Efeitos da corrente interferencial na funcionalidade do membro superior parético em pacientes após AVC
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Data
2021-06-09
Autores
Missão, Miriã Infante [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O Acidente Vascular Cerebral (AVC) é a segunda causa de morte no mundo e a primeira de incapacidade. Pacientes hemiparéticos/ plégicos freqüentemente desenvolvem distúrbios motores associados ao desequilíbrio da atividade neural, influenciando o processo de reabilitação, execução de tarefas e qualidade de vida dos pacientes. Intervenções que utilizam a estimulação elétrica têm sido utilizadas para gerir as funções motoras e sensoriais em pacientes pós AVC. O uso da corrente interferencial (CI) vem sendo descrito para complicações neurológicas, devido a possíveis efeitos anti-espáticos ocasionados pela liberação de neurotransmissores inibitórios. OBJETIVO: analisar a influência da aplicação de uma sessão de CI na espasticidade, na força de preensão, na destreza manual, e na amplitude de movimento do membro superior acometido por espasticidade após AVC. MÉTODO: a amostra foi constituída por 7 indivíduos (homens/mulheres) hemiparéticos crônicos em decorrência de AVC, que apresentaram espasticidade de membro superior. Foram avaliados quanto à espasticidade, pela Escala de Modificada de Ashworth, a força de preensão manual por meio do dinamômetro manual hidráulico Jamar, a destreza manual pelo teste de caixa e blocos e a amplitude de movimento através da fotogrametria. A CI foi aplicada no músculo bíceps braquial e flexores de punho, regulada em uma frequência de batimento de 100 Hz (4000 e 4100), ciclo de trabalho de 50%, e intensidade até o limiar sensorial, durante 30 minutos. RESULTADOS: a análise estatística apontou diferença significativa entre os momentos pré e pós tratamento, apenas para a espasticidade do músculo bíceps braquial, porém não apresentou diferença significativa em relação às demais variáveis. CONCLUSÃO: o estudo sugere que a CI pode reduzir a espasticidade do músculo bíceps braquial imediatamente após sua aplicação, mas não se sabe quanto tempo esses resultados permanecem. No entanto, a aplicação da CI não obteve resultados significativos em relação à espasticidade dos músculos flexores de punho, força de preensão, destreza manual e amplitude de movimento da articulação do cotovelo e do punho.
Stroke is the second cause of death in the world and the first one of disability. Hemiparetic/plegic patients often develop motor disorders associated with unbalance in neural activity, influencing the rehabilitation process, task execution and the patients' life quality. Interventions that use electrical stimulation have been used to manage motor and sensory functions in post-stroke patients. The use of interferential current (IC) has been prescribed for neurological complications, due to possible antispastic effects caused by the release of inhibitory neurotransmitters. OBJECTIVE: analyze the influence of the application of an IC session on spasticity, grip strength, manual dexterity, and range of motion of the upper limb affected by spasticity after stroke. METHOD: the sample consisted of 7 individuals (men/women) with chronic hemiparesis due to stroke, who presented spasticity of the upper limb. Spasticity was assessed using the Modified Ashworth Scale, handgrip strength using the Jamar hydraulic manual dynamometer, manual dexterity using the box and blocks test, and range of motion using photogrammetry. IC was applied to the biceps brachii muscle and wrist flexors, regulated at a beat frequency of 100 Hz (4000 and 4100), work cycle of 50%, and intensity up to the sensory threshold, during 30 minutes. RESULTS: the statistical analysis revealed a significant difference between the pre and post-treatment moments, only for the spasticity of the biceps brachii muscle, however, there was no significant difference in relation to the other variables. CONCLUSION: The study suggests that IC can reduce the spasticity of the biceps brachii muscle immediately after its application, but it is not known how long these results remain. Nonetheless, the application of IC did not obtain significant results in relation to the spasticity of the wrist flexor muscles, grip strength, manual dexterity and range of motion of the elbow and wrist joints.
Stroke is the second cause of death in the world and the first one of disability. Hemiparetic/plegic patients often develop motor disorders associated with unbalance in neural activity, influencing the rehabilitation process, task execution and the patients' life quality. Interventions that use electrical stimulation have been used to manage motor and sensory functions in post-stroke patients. The use of interferential current (IC) has been prescribed for neurological complications, due to possible antispastic effects caused by the release of inhibitory neurotransmitters. OBJECTIVE: analyze the influence of the application of an IC session on spasticity, grip strength, manual dexterity, and range of motion of the upper limb affected by spasticity after stroke. METHOD: the sample consisted of 7 individuals (men/women) with chronic hemiparesis due to stroke, who presented spasticity of the upper limb. Spasticity was assessed using the Modified Ashworth Scale, handgrip strength using the Jamar hydraulic manual dynamometer, manual dexterity using the box and blocks test, and range of motion using photogrammetry. IC was applied to the biceps brachii muscle and wrist flexors, regulated at a beat frequency of 100 Hz (4000 and 4100), work cycle of 50%, and intensity up to the sensory threshold, during 30 minutes. RESULTS: the statistical analysis revealed a significant difference between the pre and post-treatment moments, only for the spasticity of the biceps brachii muscle, however, there was no significant difference in relation to the other variables. CONCLUSION: The study suggests that IC can reduce the spasticity of the biceps brachii muscle immediately after its application, but it is not known how long these results remain. Nonetheless, the application of IC did not obtain significant results in relation to the spasticity of the wrist flexor muscles, grip strength, manual dexterity and range of motion of the elbow and wrist joints.
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Palavras-chave
Acidente vascular cerebral, Espasticidade muscular, Eletroterapia, Cerebrovascular disease, Spasticity