Efeitos imediatos da eletroestimulação nervosa transcutânea e crioterapia na espasticidade e na atividade eletromiográfica de sujeitos hemiparéticos

Cerebrovascular accident (CVA) is a term used to characterize an ischemic or hemorrhagic vascular injury, which has got as main clinic manifestations, the motor and reflex function disturbance. In the first stage there is flaccidity and loss of voluntary movements that afterwards is substituted by mass patterns and spasticity. The spasticity brings with itself functional deficits and can generate negative impacts in various motor patterns. The aim of this research was to investigate the hyperreflexia and identify the immediate effects of transcutaneous nervous stimulation (TENS) and cryotherapy in the spasticity and electromyographic activity of hemiparetic subjects. The study is characterized as an almost experimental type, in which were selected, to compose the sample, 16 patients of both sex with CVA sequel. These individuals were evaluated by collecting the amplitude peak to peak and H reflex latency, Motor response (M response) in solear muscle and the electromyography (EMG) of the injured and healthy legs anterior tibial muscles. In the injured limb the evaluations occurred in different days for cryotherapy, TENS and control, in two moments, before and after the interventions. The healthy limb was evaluated one single time to serve as baseline, for comparison with the injured limb. It was used an statistic analysis, the t paired student test to identify the H reflex differences, latency and EMG of the injured and healthy limbs and to compare the results before and after the recourses application. The ANOVA for related samples was used to identify the differences among the recourses used. It was attributed for the statistic tests a significance level of 5%. The amplitude peak to peak of normalized maximum H reflex through the maximum motor response (Hmax/Mmax), showed itself significantly increased in the injured limb (p=0.0245). The H reflex latency was presented reduced in the injured limb (p=0, 0375). The electromyographic activity was showed decreased in the injured limb (p< 0.0001). After the TENS there was a Hmáx/Mmáx ratio decrease (0.60±0.16 versus 0.49.±0.18; P = 0.0006). Nonetheless, Just after the cryotherapy application there was an increase of Hmáx/Mmáx ratio (0.58 ± 0,15 to 0.77 ± 0.13, P=0,0007) and increase of signal latency (30.41 ± 1.87 versus 33.24 ± 2.19; P=0.0001). The electromyographic activity wasn t altered significantly by any resource. It was met statistic significant differences when the Hmáx/Mmáx P<0.0001) ratio and H reflex latency (P<0.0001) were compared between the post TENS, cryotherapy and control. One can conclude that the TENS can be used to spasticity immediate reduction, and that the cryotherapy can increase the hyperreflexia state in spastic patients. Nonetheless, the spasticity decrease or increase didn t provoke lectromyographic activity change in the muscle that is opponent to the spastic one

Efeitos da eletroestimulação sobre os parâmetros eletromiográficos e dinamométricos do músculo quadríceps femoral

To analyze the effects of electrical stimulation at two frequencies on the EMG parameters (EMG) and dynamometer, in muscles with different typing. MATERIALS AND METHODS: This is a controlled clinical trial, randomized and double blind. Sixty healthy volunteers (23.6 ± 4.2anos; 54.2 ± 7.7kg, 1.62 ± 0.009 cm) of both sexes were divided randomly into three groups: control group (CG), experimental group 1 (SG1) with application of the current Russian 30 HZ and experimental group 2 (EG2) at 70 Hz The volunteers performed an initial assessment (AV1) on the isokinetic dynamometer with three repetitions maximum voluntary isometric (MVC) for knee extension concomitant uptake of EMG for the VM muscle, VL and RF. Later, after application of NMES, they underwent an experimental protocol of isometric fatigue using 70% of MVIC, ending with the completion of a final assessment (AV2) in the same manner as the AV1. RESULTS: By analyzing the profile of the 60 subjects in three broad, VM showed a higher value of RMS behavior when the VL and RF (p = 0.03 and p = 0.02). With respect to Fmed the RF muscle (p = 0.001) showed a higher value for the VM. The VM muscle showed significant increases of Fmed (p = 0.05) after electrical stimulation at 70 Hz when compared the AV1 AV2 and RF showed significant decreases (p = 0.009) after stimulation at 30 Hz during the fatigue showed an increase RMS in the VM and VL, with a reduction in RF. For the variable Fmed was observed in three broad decline during fatigue. CONCLUSION: Our findings provide evidence that the muscles VM, VL and RF fiber typing are different besides indicating that the frequency of NMES tend to relate to the muscle stimulated. Finally suggests the surface EMG as a noninvasive method for characterizing muscle

Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Efeito imediato da estimulação elétrica neuromuscular seletiva do músculo VMO em pacientes com síndrome da dor femoropatelar

Patellofemoral pain syndrome (PFPS) is described as anterior or retropatellar pain knee in the absence of other pathologies and is frequently associated with dysfunction of the vastus medialis oblique (VMO). However, several studies have demonstrated the inability to selectively activate this muscle through exercise. To evaluate the effect of Neuromuscular Electrical Stimulation (NMES) selective VMO in women with syndrome. We evaluated thirty-eight women: twenty in the control group (24.15 ± 2.60 years) and eighteen diagnosed with PFPS (25.56 ± 3.55 years). Both groups were evaluated before and after a protocol of electro stimulation. To measure for comparing groups before and after treatment, we assessed the extensor torque concentric and eccentric knee through an isokinetic dynamometer, the intensity (Root Mean Square - RMS) and the onset of activation (onset) of VMO compared to the vastus lateralis (VL) in two types of exercise: open and closed kinetic chain. . Statistical analysis was performed using SPSS 15.0, with a significance level of 5%. Results: Our data showed an increase in the intensity of activation (RMS) of the VMO muscle after NMES in both study groups. During concentric contraction the RMS of the VMO before the NMES was 105.69 ± 32.26 μV and after a single intervention was 122.10 ± 39.62 μV (p = 0.048) for the control group. In the group with PPS, we found a similar behavior, with RMS of the VMO before NMES of 96.25 ± 18.83 μV and 139.80 ± 65.88 μV after the intervention (p = 0.0001). However, there was no evidence in the RMS value of VL muscle. The onset was calculated by subtracting the onset of VL by the onset of VMO. For the group with PFPS, the onset before the intervention was -0.007 ± 0.14 ms, indicating a delay of the VMO relative to VL, and after NMES was 0.074 ± 0.09 ms (p = 0.016), showing an activation previous VMO to VL. The same occurred for the control group. We also observed that NMES increased knee extensor power during the concentric contraction in both groups. Before the intervention the mean power was 28.97 ± 9.01 W for the PPS group and after NMES was 34.38 ± 7.61 W (p = 0.0001). Conclusion: We observed an increase in electromyographic activity of the VMO and also an anticipatory effect of this muscle