Abstract
OBJETIVO: Estudar os efeitos da irradiação ultrassônica de baixa intensidade aplicada sobre a medula espinhal na regeneração do nervo ciático de ratos após lesão por esmagamento controlado, avaliando os resultados pelo índice funcional do ciático (SFI), medido nas imagens vídeo-filmadas das plantas das patas. MÉTODOS: Dezoito ratos foram submetidos a esmagamento controlado (do nervo ciático direito e divididos em dois grupos de acordo com o tratamento: Grupo 1 (n=9), irradiação simulada; Grupo 2 (n=9), irradiação efetiva. Irradiação ultrassônica de baixa intensidade foi iniciada no 7º dia pós-operatório e aplicada diariamente por 6 semanas. Imagens das plantas das patas dos animais foram vídeo-filmadas em uma esteira transparente sob velocidade controlada a intervalos semanais até a 6ª semana de irradiação e o correspondente SFI medido com um programa de computador específico. RESULTADOS: O SFI durante a 1ª e a 6ª semana de tratamento foi de -59,12 e -12,55 no Grupo 1, e -53,31 e -1,32 no Grupo 2, indicando uma melhora de 79% e 97%, respectivamente, mas as diferenças entre os grupos somente foram significantes (p<0,05) durante a 3ª semana de tratamento. CONCLUSÃO: Os autores concluem que o ultrassom terapêutico de baixa intensidade estimula a regeneração nervosa, com significância durante a 3ª semana de tratamento. Nivel de Evidência II, Prospectivo Comparativo.
Highlights
Spontaneous recovery occurs in most cases, posttraumatic regeneration of the peripheral nerves is a very slow and frequently incomplete process,[1,2] suffering the influence of numerous factors, such as patient age, type of trauma, lesion location, denervation time, type and diameter of the nerve fibers involved, method employed for nerve repair, intercurrence of chemical agents, temperature and other individual variables.[3,4] Ultrasound is a physical resource widely used in medicine, both in diagnostic equipment, and in therapy apparatuses.[5]
Spontaneous or stimulated posttraumatic regeneration of the peripheral nerves has been the motive of experimental investigations by our group, mostly using the rat model of sciatic nerve crush injury,[3,15,16,17,18] including investigations into the use of therapeutic ultrasound,[19,20] which confirmed the results of other authors, according to which ultrasonic irradiation effectively stimulates or accelerates conduction speed[21] and the actual regeneration of the peripheral nerves.[22]
Postoperative procedure: Ultrasonic irradiation was performed with portable ultrasound equipment of clinical use, which features a specific transducer for small areas (1.35cm in diameter, continuous mode, frequency of 1 MHz, intensity of 0.16 W/cm[2] SATA)
Summary
Spontaneous recovery occurs in most cases, posttraumatic regeneration of the peripheral nerves is a very slow and frequently incomplete process,[1,2] suffering the influence of numerous factors, such as patient age, type of trauma, lesion location, denervation time, type and diameter of the nerve fibers involved, method employed for nerve repair, intercurrence of chemical agents, temperature and other individual variables.[3,4] Ultrasound is a physical resource widely used in medicine, both in diagnostic equipment, and in therapy apparatuses.[5] It is defined as acoustic mechanical vibrations of high frequencies, which produce thermal and non-thermal[6] physiological effects, and, since its introduction as a therapeutic resource more than six decades ago,[7] has rapidly become of commonplace use within physiotherapy. The data available in literature do not yet allow us to accept such a fact as definitive
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