Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado
Ano de defesa: | 2016 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
|
Departamento: |
Faculdade de Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/6851 |
Resumo: | Introduction: Stroke is the main cause of acquired adult disability and responsible for motor disorders, which the most common is spasticity. The spasticity increase involuntary muscle activity and promote adaptations in muscle morphology and functional performance. The aim of present study is to analyze the effects of botulinum toxin type a (BTA) for spasticity treatment associated with physiotherapy on muscle arquitecture and functional performance of plantiflexors in stroke survivors. Materials and methods: Randomized and controlled clinical trial with sample composed by 20 stroke survivors with ankle spasticity allocated in two groups: intervention group (BTA + physiotherapy) and placebo group (saline solution + physiotherapy). The muscle arquitecture of medial gastrocnemius was measured by fascicle length, penation angle and muscle thickness with ultrasonography, an isokinetic dynamometer was used to measure the force of plantiflexors and was used the fast gait 8 m, Time Up and Go (TUG) and Sit-to-Stand (STS) to mesure funcional performance. All subjects realized a physiotherapy program for 12 weeks. The intervention group used BTA on medial gastrocnemius and soleus muscle; placebo group used saline solution 0.9% on same muscles. Results: Intervention group showed ankle spasticity decrease after 4 and 12 weeks. Two groups showed no significant difference on fascicle length, penation angle and muscle thickness. Similar results were observed in plantiflexors force. Intervention group and placebo group showed execution time decrease in fast gait 8 m test, TUG and STS test after 12 weeks compared to pre-intervention; however, there was observed no difference between groups. Conclusion: Ankle spasticity decrease caused by BTA does not changed arquitecture muscle parameters or better performance in gait and basic functional mobility. Physiotherapy was enough to promote gain in fast gait and basic functional mobility. |
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Buchweitz, Augusto640.892.660-68http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4762503P1018.786.060-26http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4423280Z6Freire, Bruno Bolla2016-07-26T14:07:16Z2016-03-31http://tede2.pucrs.br/tede2/handle/tede/6851Introduction: Stroke is the main cause of acquired adult disability and responsible for motor disorders, which the most common is spasticity. The spasticity increase involuntary muscle activity and promote adaptations in muscle morphology and functional performance. The aim of present study is to analyze the effects of botulinum toxin type a (BTA) for spasticity treatment associated with physiotherapy on muscle arquitecture and functional performance of plantiflexors in stroke survivors. Materials and methods: Randomized and controlled clinical trial with sample composed by 20 stroke survivors with ankle spasticity allocated in two groups: intervention group (BTA + physiotherapy) and placebo group (saline solution + physiotherapy). The muscle arquitecture of medial gastrocnemius was measured by fascicle length, penation angle and muscle thickness with ultrasonography, an isokinetic dynamometer was used to measure the force of plantiflexors and was used the fast gait 8 m, Time Up and Go (TUG) and Sit-to-Stand (STS) to mesure funcional performance. All subjects realized a physiotherapy program for 12 weeks. The intervention group used BTA on medial gastrocnemius and soleus muscle; placebo group used saline solution 0.9% on same muscles. Results: Intervention group showed ankle spasticity decrease after 4 and 12 weeks. Two groups showed no significant difference on fascicle length, penation angle and muscle thickness. Similar results were observed in plantiflexors force. Intervention group and placebo group showed execution time decrease in fast gait 8 m test, TUG and STS test after 12 weeks compared to pre-intervention; however, there was observed no difference between groups. Conclusion: Ankle spasticity decrease caused by BTA does not changed arquitecture muscle parameters or better performance in gait and basic functional mobility. Physiotherapy was enough to promote gain in fast gait and basic functional mobility.Introdu??o: O acidente vascular cerebral ? a maior causa de incapacidade motora adquirida em