Resistência ao movimento e atividade eletromiográfica dos músculos flexores e extensores de cotovelo em pacientes hemiparéticos espásticos submetidos à crioterapia e estimulação elétrica neuromuscular

Abstract

Spasticity often coexists with stroke due to an upper motor neuron lesion, which impacts the patient's quality of life. Therefore, the control of muscle tone through physical therapy such as cryotherapy and Neuromuscular Electrical Stimulation (NMES) is extremely important. Several studies have demonstrated their advantageous physiological effects. However, these studies have not provided sufficient scientific proof for the treatment of upper limb spasticity and the duration of the physiological effects after the therapy. Therefore, this work helps to establish an application protocol for cryotherapy and NMES in individuals with spastic hemiparesis. The resistance to movement of the elbow flexor and extensor muscles before and after application of cryotherapy and NMES was used to determine the effect of the therapies. The study included 15 stroke patients that required physical therapy for spastic hemiparesis. They included both sexes, mean age of 56 ± 16. An evaluation was performed before and after therapy, as well as 10, 20, and 30 minutes following the application, by means of surface electromyography (EMG). The resistance to movement was measured with an Isokinetic Dynamometer in the passive mode at an angular velocity of 30 and 150 o/s. Although not statistically significant (p < 0.05), the results showed a reduced resistance to passive movement of the elbow flexors and extensors after cryotherapy and NMES, allowing us to conclude that physical therapy effectively reduces the resistance to passive movement in spastic hemiparetic patients, however, they have different effects with respect to time.