RESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVE: The aim of this study was to compare trunk muscle activation during anterior and lateral reach in athletic and sedentary individuals with spinal cord injury (SCI) and able-bodied people. SETTINGS: University Hospital-UNICAMP, Campinas, Brazil. METHODS: Individuals with complete traumatic SCI and thoracic neurological level were separated into two groups: sedentary (SSCI: n=10) and physically active (PASCI: n=10). The control group (C: n=10) without SCI was assessed. Trunk muscle activation was recorded during reach and grasp tasks. The significant level was set at P<0.05. RESULTS: The control group showed a highest mean activation for left longissimus muscle during all activities (P<0.05). The PASCI group presented significant highest activation for left iliocostalis muscles during all activities, except in the anterior reach task of 90% maximum reach (anterior reach (AR) 75: P=0.02; right lateral reach (RLR) 75: P=0.03; RLR90: P=0.01). The SSCI group presented highest activation for the left iliocostalis during the right lateral reach task of 75 and 90% maximum reach and right iliocostalis during the anterior reach task of 75% maximum reach (AR75: P=0.007; RLR75: P=0.02; RLR90: P=0.03). A different pattern of muscle activation between the control group and the groups with SCI was observed. CONCLUSION: Our results indicated that sports practice did not affect the trunk muscle activation in people with paraplegia. However, the pattern muscle activation in individuals with SCI is different compared with people without SCI during anterior reach tasks.
Assuntos
Atividade Motora/fisiologia , Equilíbrio Postural/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Esportes/fisiologia , Adulto , Braço/fisiopatologia , Atletas , Brasil , Estudos Transversais , Eletromiografia , Humanos , Músculo Esquelético/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Vértebras Torácicas , Tronco/fisiopatologiaRESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To evaluate the efficacy of the Postural Assessment Software PAS/SAPO in the posture analysis of individuals with spinal cord injury (SCI) during sitting position and to analyze if the use of different types of seat cushions-gel and foam, with no cushion-can interfere in the individual's posture during sitting position. SETTING: Centre of Rehabilitation at the University Hospital (FMRP-USP), Ribeirão Preto, Brazil. METHODS: Eight individuals, four paraplegics and four tetraplegics with SCI and 20 healthy individuals participated in the study. Photos were taken of individuals in the sitting position using foam, gel cushions and with no cushion. They were analyzed using the PAS/SAPO. The alignment of the anterior-superior iliac spine (ASIS) and the posterior pelvic tilt were evaluated from the angle formed between the ASIS and the greater trochanter of the femur. RESULTS: The group of healthy individuals presented the best postural alignment when compared with the group with SCI, both for the ASIS alignment (P<0.05) and for the degree of posterior pelvic tilt (P<0.05). No significant differences were found in the variables analyzed when the seat cushions were compared. CONCLUSION: The different types of cushions did not alter the sitting posture; however, individuals with SCI showed worse postural alignment than the healthy individuals. PAS/SAPO was demonstrated to be useful for postural assessment.
Assuntos
Paraplegia/reabilitação , Postura , Traumatismos da Medula Espinal/reabilitação , Cadeiras de Rodas , Adulto , Brasil , Estudos Transversais , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To assess the importance of proprioceptive and vision information on different types of wheelchair seats with regard to postural control in paraplegic individuals during static posture. SETTING: Centre of Rehabilitation at the University Hospital/FMRP-USP and Rehabilitation Outpatient Clinic at University Hospital/UNICAMP, Brazil. METHODS: This study involved 11 individuals with paraplegia. All individuals were submitted to an evaluation of static balance with their eyes open and closed in three different types of seats: wheelchair seat, foam seat and gel seat. Balance evaluation was performed by using the Polhemus system, in which body displacements and anteroposterior and mediolateral speeds were assessed in a static seated position in the different types of seats. Data were analyzed using analysis of variance. The differences were considered at P<0.05. RESULTS: No statistical differences were found between the three types of seats in terms of displacements and anteroposterior and mediolateral speeds, or between seats with individuals keeping their eyes open or closed (P>0.05). However, it was observed that body displacements were more prominent toward an anteroposterior than a mediolateral direction. CONCLUSION: This study suggests that individuals with paraplegia tend to exhibit a more anteroposterior body displacement than a mediolateral one, with no significant differences between the types of seats in both situations of eyes open and closed.
