Electromyographic and strength analyses of activation patterns of the wrist flexor muscles after acupuncture.

This study analyzed the electromyographic and strength responses of the flexor muscles of the wrist following stimulation of acupuncture points. A total of 52 participants were randomly divided into four groups: local (heart 3, HT3), distant (heart 4, HT4), control (bladder 60, BL60), and naïve control groups. To obtain the root mean square electromyographic activity, we placed surface electrodes over the wrist flexors. To obtain kilogram force (kgf) values, we attached a force transducer to the floor and to the hands of participants. Both values were recorded over three repetitions of maximal isometric wrist flexion contractions. Data were analyzed using one-way analyses of variance, followed by Dunnett's post-hoc tests. We found reductions in electromyographic activity contralateral to the stimulated point in the distant group 10 minutes after removal of the needles (F(3,48) = 3.25; p < 0.05). Regarding muscle strength, ipsilateral and contralateral stimulation in the distant group produced kgf levels prior to and 10 minute and 20 minutes after withdrawal of the acupuncture needle that were lower than that obtained prior to insertion of the needle (F(3,48) = 5.82; p < 0.05). Thus, stimulation of the acupuncture points distant from the wrist flexors reduced ipsilateral and contralateral muscle strength and decreased the root mean square values contralateral to the site of stimulation.

Efeitos do treino de marcha com assistência robótica em pacientes pós - acidente vascular encefálico / Effects of robot-assisted gait training in stroke patients

Pacientes acometidos por acidente vascular encefálico (AVE) apresentam déficit significativo de marcha em decorrência da complexidade de suas deficiências. O treino de marcha com assistência robótica (TMR), além de diminuir a carga física imposta sobre o terapeuta, garante um ambiente simplificado e seguro para o treino de marcha, no qual padrões simétricos e constantes de movimentos de membros inferiores podem ser desenvolvidos e em maiores velocidades, além de permitir uma terapia com maior tempo de duração. Apesar do uso crescente deste equipamento em reabilitação pouco se sabe sobre os efeitos promovidos na reabilitação da marcha pós-AVE, assim como os protocolos de intervenção empregados para se alcançá-los. Objetivo: Avaliar as evidências atuais quanto à eficácia do TMR em indivíduos pós-AVE, com ênfase no desempenho da marcha. Método: Para isso, foi realizado um levantamento literário dos estudos publicados nos últimos 10 anos (2003-2013) com os termos "stroke" and "gait" and "robotics" nas bases de dados PubMed, MedLine e LILACS. Resultados: Foram selecionados 5 estudos que preencheram os critérios de inclusão, entre eles o de utilizar o dispositivo robótico Lokomat (Hocoma, Volketswil) para o treino de marcha em pacientes pós-AVE. A análise dos resultados obtidos em cada estudo considerou os ganhos promovidos nos parâmetros lineares da marcha (velocidade e distância percorrida) pela terapia robótica em comparação à terapia convencional. Conclusão: Os dados sugerem que o emprego da terapia robótica na reabilitação da marcha do paciente pós-AVE não produz ganhos adicionais aos obtidos com a terapia convencional

Stroke patients present significant gait deficits due to the complexity of their disabilities. Robot-assisted gait training (RGT), in addition to reducing the therapist's physical overload, ensures a simpler and safer environment for gait training, in which symmetrical and constant movement patterns of the lower limbs can be developed at higher speeds, and allows for a longer therapy session. Despite an increasing use of this equipment in rehabilitation, there is a lack of knowledge about the effects that can be promoted in paretic gait, as well as the training protocols applied to achieve them. Objective: Thus, this study aimed to assess the current evidence for efficacy of RGT in post-stroke individuals, with emphasis on gait performance. Method: For this, a survey of studies published in the last 10 years (2003-2013) with the terms "stroke" and "gait" and "robotics" was conducted in the PubMed, MedLine and LILACS databases. Results: Five studies were selected that met the inclusion criteria, including using the Lokomat robotic device (Hocoma, Volketswil) for gait training in post-stroke patients. The results obtained for each study considered the gains in linear gait parameters (speed and distance traveled) promoted by robotic therapy compared to conventional therapy. Conclusion: The data suggest that the use of robotic therapy in gait rehabilitation of post-stroke patients does not produce any more gains than those obtained with conventional therapy