Constraint Induced Movement Therapy Increases Functionality and Quality of Life after Stroke.

This blind randomized clinical trial evaluated the effect of CIMT on the functionality and quality of life (QOL) of chronic hemiparetics. Thirty volunteers were divided into two groups: Control (CG) and CIMT (CIMTG); evaluated before and after 12 and 24 intervention sessions. The scales used were: adapted Fugl-Meyer Motor Assessment (FMA), Modified Ashworth, Stroke Specific Quality Of Life (SS-QOL) and the Functional Reach Test (FRT). The scores for all FMA variables in the CIMTG increased until the 24th session, differing from the pre-treatment. In the CG, the scores increased for pain, coordination/ speed and sensitivity. In the FRT there was an increase in the scores in both groups; after the 12th and 24th sessions, the result of the CIMTG was superior to the CG. For the SS-QOL in the CIMTG, the general score and most of the variables increased, as well as in the CG. Muscle tone in CIMTG was lower compared to CG after 24 sessions. Both protocols used in the study were effective, the CIMT protocol showed benefits in recovering the functionality of the paretic upper limb, in the functional range and in reducing muscle tone, with a consequent improvement in quality of life.

Uso de prancha de baixo custo para avaliação do equilíbrio de indivíduos hemiparéticos / Use of low-cost plank for balance assessment in patients with chronic hemiparesis

Introdução: Na hemiparesia há uma inadequada descarga de peso nos membros inferiores que geram déficits de equilíbrio, sendo as pranchas de equilíbrio imprescindíveis para avaliação. Objetivo: Verificar a aplicabilidade clínica de uma prancha de baixo custo e da Escala de Equilíbrio de Berg (EEB) na avaliação do equilíbrio e a distribuição de peso nos membros inferiores de pacientes hemiparéticos. Métodos: Estudo piloto, transversal, quantitativo, de inovação tecnológica que realizou avaliação de 21 indivíduos acometidos com Acidente Vascular Encefálico (AVE) por uma prancha de baixo custo. Resultados: Houve predominância de AVE isquêmico e hemiparesia direita. Na avaliação com a prancha, participantes com hemiparesia direita descarregaram maior peso na região do retropé, tanto com os pés juntos quanto na largura do quadril, enquanto os que possuem hemiparesia esquerda houve diferenças nas posições, com os pés juntos, pois a maioria descarregou o peso na região do antepé, enquanto com os pés na largura do quadril descarregaram na região do retropé. Quanto a avaliação pela EEB, as atividades funcionais que necessitavam de maior sustentação obtiveram menores médias, porém não houve correlação estatisticamente significativa com as posições sobre a prancha. Conclusão: A avaliação em saúde por meio da prancha de baixo custo torna-se um instrumento importante para identificar as alterações do equilíbrio e realizar intervenções apropriadas, entretanto não se correlaciona com a Escala de Equilíbrio de Berg. (AU)

Introduction: In hemiparesis the inadequate weight-bearing in the lower limbs generate balance deficits, and balance planks are essential for evaluation. Objective: To verify the clinical applicability of a low-cost board and the Berg Balance Scale (BBS) in the assessment of balance and weight distribution in the lower limbs of hemiparetic patients. Methods: A pilot, cross-sectional, quantitative, technological innovation study carried out an evaluation of 21 individuals affected by stroke with a low-cost plank. Results: Ischemic stroke and right hemiparesis were predominant. In the evaluation with the plank, participants with right hemiparesis unloaded more weight in the hindfoot region, with both feet together and hip width, while those with left hemiparesis showed differences in positions, with feet together, as most unloaded the weight in the forefoot region, while with feet hip width unloaded in the hindfoot region. As for the assessment by BBS, the functional activities that needed more support obtained lower averages; however, there was no statistically significant correlation with the positions on the board. Conclusion: Health assessment using the low-cost plank can be an important tool to identify changes in balance and carry out appropriate interventions, however it does not correlate with Berg Balance Scale. (AU)