4. Discussion
loss of functional mobility, tremor, PD, orthosis, hand movements, disability
DISEASE PROGRESSION, DISEASE, DISORDERS, PATHOLOGY, DISEASES
The aim of this study was to analyze the efficacy of the use of a DEFO for the UL on the functionality and quality of life of people with PD. The main findings of the present study are an immediate improvement after the implementation of the orthosis in the OFF and ON states of motor variables in the postural tremor task; only in the OFF state in the speed of rapid alternating movements and only in the ON state in the rhythm of hand movements and amplitude of rapid alternating movements. No differences were observed after two months of orthosis use in the improvement of functionality or in the quality of life of the patient with PD.Neurological disorders, such as PD, are currently the leading source of disability in the world. The global burden of disease study estimated that the number of people with PD will double from about 7 million in 2015 to approximately 13 million in 2040. This estimation of the growth of the population with PD is worrying considering the amount of burden this disease carries for society [The neurodegenerative effects of PD lead to a loss of functional mobility in balance, postural stability and gait, decreasing independence in the performance of activities, and compromising their participation both at home and in the community [There have been many advances in the knowledge of the etiopathogenesis and in the symptomatic treatment of PD in recent years. However, there are no effective neuroprotective or disease-modifying therapies that slow disease progression and improve functionality and quality of life without producing side effects on the patient [Due to the fact that pharmacological treatment loses its efficacy with the passage of time and produces side effects in the person and the lack of precise knowledge about the currently existing non-pharmacological therapies, it is necessary to implement new non-pharmacological therapies that allow an improvement in the functionality and quality of life of the patient [All DEFOs are made in the same way, being able to be designed and adapted to the needs of the pathology and the user, so that they can be devices for UL, lower limbs or vest for the whole body. In diseases such as CP, different studies carried out with vests and meshes of these characteristics have demonstrated their efficacy on postural control, balance, walking speed, and manual dexterity [These findings should be considered within the context of their strengths and limitations; the results show new information about the efficacy of this type of orthosis in patients with PD. On the other hand, the evaluations have been carried out in the “ON” and “OFF” state of the disease, which gives us information on its effect in the different states of the disease. This device has proven to be a non-pharmacological treatment that is easy to implement, with high adherence to treatment and without any type of contraindication. With respect to the limitations, the nature of the intervention was such that the participants and investigators of the initial evaluation were not blinded, and it has not been possible to ascertain whether the results have been maintained in the long term due to the limited duration of the study.