Comparing physiotherapy approaches

Intervention: This project will lead to three. Initially all patients with Parkinson's disease (PD) (60 individuals) of both sexes in treatment in the physiotherapy clinic of Deolindo Couto Institute of Neurology will be evaluated for the cross-sectional study on the epidemiological, functional (global function, balance, mobility), activity and participation profile through an interview and the following methods: Functional Independence Measure (FIM), Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale, Stabilometry,Balance Evaluation Systems Test (Bestest), Kinematics, 10 meters Walk Test, Timed up and go (TUG), Dynamic Gait Index (DGI), Freezing of Gait Questionnaire (FOG-Q), Independence Index of Daily Life Activities Katz (Katz Index), Lawton and Brody Scale, Parkinson's Disease Questionnaire 39 (PDQ-39 ), Parkinson's Disease Quality of Life Questionnaire (PDQL) and Parkinson Activity Scale (PAS) (study 1). For the physiotherapy protocol group (study 2), 20 of this PD participants will be randomly assigned and they will be treated with exercises in groups of 6 to 8 participants, including 6 categories of exercises (tai chi, kayaking, agility training, boxing, lunges and Pilates ) about 10 minutes each, three times a week for 4 weeks for 60 minutes, a total of 12 sessions. For the application of transcranial direct current stimulation (tDCS) (study 3), the other patients with PD will be allocated randomly, by lottery, in 2 groups. Experimental group: 20 participants will receive active tDCS (transcranial direct current stimulation, which stimulates brain region on which the electrode is positioned) and physiotherapy exercise program. Control group: 20 participants will receive sham tDCS and physiotherapy exercise program. For the application of tDCS, par;Other;E02.779.483;E05.723.402;L01.453.245.945.450;G11.427.690;C23.888.550;E01.370.600.250 Primary outcome: Improved mobility, verified by the Timed up and go test, from the observation of decrease of at least 5% at execution time (seconds) in the pre and post intervention. Secondary outcome: Improving the ability to modify the gait in response to changes in demand, checked through the Dynamic Gait Index, from the increasing the score at least 5% in pre and post intervention measurements. Increased walking speed (meters/second) and cadence (steps/minute), verified through the 10-meter walk test, based on the statement of a variation of at least 5% in pre and post intervention measurements. Improvement in the level of activity (mobility, freezing, dual task), checked by Parkinson Activity Scale, from the observation of an increase in the score of at least 5% in pre and post intervention measurements. Improvement in gait parameters, such as increased stride length (cm) and speed (m/s), checked by means of kinematics, from the observation of an increase of at least 5% in pre and post intervention measurements. Improvement in disability and disability caused by Parkinson's disease, verified by the Unified Parkinson's Disease Rating Scale from the decrease of the finding in the score of at least 5% in pre and post intervention measurements. Decrease in the stage of Parkinson's disease, verified by Hoehn and Yahr Modified Scale, based on the statement of decrease of at least 5% in pre and post intervention measurements. Improves the individual's ability perform daily activities, verified by the percentage of Schwab and England Activities of Daily Living Scale, from the realization of the increase of at least 5% in pre and post intervention measurements. Improved balance and decrease the risk of falling, verified by the score of the Berg Balance Scale, based on the statement of increase of at least 5% in pre and post intervention measurements. Improvement of static balance, with decreased postural sway, verified by Stabilometry, from the variation of finding at least 5% in pre and post intervention measurements. Improvement in gait and decreased episodes of freezing of gait disorders, verified by the score Freezing of Gait Questionnaire, based on the statement of decrease of at least 5% in pre and post intervention. Improved self-reported quality of life, verified by the score of Parkinson's Disease Questionnaire 39 from the decrease of finding at least 5% in pre and post intervention.