Abstract
O aumento da incidência de traumas de alta energia esta relacionado com o crescimento da prevalência de lesões raquimedulares ocasionando seqüelas motoras nos membros. O programa de reabilitação proporciona perspectiva de melhora da qualidade de vida, colaborando para a reintegração social desses indivíduos. As síndromes dolorosas dos ombros são freqüentes nos pacientes lesados medulares, independentemente do programa de reabilitação adotado. No presente estudo, avaliou-se por meio da ultrassonografia, 32 ombros de 16 pacientes com lesão medular com localização anatômica entre C4 e T12, em reabilitação no DOT/HC-UNICAMP, constatando-se alterações nos tendões dos músculos do manguito rotador em 46,88% e nas tuberosidades umerais em 12,50% dos pacientes estudados. As alterações foram mais prevalentes entre os tetraplégicos. A execução de medidas analgésicas, fortalecimento dos músculos do manguito rotador quando possível e alterações posturais podem significar diminuição na ocorrência das síndromes dolorosas dos ombros, melhorando o aproveitamento do programa de reabilitação e com ganhos na qualidade de vida.
Highlights
The increasing number of automobile accidents associated to increasing levels of violence in urban areas of capital and metropolitan cities has led to an increased incidence of trauma in the population in general
Considering the population affected by trauma, 8.6% of the patients admitted in university hospitals in Brazil diagnosed with orthopaedic injuries present with a rachimedullary trauma (RMT)(1)
The inclusion in a rehabilitation program means more than a possibility of neurological deficit regression; it is related to a perspective of improving activities of daily life, a reduced level of dependence on caregivers, to the improvement of sociability, to the reduction of clinical co-morbidities resulting from long in-bed periods and, to a significant improvement of these people’s quality of life
Summary
The increasing incidence of high energy traumas is associated to a growing prevalence of spinal cord injuries causing motor sequels on limbs. Shoulder pain is more frequent in individuals with spinal cord injury, regardless of the rehabilitation program adopted. 32 shoulders of 16 patients with spinal cord injury levels between C4 and T12 submitted to a rehabilitation program at DOT/UNICAMP were evaluated by using ultrasound. Changes on rotator cuff tendons were detected in 56.25%, and 12.50% of the patients presented changes in humeral tuberosities. These changes were more prevalent in quadriplegic patients.
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