Razões de torque dos músculos do tornozelo de indivíduos espásticos decorrentes de acidente vascular cerebral isquêmico

• Ano de defesa: 2012
• Autor(a) principal: Teles, Rodolfo Alex
• Orientador(a): Silva Filho, Irênio Gomes da
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: MEDICINA; ACIDENTE CEREBROVASCULAR; ISQUEMIA CEREBRAL; PARESIA; MÚSCULOS
• Link de acesso: http://hdl.handle.net/10923/4440

Introduction: Spasticity is an incapacitating condition resultant from central nervous system injury such as the cerebral vascular accident, commonly known as stroke (STK). It is usually associated with hypertony and with a reduction in skeletal muscle force production. This condition may generate imbalance between antagonistic muscles at the ankle joint, which can be evaluated by torque ratios (TR). Purpose: to compare the dorsiflexor/plantarflexor (DF/PF) torque ratios between a post-stroke hemiparetic spastic group (STK) and a healthy control group (CON) and to evaluate STK group functionality. Methods: an isokinetic dynamometer was used to obtain maximal PF and DF torques at an angular velocity of 60°/s of hemiparetic spastic subjetcs (59. 7 ± 13. 74 years of age) and twelve healthy subjects (59. 0 ± 13. 64 years of age). TR were obtained through the division between the maximal DF and maximal PF torques. The STK group had their functionality evaluated through the Berg Balance Scale (BBS), the Barthel Index (BI), and the Timed Up and Go test (TUG). A Mann Whitney U test was used for the within group (spastic x non-spastic limbs) and for the between group (spastic x control) comparisons of the scale results and TR, whereas an independent T-test was used for the between groups comparison of the anthropometric variables (p ≤0. 05).Results: The within STK group comparison revealed higher TR in the spastic side compared to the non-spastic contralateral side (0,81±0,25 and 0,43±0,41 respectively; p=0. 01). The inter-group comparison revealed that the TR of the spastic side of the STK group was higher compared to the dominant side of the CON group (0,81±0,25 and 0,30± 0,10 respectively; p≤0. 01). No differences were observed for the TR between the non-spastic side of the STK group and the dominant side of the CON group (0,43±0,41 and 0,30± 0,10 respectively; p=0. 56). In addition, no changes in functionality were observed in the STK patients. Discussion: These results indicate that both limbs of the STK group show muscle imbalance, which might be explained by the smaller PF torque in both limbs, resulting on an elevated TR. The elevated TR found in the CON group is probably related to the fact that all subjects were sedentary. The STK group showed normal values for functionality, suggesting that the time post injury and the spasticity degree probably influence the results of these scales. Conclusion: Muscle imbalance is present in both lower limbs of post-STK patients, although the TR are more affected in the spastic side.