Eficácia de um protocolo de terapia multimodal para a espasticidade de membro superior em pacientes hemiplégicos pós acidente vascular cerebral: um ensaio clínico randomizado
DOI:
https://doi.org/10.11606/issn.2317-0190.v32i3a232820Palavras-chave:
Acidente Vascular Cerebral, Espasticidade Muscular, Estimulação Transcraniana por Corrente Contínua, ReabilitaçãoResumo
Objetivo: Avaliar a eficácia de um protocolo de tratamento abrangente com quatro modalidades terapêuticas para a recuperação de pacientes com acidente vascular cerebral (AVC) crônico, por meio da avaliação de desfechos clínicos, neurológicos e funcionais. Métodos: Trinta e dois indivíduos com AVC ocorrido há pelo menos seis meses antes do estudo foram randomizados para receber dez sessões do protocolo de tratamento ou da intervenção simulada (SHAM). O protocolo de tratamento consistiu em estimulação elétrica transcraniana de baixa frequência, bloqueios paraespinhais, agulhamento de músculo espástico e estimulação elétrica funcional. A espasticidade, amplitude de movimento, dor, funcionalidade e qualidade de vida foram avaliadas usando a escala de Ashworth Modificada (MAS), goniometria, Escala Visual Analógica (VAS), Medida de Independência Funcional (FIM) e questionários Short Form 36 (SF-36). Resultados: O grupo intervenção mostrou uma melhora significativa na funcionalidade (na primeira semana [p= 0,02] e em três meses [p= 0,03]), na amplitude de movimento (flexão ativa do ombro p= 0,012; rotação interna ativa do ombro p=0,01; abdução ativa do ombro p= 0,002; extensão ativa do cotovelo p= 0,042) e na qualidade de vida (melhora de 14,34% a 108,33% em todos os domínios do SF-36). Ambos os grupos tiveram melhora significativa na dor (p≤0,001). Conclusão: Este protocolo foi eficaz para o tratamento da espasticidade de membro superior pós-AVC e levou a melhorias na funcionalidade, qualidade de vida e espasticidade. (Registro ClinicalTrials.gov - NCT05940805).
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