[Effect of neuromuscular electrical stimulation and isotonic exercises in flexor and extensor muscles of knee of hemiplegic patients]. / Efecto de la estimulación eléctrica neuromuscular y de los ejercicios isotónicos en los músculos flexores y extensores de la rodilla en pacientes hémiplejicos.

AIM: To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. PATIENTS AND METHODS: The patients this study were divided into group 1 (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and the degree of spasticity by the modified Ashworth scale before and after ten sessions. RESULTS: Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001) was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified. CONCLUSIONS: The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles.

Efecto de la estimulación eléctrica neuromuscular y de los ejercicios isotónicos en los músculos flexores y extensores de la rodilla en pacientes hemipléjicos / Effect of neuromuscular electrical stimulation and isotonic exercises in flexor and extensor muscles of knee of hemiplegic patients

Comprobar la fuerza muscular y la resistencia al movimiento de los músculos flexores y extensores de larodilla de los pacientes con espasticidad después del tratamiento con estimulación eléctrica neuromuscular (EENM) y ejercicios isotónicos. Pacientes y métodos. Los pacientes se dividieron en grupo 1 (EENM) y grupo 2 (ejercicios isotónicos). Su momentode fuerza muscular y la resistencia al movimiento de los músculos flexores y extensores de la rodilla se midieron mediante el dinamómetro isocinético, y el grado de espasticidad se midió mediante la escala modificada de Ashworth antes y después de diez sesiones. Resultados. No se observaron variaciones en las puntuaciones de la escala modificada de Ashworth.Se verificó un aumento del momento de fuerza de flexión en el grupo 1 (p = 0,041) y en el grupo 2 (p = 0,001). En el modo pasivo, el grupo 1 presentó una disminución de la resistencia al movimiento de flexión (p = 0,026), mientras que en el grupo 2 se verificó una disminución de la resistencia tanto al movimiento de flexión (p = 0,029) como al movimiento de extensión(p = 0,019). Conclusiones. Los dos recursos terapéuticos demostraron su eficacia sólo para el aumento de la fuerza de los músculos flexores. En la resistencia al movimiento, los ejercicios isotónicos fueron más eficaces porque fomentaron una disminuciónde la resistencia de los músculos flexores y extensores de la rodilla

To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. Patients and methods. The patients this study were divided into group 1 (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and thedegree of spasticity by the modified Ashworth scale before and after ten sessions. Results. Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001)was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified.Conclusions. The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles

Effects of direction and curvature on variable error pattern of reaching movements.

A number of studies have analyzed various indices of the final position variability in order to provide insight into different levels of neuromotor processing during reaching movements. Yet the possible effects of movement kinematics on variability have often been neglected. The present study was designed to test the effects of movement direction and curvature on the pattern of movement variable errors. Subjects performed series of reaching movements over the same distance and into the same target. However, due either to changes in starting position or to applied obstacles, the movements were performed in different directions or along the trajectories of different curvatures. The pattern of movement variable errors was assessed by means of the principal component analysis applied on the 2-D scatter of movement final positions. The orientation of these ellipses demonstrated changes associated with changes in both movement direction and curvature. However, neither movement direction nor movement curvature affected movement variable errors assessed by area of the ellipses. Therefore it was concluded that the end-point variability depends partly, but not exclusively, on movement kinematics.