiratory system related to pulmonary function in response to a muscular treatment program by the Global Posture Reeducation method. ConScientiae Saúde. 2013;12(1):97-105.

19. Hampson NB, Kieburtz KD, Lewitt PA, Leinonen M, Freed MI. Prospective evaluation of pulmonary function in Parkinson’s disease patients with motor fluctuations. Int J Neurosci. 2017;127(3):276-284.

20. Comerlato T, Scanegatta S, Rosset D. Effects of the Global Posture Reeducation (GPR) method in the treatment of scheuermann kyphosis. FisiSenectus. 2013;1:10-19.

21. Moreno MA, Catai AM, Teodori RM, Borges BLA, Zuttin RS, Silva E. Respiratory system adaptations regarding pulmonary function in response to a muscle stretching program using the Global Posture Reeducation method. Fisioter Pesq. 2009;16(1):11-15.

22. Mota YL, Barreto SL, Bin PR, Simões HG, Campbell CSG. Cardiovascular responses during the posture of Global Posture Reeducation (GPR). Rev Bras Fisioter. 2008;12(3):161-168.

23. Refice C, Loriga R, Pompa MN, Gambale G, Altavilla R, Paolucci M et al. Global postural rehabilitation and migraine: a pilot-study. J Headache Pain. 2015;16(Suppl 1):A116.

24. Lira TBS, Barros ALS, Costa RV, Lustosa TC, Silva SACD. Analysis of the posture of subjects with stage II Parkinson’s disease. R. Ci. Med. Biol. 2012;11(3):296-300.

25. Kadastik-Eerme L, Rosenthal M, Paju T, Muldmaa M, Taba P. 2015). Health-related quality of life in Parkinson’s disease: a cross-sectional study focusing on non-motor symptoms. Health What Life Outcomes. 2015;13(83):1-8.

26. Fleck CS, Gerzson LR, Steidl EMS, Hernandez NM. Characterization of functional capacity, cognitive level and respiratory muscle strength of elderly women with parkinsonian syndrome. Estud. interdiscipl. Envelhec. 2014;19(1):109-121.

27. Silva AO, Oliveira FL, Alves AG, Nogueira MS, Valente PHF, Souza EL, et al. Effect of the global postural reeducation technique (GPR) in the treatment of patients with lumbar hyperlordosis: a case study. Revista Eletrônica FMB 2016;9(1):102-173.

28. Freitas MLM, Zager M, Campbell C. The influence of the Pilates method on the postural instability and quality of life of patients with Parkinson’s disease. Fisioter Bras. 2015;16(2):155-159.

5aa031430e8825825f77d856 mtprehab Articles
Links & Downloads

Man. Ther., Posturology Rehabil. J.

Share this page
Page Sections