RESUMO
[Purpose] Cerebrovascular accident (stroke) is characterized by an abrupt onset of focal or global neurological signs and symptoms. Asymmetry of the limbs is common following a stroke due to hemiplegia or hemiparesis. [Subject and Methods] A male patient having suffered an ischemic stroke was initially evaluated using the Timed Up-and-Go Test and the Six-Minute Walk Test. Static balance was evaluated using a force plate (Kistler model 9286BA) for the stabilometry analysis of center of pressure (COP) sway. The data were interpreted using the SWAY software program (BTS Engineering) synchronized with the SMART-D 140(®) system. Anodal transcranial direct current stimulation (tDCS; 2 mA) was applied over the primary motor cortex for 20 minutes during gait training on a treadmill. [Results] Under the condition of eyes open, reductions were found in anteroposterior sway (6.18%), trace length (3.3%) and sway velocity (3.3%) immediately following tDCS. [Conclusion] A single session of anodal tDCS combined with treadmill training had a positive effect on the static balance of a subject with chronic hemiparesis stemming from a stroke.
RESUMO
Introdução: O acidente vascular encefálico (AVE) é uma doença comum mundialmente, sendo uma das principais causas de incapacidade neurológica em adultos, geralmente acomete a função dos membros, o controle motor, o equilíbrio, a força e a mobilidade, sendo que para todas estas funções é necessário apresentar equilíbrio. O principal comprometimento motor é a hemiparesia, caracterizada pela perda parcial das funções motoras, incluindo déficit da mobilidade e a fraqueza muscular de um hemicorpo. A fisioterapia é fundamental nestes casos, ocorrendo uma melhor recuperação motora e funcional. Objetivo: Verificar a aplicação de exercícios com bola terapêutica na evolução do equilíbrioem pacientes hemiparéticos. Método: Participaram do estudo nove pacientes adultos hemiparéticos com idade 58,67 ±14,09 anos com seqüelas pós AVE e que apresentam déficits de equilíbrio, de ambos os sexos, submetidos a um programa de reabilitação de dez sessões. Conteve nove exercícios de tronco utilizando a bola terapêutica, visandotrabalhar a flexibilidade, a força, endurance, coordenação, consciência corporal e equilíbrio, sendo o tronco a base para a aquisição de equilíbrio. A própria bola já propicia um desequilíbrio, necessitando, consequentemente, da reorganização das reações de equilíbrio, que são fundamentais para as atividades de vida diária e a independência funcional. Resultados: Os resultados foram significantes e expressos em mediana, onde a pré intervenção obteve 43 pontos e pós intervenção 48 pontos (p=O,OOl). Conclusão: Os exercícios propostos com a bola terapêutica apresentaram melhora no equilíbrio dos pacientes hemiparéticos. Sendo um recurso acessível na reabilitação.
Introduction: Cerebrovascular accident (CVA) is a common disease worldwide and a leading cause of neurological disability in adults, usually affects the function of the limbs, motor control, balance, strength and mobility, and for ali these functions is must be balanced. One of the main motor impairment in hemiplegia is characterized by partial loss of motor function, including a deficit of mobility and muscie weakness of one hemisphere. Physical therapy is essential in these cases, occurring a better motor recovery and funcional. Objective: Verify the application of therapeutic ball exercises with the evolution of balance in hemiparetic patients. Method: Participated study of nine adult patients with hemiparetic age 58.67 ± 14.09 years with sequei after stroke and who have deficits in balance of both sexes, submitted to a rehabilitation program of ten sessions, contained nine exercises using the ball stem therapy, aiming to work on flexibility, strength, endurance, coordination, body awareness and balance, and the stem base to acquire balance. The ball itself already providesan imbalance, requiring, therefore, the reorganization of the balance reactions, which is fundamental to the activities of daily living and functional independence. Results: The results were significant and expressed as median, where the pre-treatment was 43 points and post-intervention was 48 points (p = 0.001). Conclusion: The proposed exercises with the ball therapy showed improvement in the balance of hemiparetic patients. Being an accessible resource rehabilitation.