Comparação da força muscular mensurada com o teste do esfigmomanômetro modificado entre indivíduos pós acidente vascular encefálico subagudo, crônico e indivíduos saudáveis

Abstract

Introduction: Stroke is a classic sign of neurovascular disease, resulting from a sudden and specific deficit characterized by interruption or extravasation of the blood. Being a neurological syndrome with high prevalence in adults and elderly, one of the major causes of mortality in the world and one of the main causes of disabilities and hospitalizations. Muscle weakness is one of the factors responsible for functional limitations in individuals after stroke. Therefore, the measurement of muscular strength is important, and is commonly used in clinical practice with the objective of establishing functional diagnosis, for evaluation of improvement or worsening over time and as a measure of success of training programs. Objective: To compare the bilateral strength of 34 muscle groups of individuals after stroke both in the subacute and in the chronic phase with the muscular strength of healthy individuals matched by sex and age. Methodology: This study was developed at the Physiotherapy Department of the School of Physical Education, Physiotherapy and Occupational Therapy of the Federal University of Minas Gerais (UFMG), approved by the Research Ethics Committee of UFMG (No. 0492.0.203.000- 10), by the Research Ethics Committee of the Municipal Health Secretariat of Belo Horizonte (CEP/SMSA/BH) and the Risoleta Tolentino Neves Teaching, Research and Extension Center (NEPE/HRTN/UFMG). Subjects of both sexes, aged 20 years or older, with a diagnosis of stroke of at least three months or at least 6 months were included in the study; The bilateral muscular strength of the muscles of the lower limbs, upper limbs and trunk were measured with the Modified Sphygmomanometer Test (MST), and compared to the reference values of healthy individuals matched by age and sex. Descriptive statistics were performed for all variables. The measure of the muscular strength of individuals after stroke was compared with the 95% confidence interval of the reference values of the muscular strength measured with the MST in healthy individuals. The relative difference was calculated as the measure of muscular strength of the paretic and non-paretic side of individuals after stroke divided by the mean of the muscular strength reference value of the non-dominant and dominant side, respectively, of healthy individuals of the same sex and age group and then multiplied by 100%. Results: Twenty-four subjects were included in the study, 65 in the subacute phase (62 (14) years, 3.7 (0.77) months post-stroke) and 59 in the chronic phase (59 (15) months post-stroke). In the subacute phase, 35 (54%) were male and in the chronic phase 29 (51%) were male. All individuals after stroke had reduced muscle strength compared to healthy individuals of the same age and sex. Conclusion: Individuals after stroke in the subacute and chronic phases present loss of muscle strength in the upper limbs, lower limbs and trunk, not only on the side most affected by the lesion (paretic side), but also on the side contralateral to the encephalic lesion when compared with healthy individuals matched by sex and age. As it was observed a great variability of muscular strength between the individuals, it is emphasized the importance of the measurement of the muscle strength as a relevant component during the process of evaluation of this population susceptible to present chronic disabilities.