Influência do padrão de variação da velocidade de estiramento na avaliação da espasticidade por meio do reflexo de estiramento tônico em pacientes pós acidente vascular encefálico

Abstract

Spasticity is a motor disorder that affects millions of people worldwide, it is considered an important sequel, since it results in damage to many people affected by this disorder. This disorder is characterized by motor-dependent increase speed, the tonic stretch reflex with exacerbation tendon, reflexes resulting from hyperexcitability of the stretch reflex. Their clinical evaluation is of great importance to all who are involved in the rehabilitation process, however, there are still no standard for evaluating clinical measures of spasticity. Thus, there has been a great interest in finding alternative objective assessment of disturbance, such as the development of evaluation systems based on detection of the tonic stretch reflex threshold tonic (TSRT). This measure is represented by the joint angle at which motoneurons and their muscles are recruited articulation, estimated indirectly by the values of the thresholds of the Dynamic Stretch Reflex (TSRT), when the velocity is equal to zero. The objective of this study was to evaluate spasticity quantitatively in real time. For this, three forms of velocity of stretch were adopted: increasing, decreasing and random, in order to examine the influence of each on the assessment of spasticity through TSRT. The results of the study confirmed that the evaluation TRRT can be an efficient method for quantification of the disturbance. Also showed that there are statistically significant differences between the disorder assessment methodologies (up and down), with p = 0.04504. Thus, there is greater efficiency for the set of corresponding measurements at increasing speed in general. But no need to further analyze characteristics such as the type of stroke and side involvement to understand what speed application methodology will suit best to the individual characteristics. Furthermore, it was demonstrated once more that the assessment of spasticity by Modified Ashworth scale may not be the parameter that best evaluates the disorder.