Degree of disability, pain levels, muscle strength, and electromyographic function in patients with Hansen's disease with common peroneal nerve damage.

INTRODUCTION: This study evaluated the degree of disability, pain levels, muscle strength, and electromyographic function (RMS) in individuals with leprosy. METHODS: We assessed 29 individuals with leprosy showing common peroneal nerve damage and grade 1 or 2 disability who were referred for physiotherapeutic treatment, as well as a control group of 19 healthy participants without leprosy. All subjects underwent analyses of degree of disability, electromyographic tests, voluntary muscle force, and the Visual Analog Pain Scale. RESULTS: McNemar's test found higher levels of grade 2 of disability (Δ = 75.9%; p = 0.0001) among individuals with leprosy. The Mann-Whitney test showed greater pain levels (Δ = 5.0; p = 0.0001) in patients with leprosy who had less extension strength in the right and left extensor hallucis longus muscles (Δ = 1.28, p = 0.0001; Δ = 1.55, p = 0.0001, respectively) and dorsiflexion of the right and left feet (Δ = 1.24, p = 0.0001; Δ = 1.45, p = 0.0001, respectively) than control subjects. The Kruskal-Wallis test showed that the RMS score for dorsiflexion of the right (Δ = 181.66 m·s-2, p = 0.001) and left (Δ = 102.57m·s-2, p = 0.002) feet was lower in patients with leprosy than in control subjects, but intragroup comparisons showed no difference. CONCLUSIONS: Leprosy had a negative influence on all of the study variables, indicating the need for immediate physiotherapeutic intervention in individuals with leprosy. This investigation opens perspectives for future studies that analyze leprosy treatment with physical therapeutic intervention.

Degree of disability, pain levels, muscle strength, and electromyographic function in patients with Hansen's disease with common peroneal nerve damage / Grau de incapacidade, níveis de dor, força muscular e função eletromiográfica em portadores de hanseníase com lesão do nervo fibular comum

INTRODUCTION: This study evaluated the degree of disability, pain levels, muscle strength, and electromyographic function (RMS) in individuals with leprosy. METHODS: We assessed 29 individuals with leprosy showing common peroneal nerve damage and grade 1 or 2 disability who were referred for physiotherapeutic treatment, as well as a control group of 19 healthy participants without leprosy. All subjects underwent analyses of degree of disability, electromyographic tests, voluntary muscle force, and the Visual Analog Pain Scale. RESULTS: McNemar's test found higher levels of grade 2 of disability (Δ = 75.9%; p = 0.0001) among individuals with leprosy. The Mann-Whitney test showed greater pain levels (Δ = 5.0; p = 0.0001) in patients with leprosy who had less extension strength in the right and left extensor hallucis longus muscles (Δ = 1.28, p = 0.0001; Δ = 1.55, p = 0.0001, respectively) and dorsiflexion of the right and left feet (Δ = 1.24, p = 0.0001; Δ = 1.45, p = 0.0001, respectively) than control subjects. The Kruskal-Wallis test showed that the RMS score for dorsiflexion of the right (Δ = 181.66 m·s-2, p = 0.001) and left (Δ = 102.57m·s-2, p = 0.002) feet was lower in patients with leprosy than in control subjects, but intragroup comparisons showed no difference. CONCLUSIONS: Leprosy had a negative influence on all of the study variables, indicating the need for immediate physiotherapeutic intervention in individuals with leprosy. This investigation opens perspectives for future studies that analyze leprosy treatment with physical therapeutic intervention.

