Análise do planejamento e execução de movimentos de alcance do membro superior ipsilesional em pacientes após acidente vascular encefálico: efeito da direção e índice de dificuldade da tarefa

• Ano de defesa: 2012
• Autor(a) principal: Coqueiro, Paola Ribeiro
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Membro superior; Acidente Vascular Cerebral; Atividade motora; Desempenho sensório-motor; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: http://repositorio.cruzeirodosul.edu.br/handle/123456789/231

Unilateral stroke causes impairment of the ipsilesional arm function. Specific changes dependent on the compromised hemisphere are described. The purpose of this study was to evaluate the planning and execution of the ipsilesional reaching movements in patients with brain damage, and whether the direction and the index of difficulty (ID) influence the reaching movement performance. Thirty right-handed individuals, ten with right hemisphere stroke, ten with left hemisphere stroke, and ten age and gender matched controls participated in the study. Patients performed the reaching movements using their ipsilesional arm and the controls using their right and left arms. Aiming movements were made on a digitizing tablet, as fast as possible. The direction (ipsilateral and contralateral), size (0.8 or 1.6 cm) and distance (9 or 18 cm from the initial position) were manipulated, and determined three different ID (3.5, 4.5 and 5.5). For ID 4.5, two combinations of size and distance were used (4.5P; 4.5L). The position of the target was presented on a monitor placed in front of the participant. Temporal and spatial variables, related to motor planning and execution, were analyzed. The results of the current study indicate that right hemisphere lesion are more sensitive to spatial constraints of the task, which affects both planning and the final position accuracy of the movement. In contrast, the left hemisphere lesion generates slower and smoothless movements. It was also found that the contralateral movements and higher IDs increased planning demands and hinder movement execution. We concluded that the reaching movement performance is influenced differently by the target constraints and that the cerebral hemispheres play complementary roles in the control of the arm function.