adultos, respons?vel por diversas complica??es neuromotoras, entre essas a mais frequente ? a espasticidade. A espasticidade causa um aumento da atividade muscular de forma involunt?ria que por sua vez resulta em adapta??es na morfologia muscular e no desempenho funcional. O objetivo desse estudo ? avaliar os efeitos da aplica??o de toxina botul?nica tipo A (TBA) para o tratamento da espasticidade associada a interven??o de fisioterapia nos par?metros de arquitetura muscular e desempenho funcional dos plantiflexores em indiv?duos com espasticidade p?s-AVC. Materiais e m?todos: Ensaio cl?nico randomizado e controlado em que a amostra foi composta por 20 indiv?duos com espasticidade em tornozelo alocados em dois grupos: grupo interven??o (TBA + fisioterapia) e grupo placebo (solu??o salina + fisioterapia). Foi avaliada ? arquitetura muscular do gastrocn?mio medial atrav?s do comprimento de fasc?culo, ?ngulo de pena??o e espessura muscular por meio de ecografia, tamb?m foi mensurado a for?a dos plantiflexores por meio de dinamometria isocin?tica e o desempenho funcional no teste de caminhada r?pida 8 m, Time Up and Go (TUG) e Sit-to-Stand (STS). Todos os participantes realizaram um programa de fisioterapia por 12 semanas em que um grupo aplicou TBA no m?sculo gastrocn?mio medial e s?leo e, o outro grupo aplicou solu??o salina 0,9% nos mesmos m?sculos. Resultados: O grupo interven??o apresentou redu??o da espasticidade no tornozelo ap?s quatro e 12 semanas. Os dois grupos n?o obtiveram diferen?a significativa no comprimento de fasc?culo, ?ngulo de pena??o e espessura muscular. Da mesma forma, n?o houve diferen?a significativa na for?a dos plantiflexores. O grupo interven??o e o grupo placebo obtiveram redu??o do tempo de execu??o ap?s 12 semanas no teste de caminhada r?pida 8 m, TUG e STS comparado ao momento pr?-interven??o, por?m sem diferen?a entre os grupos. Conclus?o: A redu??o do n?vel de espasticidade nos plantiflexores causada pela TBA n?o modificou os par?metros de arquitetura muscular e n?o promoveu um melhor desempenho na marcha ou mobilidade funcional b?sica. A fisioterapia foi suficiente para melhorar o desempenho na marcha e mobilidade funcional b?sica.Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-07-26T14:07:16Z No. of bitstreams: 1 DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf: 1568704 bytes, checksum: 506aa656de55aafd680c5b42ed011bf3 (MD5)Made available in DSpace on 2016-07-26T14:07:16Z (GMT). No. of bitstreams: 1 DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf: 1568704 bytes, checksum: 506aa656de55aafd680c5b42ed011bf3 (MD5) Previous issue date: 2016-03-31application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/165793/DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina e Ci?ncias da Sa?dePUCRSBrasilFaculdade de MedicinaNEUROFISIOLOGIAESPASTICIDADE MUSCULARREABILITA??O (MEDICINA)TOXINA BOTUL?NICA TIPO AACIDENTE VASCULAR CEREBRALMEDICINACIENCIAS DA SAUDE::MEDICINAEfeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizadoEffects of botulinum toxin type A and physiotherapy on muscle morphology and functional mobility in stroke survivors : randomized clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis7620745074616285884600600600-8624664729441623247-969369452308786627info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.jpgDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.jpgimage/jpeg3364http://tede2.pucrs.br/tede2/bitstream/tede/6851/4/DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.jpg4476d62cd8556fb5aff3a8c386b52c82MD54TEXTDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.txtDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.txttext/plain151731http://tede2.pucrs.br/tede2/bitstream/tede/6851/5/DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf.txtd74dabb60e30c9a54c622c725b11c2dcMD55LICENSElicense.txtlicense.txttext/plain; charset=utf-8610http://tede2.pucrs.br/tede2/bitstream/tede/6851/3/license.txt5a9d6006225b368ef605ba16b4f6d1beMD53ORIGINALDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdfDIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdfapplication/pdf1568704http://tede2.pucrs.br/tede2/bitstream/tede/6851/2/DIS_BRUNO_BOLLA_FREIRE_COMPLETO.pdf506aa656de55aafd680c5b42ed011bf3MD52tede/68512016-07-26 20:00:22.184oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2016-07-26T23:00:22Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
dc.title.alternative.eng.fl_str_mv |
Effects of botulinum toxin type A and physiotherapy on muscle morphology and functional mobility in stroke survivors : randomized clinical trial |
