RESUMO
The six-minute walking test (6MWT) is used to assess exercise tolerance that is associated with motor function of the lower limbs in hemiparetic patients. It is suggested that, for post-stroke subjects, performance in the 6MWT may be limited by biomechanical and cardiovascular factors. Our aim is to determine the correlation between the six-minute walk distance (6MWD) and the biomechanical profile of hemiparetic patients. During this cross-sectional controlled study, 10 hemiparetic patients with heart failure underwent 6MWT (ATS protocol). Tonus (Ashworth Scale) and goniometry of the lower limbs were measured. The average of 6MWD in two tests was 279±8 m. There was a negative correlation between the degree of spasticity for both the sural triceps (r=-0.57, P<0.05), quadriceps (r=-0.58, P<0.05) and the limitation in ankle dorsiflexion and the 6MWD (r=-0.76, P<0.05). Also, there was correlation between hip extension and ankle dorsiflexion limitations with 6MWD (r=0.66, P<0.05), (r=0.77, P<0.05). The negative correlation between the highest spasticity in paretic limb and the 6MWD and the correlation between the lower movement range of paretic hip and ankle suggest association with these factors and gait velocity in 6MWT. Loss percentage represents the percentage calculation between distance traveled and the distance predicted achieved by patients. In this study, the negative correlation between the percentage of loss of 6MWD and the limitation in the ankle dorsiflexion movement suggests that for a minor motion arch of the ankle, there is a higher percentage of walking distance loss foretold.
RESUMO
INTRODUÇÃO: A aprendizagem motora surge de um processo complexo de percepção/cognição/ação. Para a Fisioterapia, o conhecimento sobre aprendizado motor fornece bases neurofisiológicas que sustentam a intervenção terapêutica. Na área de ensino de Ciências, a realidade virtual pode se apresentar como um instrumental pelo qual possam ser alcançadas as adolescentes com paralisia cerebral, com déficit no desempenho motor. OBJETIVOS: O presente estudo propôs a inserção de conhecimentos do ensino de ciências por meio de recursos tecnológicos na prática fisioterapêutica direcionada a adolescentes portadores de paralisia cerebral. Essa abordagem foi mediada pela realidade virtual, visando ao incremento do aprendizado motor. MÉTODOS: O desenho experimental utilizado no presente estudo foi o de abordagem qualitativa participante, utilizando-se como instrumento de coleta de dados as oficinas pedagógicas que tratavam de conceitos da ciência para o aprendizado motor aliado à realidade virtual. A amostra analisada foi constituída de quatro adolescentes, entre 11 e 18 anos, portadores de paralisia cerebral, matriculados no ensino fundamental da rede de ensino do município de Teresópolis (RJ), em tratamento fisioterapêutico na Clínica-Escola de Fisioterapia do Unifeso. Foi utilizada, também, a escala de função motora grossa (GMFM) como escala avaliativa pré e pós-intervenção. RESULTADOS: Os sujeitos/pacientes apresentaram melhora em seu desempenho neuromotor associado com o ensino de ciências, demonstrando ser possível a potencialização do aprendizado motor com a aproximação do aprendizado científico. Em relação à escala GMFM, pode-se perceber aumento de 4% na média geral, confirmando o avanço motor dos participantes, percebido nessa análise qualitativa. CONCLUSÃO: A criação de subsídios para a construção do conhecimento científico por meio dos recursos do ambiente virtual aponta para o incremento do desempenho motor e para a formação de sujeitos histórico-sociais.
INTRODUCTION: Motor learning arises from a complex process of perception/cognition/action. For Physiotherapy, knowledge of motor learning provides neurophysiological bases that support therapeutic intervention. In the area of science education, virtual reality may represent an instrument by which adolescents with cerebral palsy and deficit in motor performance can be reached. OBJETIVES: The present study has as purpose the inclusion of knowledge of science education through technology in physical therapy practice directed at adolescents with cerebral palsy. This approach was mediated by virtual reality, aiming to increase motor learning. METHODS: The experimental design used was a qualitative participant study, using as instrument to collect data pedagogical workshops, which dealt with science concepts for motor learning combined with virtual reality. The sample consisted of four subjects, aged 11 and 18 years, with cerebral palsy, enrolled in primary schools in the municipality of Teresopolis (RJ), and on physiotherapy in the School of Physiotherapy Clinic Unifeso. The scale of motor function (GMFM) as pre- and post-intervention was also used for evaluation. RESULTS: Subjects/patients showed improvement in their neuromotor performance associated with the teaching of science, demonstrating the feasibility of the enhancement of motor learning with the scientific learning approach. Regarding the GMFM scale it could be perceived an increase of 4% in the overall average, confirming the motor progress of the participants, perceived by this qualitative analysis. CONCLUSION: The creation of subsidies for the construction of scientific knowledge, by means of virtual resources environment, point to the enhancement of the motor performance and for the formation of social-historical subjects.
