Parâmetros na marcha na paralisia supranuclear progressiva: um estudo de caso
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Data
2012-12-01
Autores
Teixeira-Arroyo, Claudia [UNESP]
Barbieri, Fabio Augusto [UNESP]
Vitório, Rodrigo [UNESP]
Pereira, Marcelo Pinto [UNESP]
Lirani-Silva, Ellen [UNESP]
Gobbi, Lilian Teresa Bucken [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Pontifícia Universidade Católica do Paraná (PUC-PR)
Resumo
INTRODUÇÃO: Comprometimentos na marcha de pacientes com paralisia supranuclear progressiva (PSP) podem aumentar o risco de quedas durante o andar, especialmente em ambientes complexos. OBJETIVO: Descrever o comportamento locomotor de uma paciente com PSP, nas condições de marcha livre e marcha adaptativa. MATERIAIS E MÉTODOS: Estudo de caso de uma paciente com PSP (71 anos). Para análise cinemática, nas condições de marcha livre, com obstáculo baixo e alto, uma câmera digital registrou uma passada completa da paciente. RESULTADOS: Com o aumento da complexidade do ambiente (marcha livre, obstáculo baixo e alto, respectivamente), foi observada diminuição do comprimento do passo (0,37 ± 0,07; 0,30 ± 0,07; 0,26 ± 0,06 m), do comprimento da passada (0,71 ± 0,11; 0,58 ± 0,15; 0,47 ± 0,07 m) e da velocidade da passada (0,55 ± 0,14; 0,43 ± 0,11; 0,36 ± 0,11 m/s). Aumento progressivo ocorreu na duração do duplo suporte da passada livre (29,47%) para a passada antes do obstáculo alto (41,11%). Observou-se, ainda, ligeira diminuição na distância vertical pé/obstáculo alto (membro/abordagem: 7,18 ± 1,88; e membro/suporte: 8,84 ± 2,57 cm) em relação ao obstáculo baixo (membro de abordagem: 8,86 ± 1,88; e membro de suporte: 11,67 ± 2,09 cm). CONCLUSÃO: A PSP afetou de forma evidente a marcha da paciente. Inflexibilidade para a adaptação da marcha às demandas do ambiente foi observada durante a aproximação e a transposição dos obstáculos, o que pode aumentar o risco de tropeços e quedas.
INTRODUCTION: Gait impairments in patients with progressive supranuclear palsy (PSP) can lead to increased risk of trips and falls while walking, especially in complex environments. OBJECTIVE: To describe the locomotor behavior of a woman with PSP during free and adaptive walking. MATERIALS and METHODS: A case study of a PSP patient (71 years old). For kinematic data collection during free and adaptive walking (low and high obstacle crossing), a digital camcorder captured an entire gait cycle of the patient. RESULTS: Decrease in step length (0.37 ± 0.07; 0.30 ± 0.07; 0.26 ± 0.06 m), stride length (0.71 ± 0.11; 0.58 ± 0 15; 0.47 ± 0.07 m), and stride velocity values (0.55 ± 0.14, 0.43 ± 0.11, 0.36 ± 0.11 m/s) was observed with the increasing of complexity (free walking, low obstacle crossing, and high obstacle crossing, respectively). The patient showed greater duration of double support phase in the high obstacle condition (41.11%) than in the free walking condition (29.47%). Also, toe clearance distance was slightly shorter in high obstacle condition (leading limb: 7.18 ± 1.88 and trailing limb: 8.84 ± 2.57 cm) than in the low obstacle condition (leading limb: 8.86 ± 1.88 and trailing limb: 11.67 ± 2.09 cm). CONCLUSION: PSP clearly impairs the patient's gait. The patient showed inflexibility to adapt to environmental demands during both approaching and crossing obstacle. This behavior could increase the risk of trips and falls.
INTRODUCTION: Gait impairments in patients with progressive supranuclear palsy (PSP) can lead to increased risk of trips and falls while walking, especially in complex environments. OBJECTIVE: To describe the locomotor behavior of a woman with PSP during free and adaptive walking. MATERIALS and METHODS: A case study of a PSP patient (71 years old). For kinematic data collection during free and adaptive walking (low and high obstacle crossing), a digital camcorder captured an entire gait cycle of the patient. RESULTS: Decrease in step length (0.37 ± 0.07; 0.30 ± 0.07; 0.26 ± 0.06 m), stride length (0.71 ± 0.11; 0.58 ± 0 15; 0.47 ± 0.07 m), and stride velocity values (0.55 ± 0.14, 0.43 ± 0.11, 0.36 ± 0.11 m/s) was observed with the increasing of complexity (free walking, low obstacle crossing, and high obstacle crossing, respectively). The patient showed greater duration of double support phase in the high obstacle condition (41.11%) than in the free walking condition (29.47%). Also, toe clearance distance was slightly shorter in high obstacle condition (leading limb: 7.18 ± 1.88 and trailing limb: 8.84 ± 2.57 cm) than in the low obstacle condition (leading limb: 8.86 ± 1.88 and trailing limb: 11.67 ± 2.09 cm). CONCLUSION: PSP clearly impairs the patient's gait. The patient showed inflexibility to adapt to environmental demands during both approaching and crossing obstacle. This behavior could increase the risk of trips and falls.
Descrição
Palavras-chave
Marcha, Paralisia supranuclear progressiva, Controle motor, Cinemática, Gait, Supranuclear progressive palsy, Motor control, Kinemathic
Como citar
Fisioterapia em Movimento. Pontifícia Universidade Católica do Paraná (PUCPR), v. 25, n. 4, p. 885-894, 2012.