INTRODUÇÃO: O objetivo do estudo foi avaliar o grau de incapacidade, níveis de dor, força muscular e a função eletromiográfica (RMS) em indivíduos portadores de hanseníase. MÉTODOS: A amostra foi composta de um grupo de 29 sujeitos portadores de hanseníase, apresentando lesão do nervo fibular comum e grau 1 ou 2 de incapacidade, com indicação ao tratamento fisioterapêutico, e um grupo controle de 19 indivíduos saudáveis, sem hanseníase. Os sujeitos foram submetidos à análise do grau de incapacidade, testes de eletromiografia, de força muscular voluntária e da Escala Visual Analógica (EVA) para a dor. RESULTADOS: O teste de McNemar mostrou maior prevalência do grau dois de incapacidade (Δ=75,9%; p=0,0001) entre os indivíduos com hanseníase. O teste de Mann-Whitney revelou maiores níveis de dor (Δ=5,0; p=0,0001) nos pacientes com hanseníase apresentando menores níveis de força muscular da extensão do hálux direito e esquerdo (Δ=1,28, p=0,0001; Δ=1,55, p=0,0001) e flexão dorsal do pé direito e esquerdo (Δ=1,24, p=0,0001; Δ=1,45, p=0,0001) do que os indivíduos sem hanseníase. O teste de Kruskal-Wallis revelou que os valores do RMS da flexão dorsal dos pés direito (Δ=181,66m.s-², p=0,001) e esquerdo (Δ=102,57m.s-2, p=0,002) apresentaram menores valores que o grupo controle em ambos os lados, mas as comparações intragrupos não mostraram diferenças. CONCLUSÕES: Conclui-se que a hanseníase altera todas as variáveis analisadas na pesquisa, indicando a necessidade de intervenção fisioterapêutica imediata nos sujeitos com Hanseníase. Esta investigação abre perspectivas de futuras pesquisas que analisem o tratamento da hanseníase com intervenção fisioterapêutica.

Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment.

INTRODUCTION: This study aimed to evaluate the effect of the neural mobilization technique on electromyography function, disability degree, and pain in patients with leprosy. METHODS: A sample of 56 individuals with leprosy was randomized into an experimental group, composed of 29 individuals undergoing treatment with neural mobilization, and a control group of 27 individuals who underwent conventional treatment. In both groups, the lesions in the lower limbs were treated. In the treatment with neural mobilization, the procedure used was mobilization of the lumbosacral roots and sciatic nerve biased to the peroneal nerve that innervates the anterior tibial muscle, which was evaluated in the electromyography. RESULTS: Analysis of the electromyography function showed a significant increase (p<0.05) in the experimental group in both the right (Δ%=22.1, p=0.013) and the left anterior tibial muscles (Δ%=27.7, p=0.009), compared with the control group pre- and post-test. Analysis of the strength both in the movement of horizontal extension (Δ%right=11.7, p=0.003/Δ%left=27.4, p=0.002) and in the movement of back flexion (Δ%right=31.1; p=0.000/Δ%left=34.7, p=0.000) showed a significant increase (p<0.05) in both the right and the left segments when comparing the experimental group pre- and post-test. The experimental group showed a significant reduction (p=0.000) in pain perception and disability degree when the pre- and post-test were compared and when compared with the control group in the post-test. CONCLUSIONS: Leprosy patients undergoing the technique of neural mobilization had an improvement in electromyography function and muscle strength, reducing disability degree and pain.

Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment / Função eletromiográfica, grau de incapacidade e de dor em portadores de hanseníase submetidos à mobilização neural

INTRODUCTION: This study aimed to evaluate the effect of the neural mobilization technique on electromyography function, disability degree, and pain in patients with leprosy. METHODS: A sample of 56 individuals with leprosy was randomized into an experimental group, composed of 29 individuals undergoing treatment with neural mobilization, and a control group of 27 individuals who underwent conventional treatment. In both groups, the lesions in the lower limbs were treated. In the treatment with neural mobilization, the procedure used was mobilization of the lumbosacral roots and sciatic nerve biased to the peroneal nerve that innervates the anterior tibial muscle, which was evaluated in the electromyography. RESULTS: Analysis of the electromyography function showed a significant increase (p<0.05) in the experimental group in both the right (Δ percent=22.1, p=0.013) and the left anterior tibial muscles (Δ percent=27.7, p=0.009), compared with the control group pre- and post-test. Analysis of the strength both in the movement of horizontal extension (Δ percentright=11.7, p=0.003/Δ percentleft=27.4, p=0.002) and in the movement of back flexion (Δ percentright=31.1; p=0.000/Δ percentleft=34.7, p=0.000) showed a significant increase (p<0.05) in both the right and the left segments when comparing the experimental group pre- and post-test. The experimental group showed a significant reduction (p=0.000) in pain perception and disability degree when the pre- and post-test were compared and when compared with the control group in the post-test. CONCLUSIONS: Leprosy patients undergoing the technique of neural mobilization had an improvement in electromyography function and muscle strength, reducing disability degree and pain.

