Natália Padula

Propriedades mecânicas do gastrocnêmio eletroestimulado pós-imobilização

Introduction: Mechanical properties (MP) are clinically applicable tools for healthcare professionals working on the musculoskeletal system. Objectives: The aim of this study was to evaluate two protocols of neuromuscular electric stimulation (NMES) to improve MP regeneration of the myotendinous complex after segment immobilization in female rats. Materials and Methods: Fifty animals were equally distributed into five groups: Control (CG, n=10); Immobilized (IG, n=10); Immobilized and freely remobilized (IFG, n=10); Immobilized and NMES once /day (IEG1, n=10); Immobilized and MNES twice/day (IEG2, n=10). Immobilization was kept for 14 days, and remobilization was subsequently released for 10 days. NMES was applied for 10 days, post-immobilization, every morning for 10 minutes to IEG1 animals and every morning and afternoon (total 20 minutes) to the IEG2 group. After these procedures, the gastrocnemius muscle was submitted to the mechanical traction assay to evaluate stiffness, resilience, load and stretching at maximum limit MPs. Results: Immobilization reduced the MP values concerning load and stiffness (p 0.05). Conclusion: It is concluded that the gastrocnemius muscle became structurally better organized through a single NMES application and by remobilization.

Propriedades mecânicas do músculo gastrocnêmio de ratas, imobilizado e posteriormente submetido a diferentes protocolos de alongamento

Stretching is widely employed in physiotherapeutic clinical practice and in sportive activities; however, the mechanical alterations of the skeletal muscle generated by this technique are poorly scientifically investigated. This study evaluated the mechanical alterations suffered by the gastrocnemius muscle of young adult female Wistar rats, submitted to14 days of immobilization followed by passive manual stretching during 10 consecutive days once or twice a day. Fifty animals were equally distributed in five groups, Control (CG); Immobilized (IG); Immobilized and liberated (ILG); Immobilized and submitted to stretching once a day (IEG1); Immobilized and submitted to stretching twice a day (IEG2). The gastrocnemius muscle was analyzed by mechanical traction assay and the properties related to load and maximal and proportional stretching evaluated in addition to stiffness and resilience. Immobilization decreased load at maximal thresholds (MTL), load at proportional thresholds (LPT), stretch at maximal thresholds (SMT), stiffness and resilience were reduced in 44.4%, 34.4%, 27.6%, 64.4% and 54% respectively, compared to CG values. With subsequent free remobilization and stretching, all parameters were restored except for IEG2 in which SMT remained reduced in 31.3%, when compared to CG. It is concluded that after 14 days of segmental immobilization, individual stretching loads and free movements contribute to regain muscle mechanical properties.

Efeitos morfológicos do retorno da sobrecarga após imobilização em alongamento de músculo esquelético de ratas

CONTEXTUALIZACAO: Na reabilitacao, a imobilizacao em alongamento do musculo esqueletico e realizada como contramedida para reverter efeitos de encurtamento muscular severo e em eventos pos-cirurgicos. Acredita-se que o retorno as atividades funcionais normais estimule mecanotransdutores capazes de reorganizar a citoarquitetura normal muscular, porem a descricao das alteracoes histopatologicas relacionadas a esses procedimentos sao escassas na literatura. OBJETIVOS: Avaliar e quantificar anomalias histologicas induzidas pela imobilizacao em alongamento do musculo EDL (Extensor Digitorum Longus) e confronta-las com a livre movimentacao do animal apos esse procedimento. METODOS: Foram utilizadas 18 ratas Wistar, distribuidas nos grupos: controle (GC); imobilizadas em flexao plantar (EDL em posicao alongada) por 14 dias (GI); imobilizadas por 14 dias e liberadas por dez dias (GIL). Fragmentos do EDL foram congelados, seccionados e processados com reacoes imuno-histoquimica para colagenos I e III e histoquimica para Adenosina Trifosfatase Miofibrilar e Hematoxilina-Eosina. RESULTADOS: Os animais do GI apresentaram discreto aumento da expressao de colageno I e de fibras em processo degenerativo/necrotico, reducao da proporcao de fibras tipo (FT) 2A e do diâmetro menor de todos os tipos de fibras, quando comparados com os animais do GC. Para o GIL, observou-se retorno da quantidade de colageno I as condicoes controle, alem de reducao na proporcao de FT2D, aumento do numero de nucleos centralizados e do diâmetro menor das fibras quando comparadas com o GI, porem a expressao de FT2B e FT2D nao atingiu os valores de referencia. CONCLUSOES: Os dados apresentados mostram que a retomada da funcao durante dez dias foi parcialmente eficiente na recuperacao das caracteristicas do musculo EDL apos o periodo de imobilizacao e que, se extrapolados os dados a clinica fisioterapeutica, a adocao de procedimentos orientados as disfuncoes primarias do musculo pode favorecer a resposta morfofuncional do segmento e o seu integro restabelecimento.

Long-term effects of an intensive interventional training program based on activities for individuals with spinal cord injury: a pilot study.

Abstract Objectives: To investigate the long-term effects of a rehabilitation program using activity-based therapies in daily activities and the participation of individuals with spinal cord injury (SCI). Method: A descriptive study of case reports assessing the performance of daily activities and quality of life as a dependent variable, using the Functional Independence Measure (FIM) and the Short-Form Health Survey (SF-36), respectively. Seven individuals were included in the intervention composed of a multimodal intensive therapies program based on activities (activity-based therapy, ABT) conducted for 18 months. Results: It was possible to descriptively observe that the individual with the shortest time of injury and previous training obtained the largest variation in the FIM score. But no statistically significant difference was found in the assessments. Conclusion: For trained individuals with chronic SCIs, classified “A” according to the American Spinal Injury Association (ASIA), an ABT program did not significantly affect the scores of the scales used to assess quality of life (SF-36) and functional independence (FIM).

PHYSICAL EXERCISE FOR INDIVIDUALS WITH SPINAL CORD INJURY: SYSTEMATIC REVIEW BASED ON THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH

Introduction: Considering the reduction of physical activity performed daily in people with spinal cord injury, it is necessary to analyze the interventions based on physical exercises in order to provide recommendations based on evidence. Objectives: To review and evaluate the literature on physical exercise interventions for individuals with SCI, based on the International Classification of Functioning, Disability and Health, as well as physiological parameters for exercise prescription. Method: A systematic review of the literature produced from August 2016 to February 2017 within the PubMed, Embase, Cochrane Library, and MEDLINE databases. Results: Two independent examiners conducted a search in which 223 articles were initially found. A third evaluator verified possible divergences and generated a final list of 25 articles that strictly met the inclusion criteria, 5 of which investigated the effects of aerobic exercise, 2 of resistance training, 2 of balance training, 12 of gait training, and 4 evaluating the combined effect of 2 or more forms of training. Conclusion: Considering studies classified as of high and moderate quality of evidence, positive effects were observed in the domains of structures and functions, in aerobic, resistance training and combined exercises, and in some studies with gait training. In the domain of activities and participation, positive effects were observed in the studies with gait training, balance training, and combined interventions.

Twice a day neuromuscular electrical stimulation postimmobilization alters the mechanical properties and the histomorphometry of the skeletal muscle

Abstract Background: The responses to the use of neuromuscular electrical stimulation (NMES) technique, once or twice a day, are not well described in literature. In this direction, we measured the biomechanical