Desenvolvimento e avaliação de sistema de auxílio à reabilitação motora do membro superior após acidente vascular encefálico

Abstract

The number of victims of stroke has increased significantly in recent years. The main impairment due to stroke is hemiparesis. Several treatments have been applied with the objective of rehabilitation. However, only a small percentage of patients restores the functionality of the upper limb. The objective of this study was to develop a system of functional rehabilitation for upper limbs, and to evaluate its use and compare it with two other therapies. Eighteen volunteers of both sexes, with hemiparesis, were assessed and divided randomly into three groups. The volunteers in group 1 underwent conventional physical therapy, as the volunteers of group 2 were trained with feedback electromyographic (EMG) and the volunteers in group 3 used the system of rehabilitation with functional bracing (SROF). The SROF was activated from electromechanical actuators that helped the flexion-extension of elbow and fingers, controlled by EMG signals of biceps (BB), triceps (TB), extensor digitorum (ECD) and flexor digitorum superficialis (FSD). Treatment protocols were eight weeks long, with three weekly sessions of 50 minutes, completing 24 sessions. The assessments were done at the beginning and end of protocols, which there were assessed motor function, manual dexterity, spasticity, and muscle EMG activity BB, TB, ECD and FSD during maximal voluntary contractions in the test manual function of each muscle. There were realized intergroup and intragroup analyzes to comparison of the effect of each therapy. There were applied statistical tests of means analysis with a significance level of 5%. The results showed that all three groups improved their motor function, and only groups 2 and 3 showed gains in the joints of the wrist and hand. In relation to handedness, we observed that only volunteers of group 2 and 3 had significant improvement. Spasticity was not significantly changed for the three groups. We conclude that the SROF is an effective aid for rehabilitation of motor function of upper limb, especially in relation to the joints of the wrist and hand.