INTRODUÇÃO: Este estudo tem como objetivo avaliar o efeito da técnica de mobilização neural sobre a função eletromiográfica, grau de incapacidade e dor em portadores de hanseníase. MÉTODOS: A amostra de 56 indivíduos portadores de hanseníase foi randomizada em: grupo experimental composto por 29 indivíduos submetidos ao tratamento com mobilização neural e grupo controle composto por 27 indivíduos submetidos ao tratamento convencional. Em ambos os grupos, foram tratadas as lesões nos membros inferiores. No tratamento com mobilização neural, o procedimento utilizado foi a mobilização das raízes lombossacrais e do nervo isquiático com viés para o nervo fibular, que inerva o músculo tibial anterior, o qual foi avaliado na eletromiografia. RESULTADOS: Ao analisar a função eletromiográfica, observou-se aumento significativo (p<0,05) no grupo experimental em ambos os músculos tibiais anteriores, direito (∆ por cento=22,1; p=0,01) e esquerdo (∆ por cento=27,7; p=0,009), comparado ao grupo controle no pré e pós teste. Ao analisar a força no movimento de extensão horizontal (∆ por centodir=11,7; p=0,003/∆ por cento esq=27,4; p=0,002) e no movimento de dorso flexão (∆ por cento dir=31,1; p=0,000/∆ por cento esq=34,7; p=0,000), observou-se aumento significativo (p<0,05) em ambos os segmentos direito e esquerdo ao comparar o grupo experimental no pré e pós teste. O grupo experimental apresentou redução significativa (p=0,000) na percepção de dor e no grau de incapacidade ao comparar o pré e pós teste e na comparação com o grupo controle no pós teste. CONCLUSÕES: Pacientes submetidos à técnica de mobilização neural obtiveram melhora na função eletromiográfica e nos níveis de força muscular reduzindo o grau de incapacidade e dor.

Avaliação da dor em portadores de hanseníase submetidos à mobilização neural / Pain in leprosy patients undergoing neural mobilisation treatment

Este estudo tem como objetivo avaliar o efeito da técnica de mobilização neural sobre a percepção da dor em portadores de hanseníase. A amostra de 56 indivíduos portadores de hanseníase foi randomizada em: grupo experimental (GMN) composto por 29 indivíduos submetidos ao tratamento com mobilização neural e grupo controle (GC) composto por 27 indivíduos que foram submetidos ao tratamento convencional. A percepção da dor foi avaliada através da Escala Visual Analógica, indicando-se em uma extremidade a marcação de ausência de dor e na outra, pior dor imaginável. O GMN foi submetido ao tratamento utilizando a técnica de mobilização neural, que consistiu de dezoito atendimentos (seis semanas), três vezes por semana. O GC foi submetido ao tratamento convencional com exercícios de flexibilidade, fortalecimento, com uso de exercitadores de tornozelo ou de recursos eletroterápicos. O GMN apresentou redução significativa (p=0,000) na percepção da dor ao comparar o pré e o pós-teste e na comparação com o GC no pós-teste. O GC não apresentou diferença significativa (p=0,520). Conclui-se que a utilização da técnica de mobilização neural promoveu redução nos níveis de dor em portadores de hanseníase.

This study aimed to evaluate the effect of the neural mobilisation technique on pain in patients with leprosy. A sample of 56 individuals with leprosy was randomised into an experimental group (GMN), composed of 29 individuals undergoing treatment with neural mobilisation, and the control group (CG) of 27 individuals who underwent conventional treatment. We evaluated the perception of pain by Visual Analogue Scale - EVA. The GMN underwent treatment using the neural mobilisation technique, which consisted of eighteen treatments (six weeks), at three times per week. The CG was subjected to conventional treatment. The GMN showed a significant reduction (p = 0.000) in pain perception when comparing the pre and post-test for the GMN and when comparing the GMN and CG in the post-test. The CG didn’t show any significant result (p=0.520). We concluded that the technique of neural mobilisation promote an improvement on reducing the pain in leprosy patients.