Protocolo 3D para avaliação quantitativa de déficits proprioceptivos

Abstract

The assessment of proprioceptive deficits is usually based on qualitative clinical scales and observations of clinical personnel. It is a subjective process that may not be sensitive enough to adequately follow the progress of the therapy or even allow more accurate diagnoses. The objective of this research was to propose a protocol for the quantitative evaluation of proprioceptive deficits based on three-dimensional inertial sensors, in addition to exploring and characterizing the nature of the deficits in subjects with subacute stroke as a strategy for validation of the proposal. For this, a three-dimensional upper limb tracking system was developed to monitor joint movements with precision. To validate the equipment and establish the protocol for the evaluation of proprioceptive deficits, 30 healthy subjects were recruited, divided into 3 groups, by age group: (G1) 10 subjects aged 20 to 39, (G2) 10 subjects with ages 40 to 59 years, and (G3) 10 subjects aged 60 to 80 years. To validate the system as a tool for the evaluation of proprioceptive deficits, 06 subjects with subacute Ischemic Stroke (AISi) were recruited. The groups were submitted to assessments of upper limb movements, in addition to the application of proprioceptive evaluation scales: Fugl-Meyer Assessment (FMA) and Nottingham Sensory Assessment (NSA). Three angles were evaluated for the shoulder joint, and three angles for the elbow joint. The experiments consisted in positioning the joints at a particular angle and, later, the subject was asked to position the corresponding articulation of the contralateral limb (in the case of AISi volunteers, the affected limb) in the same angle, blindfolded. The results of this research demonstrate that the equipment can adequately measure joint positioning differences, common in cases of proprioceptive deficits resulting from lesions in the nervous system. The protocol and the proposed equipment can generate quantitative information with greater precision and greater capacity of discrimination than the traditional methods based on clinical scales.