Alberto Cliquet Junior

Impact of Wheelchair Rugby on Body Composition of Subjects With Tetraplegia: A Pilot Study.

OBJECTIVE To investigate the longitudinal effects of wheelchair rugby (WR) training on body composition of subjects with tetraplegia. DESIGN Subjects were evaluated at baseline and after WR training. SETTING Faculty of physical education settings. PARTICIPANTS Individuals with tetraplegia (N=13; age, 26.6±6.0y). INTERVENTIONS Four sessions per week of WR training composed by aerobic and anaerobic activities and technical and tactical aspects of WR. The average time of intervention was 8.1±2.5 months. MAIN OUTCOME MEASURES Body composition assessed by dual-energy x-ray absorptiometry. RESULTS After training, fat mass was significantly reduced in the whole body (15,191±4603 vs 13,212±3318 g, P=.016), trunk (7058±2639 vs 5693±1498 g, P=.012), and legs (2847±817 vs 2534±742 g, P=.003). Conversely, increased bone mineral content (183±35 vs 195±32 g, P=.01) and fat-free mass (2991±549 vs 3332±602 g, P=.016) in the arms and reduced bone mineral content in the trunk (553±82 vs 521±86 g, P=.034) were observed after training. Furthermore, no significant correlation between the duration of training and changes in body composition was detected. CONCLUSIONS Regular WR training increased lean mass and bone mineral content in the arms and decreased total body fat mass. Conversely, WR training was associated with decreased bone mineral content in the trunk. These results suggest that regular WR training improves body composition in subjects with tetraplegia.

Análise clinica da espasticidade em indivíduos com lesão medular

OBJECTIVE: To evaluate the effect of neuromuscular electrical stimulation on spasticity in patients with spinal cord injury. METHODS: The study included eleven subjects with spinal cord injuries (C4 to T5). The modified Ashworth scale and pendulum test, which is accomplished through the Pendular Test Device - PTD (equipment which has a quartz crystal transducer accelerometer and optic fiber flexible electrogoniometer measuring the tensions and angular displacements). Patients underwent neuromuscular electrical stimulation (NMES) to the quadriceps muscle from fibular nerve, and the tests were administered before and after therapy. RESULTS: The data show a decrease in spasticity after NMES, with features such as increasead variation between maximum and minimum peaks, i.e. increased amplitude of the curves. Furthermore, data from the subjective scale, and modified Ashworth scale after neuromuscular electrical stimulation also showed a reduction in the values of spasticity. CONCLUSION: The data suggest that NMES is effective in reducing spasticity immediately after completion. Level of Evidence II, Therapeutic Studies-Investigating the Results of Treatment.Objective To evaluate the effect of neuromuscular electrical stimulation on spasticity in patients with spinal cord injury. Methods The study included eleven subjects with spinal cord injuries (C4 to T5). The modified Ashworth scale and pendulum test, which is accomplished through the Pendular Test Device - PTD (equipment which has a quartz crystal transducer accelerometer and optic fiber flexible electrogoniometer measuring the tensions and angular displacements). Patients underwent neuromuscular electrical stimulation (NMES) to the quadriceps muscle from fibular nerve, and the tests were administered before and after therapy. Results The data show a decrease in spasticity after NMES, with features such as increased variation between maximum and minimum peaks, i.e. increased amplitude of the curves. Furthermore, data from the subjective scale, and modified Ashworth scale after neuromuscular electrical stimulation also showed a reduction in the values of spasticity. Conclusion The data suggest that NMES is effective in reducing spasticity immediately after completion. Level of Evidence II, Therapeutic Studies-Investigating the Results of Treatment.

Adapted sport effect on postural control after spinal cord injury.

