Correlação entre o sinal mecanomiográfico e a escala modificada de Ashworth durante avaliação clínica da espasticidade

Spasticity is a common disorder in people who have upper motor neuron injury. The involvement may occur at different levels. The Modified Ashworth Scale (MAS) is the most used method to measure involvement levels. But it corresponds to a subjective evaluation. Mechanomyography (MMG) is an objective technique that quantifies the muscle vibration during the contraction and stretching events. So, it may assess the level of spasticity accurately. This study aimed to investigate the correlation between spasticity levels determined by MAS with MMG signal in spastic and not spastic muscles. In the experimental protocol, we evaluated 34 members of 22 volunteers, of both genders, with a mean age of 39.91 ± 13.77 years. We evaluated the levels of spasticity by MAS in flexor and extensor muscle groups of the knee and/or elbow, where one muscle group was the agonist and one antagonist. Simultaneously the assessment by the MAS, caught up the MMG signals. We used a custom MMG equipment to register and record the signals, configured in LabView platform. Using the MatLab computer program, it was processed the MMG signals in the time domain (median energy) and spectral domain (median frequency) for the three motion axes: X (transversal), Y (longitudinal) and Z (perpendicular). For bandwidth delimitation, we used a 3rd order Butterworth filter, acting in the range of 5-50 Hz. Statistical tests as Spearman's correlation coefficient, Kruskal-Wallis test and linear correlation test were applied. As results in the time domain, the Kruskal-Wallis test showed differences in median energy (MMGME) between MAS groups. The linear correlation test showed high linear correlation between MAS and MMGME for the agonist muscle as well as for the antagonist group. The largest linear correlation occurred between the MAS and MMG ME for the Z axis of the agonist muscle group (R2 = 0.9557) and the lowest correlation occurred in the X axis, for the antagonist muscle group (R2 = 0.8862). The Spearman correlation test also confirmed high correlation for all axes in the time domain analysis. In the spectral domain, the analysis showed an increase in the median frequency (MMGMF) in MAS’ greater levels. The highest correlation coefficient between MAS and MMGMF signal occurred in the Z axis for the agonist muscle group (R2 = 0.4883), and the lowest value occurred on the Y axis for the antagonist group (R2 = 0.1657). By means of the Spearman correlation test, the highest correlation occurred between the Y axis of the agonist group (0.6951; p <0.001) and the lowest value on the X axis of the antagonist group (0.3592; p <0.001). We conclude that there was a significantly high correlation between the MMGME and MAS in both muscle groups. Also between MMG and MAS occurred a significant correlation, however moderate for the agonist group, and low for the antagonist group. So, the MMGME proved to be more an appropriate descriptor to correlate with the degree of spasticity defined by the MAS.

Biomonitoramento da comunidade de macroinvertebrados de um reservatório de abastecimento público no sul do Brasil

The faunal inventory of the macroinvertebrate community is important to the environmental assessment, since this biota is sensitive to human disturbance. The reservoir of Rio Verde, located on the first plateau of Paraná, is inserted into an agricultural region with several forest fragments Araucaria. The aim of this study was to evaluate the environmental integrity of the reservoir through ecological indexes of macroinvertebrate community benthic and associated with macrophytes. Five sampling points were defined in the study area, which comprise distinct microhabitats in the basin. There were four sampling campaigns, each by weather station: Spring (2014); Summer (2015); Autumn (2015) and Winter (2015). In each sample were measured abiotic various parameters in the field and be collected water samples for nutrient analysis in the laboratory. The macroinvertebrates were collected in triplicate at adapted Macan method using mesh sieve 1 mm and CPUE (catch per unit effort) for 20 minutes. In order to pellet sample was used a dredger model Petersen 2L. Still in the field, by season, samples were collected from macrophytes Myriophyllum aquaticum (Vell) Verdc. and Potamogeton montevidensis A. Benn. in triplicates in the fluvial region of the reservoir, to analyze the associated fractal dimension and macrofauna. For this we used a PVC sampler specific volume 0.025 m3. the following ecological descriptors were calculated in each case: abundance, wealth tax, wealth Margalef, Shannon-Wiener diversity, evenness evenness through the Past software. The index Biological Monitoring Working Party (BMWP) for monitoring sampling points was also calculated. Regarding the statistical analysis, we used the analysis of PERMANOVA to compare points and seasons and canonical correspondence analysis (CCoA) for variables. Regarding M. aquaticum and P. montevidensis it was not verified difference to the average associated macroinvertebrates. However there was a difference for abundance of organisms in the fractal dimension and biomass of specimens. M. aquaticum is more complex and took more macrofauna in relation to P. montevidensis. Regarding the monitoring of the reservoir, it showed up mesotrophic with moderate nutrient concentrations and within the regulatory limits. Benthic macrofauna showed statistical differences in relation to the reservoir region, sample point and temporal variation. The BMWP index showed that the river region has the highest biotic integrity (in all samples above 70 points), and the ecological descriptors of wealth and Margalef diversity of Shannon- Wiener higher. In point 4 (dam downstream) were recorded evidence of possible impacts due to lower wealth and BMWP index which resulted in a questionable quality water. New approaches are needed to focus on the aquatic community in the best understanding of this ecosystem and also with a view to environmental preservation of the Green River Basin.