Efeitos do treino em esteira com suporte parcial de peso e do m?todo de facilita??o neuromuscular proprioceptiva na marcha hemipar?tica: estudo comparativo

• Main Author: Ribeiro, Tatiana Souza
• Other Authors: CPF:84091193404
• Format: Others
• Language: Portuguese
• Published: Universidade Federal do Rio Grande do Norte 2014
• Subjects: Acidente cerebral vascular; Hemiparesia; Reabilita??o; Marcha; Stroke; Hemiparesis; Rehabilitation; Gait; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Online Access: http://repositorio.ufrn.br:8080/jspui/handle/123456789/16700

Made available in DSpace on 2014-12-17T15:16:12Z (GMT). No. of bitstreams: 1 TatianaSR_DISSERT.pdf: 1545029 bytes, checksum: 047ba30fa9186420d02f968d61a9ac30 (MD5) Previous issue date: 2011-02-10 === Objective: To compare the effects of the treadmill training with partial body-weight support (TPBWS) and Proprioceptive Neuromuscular Facilitation (PNF) method on gait of subjects with chronic stroke. Design: Quasi-experimental study. Setting: Laboratorial research. Participants: Twenty-three subjects (13 men and 10 women), with a mean age of 56,7 ? 8,0 years and a mean time since the onset of the stroke of 27,7 ? 20,3 months, and able to walk with personal assistance or assistive devices. Interventions: Two experimental groups underwent gait training based on PNF method (PNF group, n=11) or using the TPBWS - Gait Trainer System 2, Biodex, USA (TPBWS group, n=12), for three weekly sessions, during four weeks. Measures: Evaluation of motor function - using the Stroke Rehabilitation Assessment of Movement (STREAM) and the motor subscale of the Functional Independence Measure (motor FIM) -, and kinematic gait analyze with the Qualisys System (Qualisys Medical AB, Gothenburg, Sweden) were carried out before and after the interventions. Results: Increases in the STREAM scores (F=49.189, P<0.001) and in motor FIM scores (F=7.093, P=0.016), as well as improvement in symmetry ratio (F=7.729, P=0.012) were observed for both groups. Speed, stride length and double-support time showed no change after training. Differences between groups were observed only for the maximum ankle dorsiflexion over the swing phase (F=6.046, P=0.024), which showed an increase for the PNF group. Other angular parameters remain unchanged. Conclusion: Improvement in motor function and in gait symmetry was observed for both groups, suggesting similarity of interventions. The cost-effectiveness of each treatment should be considered for your choice === Objetivo: Comparar os efeitos do treino em Esteira com Suporte Parcial de Peso (ESPP) e do m?todo de Facilita??o Neuromuscular Proprioceptiva (FNP) na marcha de indiv?duos com hemiparesia cr?nica. Desenho: Estudo quase-experimental. Local: Pesquisa laboratorial. Participantes: Vinte e tr?s sujeitos (13 homens e 10 mulheres), com m?dia de idade de 56,7 ? 8,0 anos e tempo m?dio de les?o de 27,7 ? 20,3 meses, capazes de deambular com alguma assist?ncia pessoal ou com dispositivos auxiliares. Interven??es: Dois grupos experimentais realizaram treinamento de marcha baseado no m?todo de FNP (grupo FNP, n=11), ou utilizando o sistema de ESPP - Gait Trainer System 2, Biodex, USA - (grupo ESPP, n=12), por tr?s sess?es semanais, durante quatro semanas. Medidas: Avalia??o da fun??o motora - utilizando o protocolo Stroke Rehabilitation Assessment of Movement (STREAM) e o dom?nio motor da Medida de independ?ncia Funcional (MIF motora) -, al?m de an?lise cinem?tica da marcha com o sistema Qualisys (Qualisys Medical AB, Gothenburg, Su?cia), foram realizadas antes e ap?s as interven??es. Resultados: Houve aumento dos escores do STREAM (F=49,189; P<0,001) e da MIF motora (F=7,093; P=0,016), al?m de melhora na raz?o de simetria (F=7,729; P=0,012) em ambos os grupos. Velocidade, comprimento da passada e tempo de duplo suporte n?o mostraram altera??es ap?s os treinamentos. Diferen?as entre os grupos foram observadas apenas para a m?xima dorsiflex?o do tornozelo no balan?o (F=6,046; P=0,024), a qual exibiu aumento no grupo FNP. Demais vari?veis angulares n?o sofreram altera??es. Conclus?o: Melhora na fun??o motora e na simetria da marcha foi observada em ambos os grupos, aludindo a uma similaridade das interven??es. O custo-benef?cio de cada tratamento deve ser considerado para sua escolha