Study design:Cross-sectional study.Objective:The aim of this study was to compare trunk muscle activation during anterior and lateral reach in athletic and sedentary individuals with spinal cord injury (SCI) and able-bodied people.Settings:University Hospital—UNICAMP, Campinas, Brazil.Methods:Individuals with complete traumatic SCI and thoracic neurological level were separated into two groups: sedentary (SSCI: n=10) and physically active (PASCI: n=10). The control group (C: n=10) without SCI was assessed. Trunk muscle activation was recorded during reach and grasp tasks. The significant level was set at P<0.05.Results:The control group showed a highest mean activation for left longissimus muscle during all activities (P<0.05). The PASCI group presented significant highest activation for left iliocostalis muscles during all activities, except in the anterior reach task of 90% maximum reach (anterior reach (AR) 75: P=0.02; right lateral reach (RLR) 75: P=0.03; RLR90: P=0.01). The SSCI group presented highest activation for the left iliocostalis during the right lateral reach task of 75 and 90% maximum reach and right iliocostalis during the anterior reach task of 75% maximum reach (AR75: P=0.007; RLR75: P=0.02; RLR90: P=0.03). A different pattern of muscle activation between the control group and the groups with SCI was observed.Conclusion:Our results indicated that sports practice did not affect the trunk muscle activation in people with paraplegia. However, the pattern muscle activation in individuals with SCI is different compared with people without SCI during anterior reach tasks.

AVALIAÇÃO CINEMÁTICA DA TRANSFERÊNCIA DE PARAPLÉGICOS DA CADEIRA DE RODAS

Objective: To evaluate the transfer strategy of paraplegic subjects from their wheelchairs. Methods: Twelve thoracic spinal cord injured subjects participated in this study (T2 to T12). The subjects were able to independently transfer from a wheelchair to a one square meter (m2) platform, half a meter in height. Images of reflexive anatomic markers were captured by six ProReflex infrared cameras and processed using a QTRac Capture software. Kinematic parameters of the trunk, head, shoulders and elbows were evaluated. Results: The data analyzed compared the subjects’ preferential side for performing transfers, according to the functions performed by each body segment. Angular displacement of the head on sagittal plan (y-z), and the shoulders on the transversal plan (x-y), showed statistical differences (p<0.05). Conclusion: The data obtained on this study showed that there are differences in transfer strategies of paraplegic subjects to their preferential side, in comparison with the non-preferential side. Level of Evidence II, Development of diagnostic criteria on consecutive patients (with universally applied reference “gold” standard).

AVALIAÇÃO DO CONTROLE POSTURAL EM INDIVÍDUOS COM PARAPLEGIA FISICAMENTE ATIVOS E SEDENTÁRIOS

ABSTRACT Objective: The aim of this study was to evaluate functional independence and trunk control during maximum-range tasks in individuals with spinal cord injuries, who were divided into sedentary (SSI, n=10) and physically active (PASI, n=10) groups . Methods: Anamnesis was conducted and level and type of injury were identified (according to the American Spinal Injury Association protocol, ASIA) and the Functional Independence Measure (FIM) questionnaire was applied. For the forward and lateral reach task, the subjects were instructed to reach as far as possible. Mean data were compared using the unpaired t test and Mann-Whitney test and differences were considered significant when p<0.05 . Results: The PASI group performed better in self-care activities (PASI: 40.8±0.42 points, SSI: 38.0±3.58 points, p=0.01), sphincter control (PASI: 10.5±1.84 points, SSI: 8.2±3.04 points, p=0.02), transfers (PASI: 20.7±0.48 points, SSI: 16.9±4.27 points, p=0.04), and total FIM score (PASI: 104.0±2.30 points, SSI 105.1±8.56 points, p=0.01). On the maximum reach task, the PASI group had a greater average range in all directions evaluated (p<0.05) . Conclusion: The continuous practice of exercise increased motor function independence and trunk control in individuals with complete spinal cord injury. Level of Evidence II, Prospective Comparative Study.

Exploratory Study of Metabolomic Profile in Individuals with Spinal Cord Injury

The main causes of death in SCI subjects are connect with cardiovascular diseases, confirmed by intimal carotid layer stiffness, Metabolic Syndrome thru fat accumulation in the torso, upper body and caquexia and inflammation caused by physical inactivity (MATOS-SOUZA et al. 2009; MARUYAMA et al. 2008; MYERS et al. 2007; FROST et al. 2005; MANNS et al. 2005). We analyzed the blood samples of 29 athletes with disabilities and compared with sedentary subjects, that belong to the same group of disabilities, paraplegics and tetraplegics. Using the metabolomics technique we were able to identify small molecules in the blood samples that in conjunction form a profile which characterize a group.