Assuntos
Transtornos dos Movimentos/diagnóstico , Paraplegia/reabilitação , Postura/fisiologia , Cadeiras de Rodas/normas , Adulto , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/fisiopatologia , Paraplegia/fisiopatologiaRESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To observe if there is a relationship between the level of injury by the American Spinal Cord Injury Association (ASIA) and cortical somatosensory evoked potential (SSEP) recordings of the median nerve in patients with quadriplegia. SETTING: Rehabilitation Outpatient Clinic at the university hospital in Brazil. METHODS: Fourteen individuals with quadriplegia and 8 healthy individuals were evaluated. Electrophysiological assessment of the median nerve was performed by evoked potential equipment. The injury level was obtained by ASIA. N(9), N(13) and N(20) were analyzed based on the presence or absence of responses. The parameters used for analyzing these responses were the latency and the amplitude. Data were analyzed using mixed-effect models. RESULTS: N(9) responses were found in all patients with quadriplegia with a similar latency and amplitude observed in healthy individuals; N(13) responses were not found in any patients with quadriplegia. N(20) responses were not found in C5 patients with quadriplegia but it was present in C6 and C7 patients. Their latencies were similar to healthy individuals (P>0.05) but the amplitudes were decreased (P<0.05). CONCLUSION: This study suggests that the SSEP responses depend on the injury level, considering that the individuals with C6 and C7 injury levels, both complete and incomplete, presented SSEP recordings in the cortical area. It also showed a relationship between the level of spinal cord injury assessed by ASIA and the median nerve SSEP responses, through the latency and amplitude recordings.
Assuntos
Potenciais Somatossensoriais Evocados , Nervo Mediano/fisiopatologia , Quadriplegia/fisiopatologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Adolescente , Adulto , Brasil , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Quadriplegia/etiologia , Tempo de Reação , Índice de Gravidade de Doença , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/etiologia , Adulto JovemRESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVE: Pulmonary functional capacity in 23 Brazilian quadriplegic subjects (ASIA A), aged 30 (9.5) years, weight 66 (10.75) kg, height 176 (7) cm, was investigated at 42 (64) months postinjury. SETTING: University Hospital--UNICAMP, Campinas, Brazil. METHOD: Subjects performed forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests while seated in their standard wheelchairs. Forced Expired Volume after 1 s (FEV1) and FVC/FEV1 ratio were calculated from these tests. Values obtained were compared to three prediction equations from the literature that are used specifically for spinal cord subjects and include different variables in their formulae, such as age, gender, height, postinjury time and injury level. Data are expressed as median (interquartile interval). Differences between values were demonstrated by median confidence interval with significance level set at alpha=0.05. RESULTS: Obtained data were statistically different from prediction equation results, with FVC 3.11 (0.81), 4.46 (0.28), 4.16 (0.33), 4.26 (0.42); FEV1 2.77 (1.03), 3.67 (0.21), 3.66 (0.30), 3.45 (0.39) and MVV 92 (27), 154.2 (11.9), 156.6 (14), 157.3 (16.8), where the first value is obtained experimentally and the second, third and fourth values correspond to predicted values. The results obtained from spirometry test in this study differed significantly from the results obtained when prediction equations were used. CONCLUSION: The use of prediction equations developed to estimate pulmonary function in wheelchair users significantly overestimates pulmonary function of quadriplegic individuals with complete lesions (ASIA group A), in comparison to measured values.