title |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
spellingShingle |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado Freire, Bruno Bolla NEUROFISIOLOGIA ESPASTICIDADE MUSCULAR REABILITA??O (MEDICINA) TOXINA BOTUL?NICA TIPO A ACIDENTE VASCULAR CEREBRAL MEDICINA CIENCIAS DA SAUDE::MEDICINA |
title_short |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
title_full |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
title_fullStr |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
title_full_unstemmed |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
title_sort |
Efeitos da toxina botul?nica tipo A associada ? fisioterapia na morfologia muscular e mobilidade funcional em indiv?duos p?s-AVC : ensaio cl?nico randomizado |
author |
Freire, Bruno Bolla |
author_facet |
Freire, Bruno Bolla |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Buchweitz, Augusto |
dc.contributor.advisor1ID.fl_str_mv |
640.892.660-68 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4762503P1 |
dc.contributor.authorID.fl_str_mv |
018.786.060-26 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4423280Z6 |
dc.contributor.author.fl_str_mv |
Freire, Bruno Bolla |
contributor_str_mv |
Buchweitz, Augusto |
dc.subject.por.fl_str_mv |
NEUROFISIOLOGIA ESPASTICIDADE MUSCULAR REABILITA??O (MEDICINA) TOXINA BOTUL?NICA TIPO A ACIDENTE VASCULAR CEREBRAL MEDICINA |
topic |
NEUROFISIOLOGIA ESPASTICIDADE MUSCULAR REABILITA??O (MEDICINA) TOXINA BOTUL?NICA TIPO A ACIDENTE VASCULAR CEREBRAL MEDICINA CIENCIAS DA SAUDE::MEDICINA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Stroke is the main cause of acquired adult disability and responsible for motor disorders, which the most common is spasticity. The spasticity increase involuntary muscle activity and promote adaptations in muscle morphology and functional performance. The aim of present study is to analyze the effects of botulinum toxin type a (BTA) for spasticity treatment associated with physiotherapy on muscle arquitecture and functional performance of plantiflexors in stroke survivors. Materials and methods: Randomized and controlled clinical trial with sample composed by 20 stroke survivors with ankle spasticity allocated in two groups: intervention group (BTA + physiotherapy) and placebo group (saline solution + physiotherapy). The muscle arquitecture of medial gastrocnemius was measured by fascicle length, penation angle and muscle thickness with ultrasonography, an isokinetic dynamometer was used to measure the force of plantiflexors and was used the fast gait 8 m, Time Up and Go (TUG) and Sit-to-Stand (STS) to mesure funcional performance. All subjects realized a physiotherapy program for 12 weeks. The intervention group used BTA on medial gastrocnemius and soleus muscle; placebo group used saline solution 0.9% on same muscles. Results: Intervention group showed ankle spasticity decrease after 4 and 12 weeks. Two groups showed no significant difference on fascicle length, penation angle and muscle thickness. Similar results were observed in plantiflexors force. Intervention group and placebo group showed execution time decrease in fast gait 8 m test, TUG and STS test after 12 weeks compared to pre-intervention; however, there was observed no difference between groups. Conclusion: Ankle spasticity decrease caused by BTA does not changed arquitecture muscle parameters or better performance in gait and basic functional mobility. Physiotherapy was enough to promote gain in fast gait and basic functional mobility. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-07-26T14:07:16Z |
dc.date.issued.fl_str_mv |
2016-03-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
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http://tede2.pucrs.br/tede2/handle/tede/6851 |
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http://tede2.pucrs.br/tede2/handle/tede/6851 |
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por |
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por |
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7620745074616285884 |
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600 600 600 |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de |
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PUCRS |
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Brasil |
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Faculdade de Medicina |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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