ABSTRACT
Este estudo revisou artigos nas bases de dados do MEDLINE (Pub-Med) e demais fontes de pesquisa, sem limite de tempo. Para tanto, adotou-se a estratégia de busca baseada em perguntas estruturadas na forma (P.I.C.O.) das iniciais: "Paciente"; "Intervenção"; "Controle" e "Outcome". Como descritores utilizaram-se: (cerebrovascular disorders OR Stroke) AND acute AND (movement OR physical therapy modalities OR exercise movement techniques); (cerebrovascular disorders OR stroke) AND (Postural Balance OR Musculoskeletal Physiological Phenomena) AND Rehabilitation AND trunk; (cerebrovascular disorders OR Stroke)AND (virtual reality OR user-computer interface OR video games); cerebrovascular disorders AND (home care services, hospital-based); cerebrovascular disorders AND (contractures OR splint OR orthotic devices); cerebrovascular disorders AND acute AND (rehabilitation OR physical therapy disorders or task performance); cerebrovascular disorders AND (physical therapy modalities OR rehabilitation OR exercise therapy) AND (Home Care Services OR self care); (cerebrovascular disorders OR stroke) AND (electric stimulation OR electric stimulation therapy) AND (muscle tonus OR muscle hypotonia OR muscle hypertonia); cerebrovascular disorders AND (restraint physical OR constraint induced movement therapy OR constraint); (cerebrovascular disordersOR stroke) AND (body weight support OR supported treadmill training OR partial weight bearing); (cerebrovascular disorders OR stroke) AND transcranial magnetic stimulation; (cerebrovascular disorders OR stroke) AND bandages. Com esses descritores efetivaram-se cruzamentos de acordo com o tema proposto em cada tópico das perguntas (P.I.C.O.). Analisado esse material, foram selecionados os artigos relativos às perguntas e, por meio do estudo dos mesmos, estabeleceram-se as evidências que fundamentaram às diretrizes do presente documento.
This study revised articles from the MEDLINE (PubMed) databases and other research sources, with no time limit. To do so, the search strategy adopted was based on (P.I.C.O.) structured questions (from the initials "Patient"; "Intervention"; "Control" and "Outcome". As keywords were used: (cerebrovascular disorders OR Stroke) AND acute AND (movement OR physical therapy modalities OR exercise movement techniques); (cerebrovascular disorders OR stroke) AND (Postural Balance OR Musculoskel et al. Physiological Phenomena) AND Rehabilitation AND trunk; (cerebrovascular disorders OR Stroke) AND (virtual reality OR user-computer interface OR video games); cerebrovascular disorders AND (home care services, hospital-based); cerebrovascular disorders AND (contractures OR splint OR orthotic devices); cerebrovascular disorders AND acute AND (rehabilitation OR physical therapy disorders or task performance); cerebrovascular disorders AND (physical therapy modalities OR rehabilitation OR exercise therapy) AND (Home Care Services OR self care); (cerebrovascular disorders OR stroke) AND (electric stimulation OR electric stimulation therapy) AND (muscle tonus OR muscle hypotonia OR muscle hypertonia); cerebrovascular disorders AND (restraint physical OR constraint induced movement therapy OR constraint); (cerebrovascular disorders OR stroke) AND (body weight support OR supported treadmill training OR partial weight bearing); (cerebrovascular disorders OR stroke) AND transcranial magnetic stimulation; (cerebrovascular disorders OR stroke) AND bandages. With the above keywords crossings were performed according to the proposed theme in each topic of the (P.I.C.O.) questions. After analyzing this material, articles regarding the questions were selected and, by studying those, the evidences that fundamented the directives of this document were established.
Subject(s)
Humans , Electric Stimulation Therapy , Physical Therapy Modalities/instrumentation , Early Ambulation/instrumentation , Walk Test , Stroke Rehabilitation , Hemiplegia/etiologyABSTRACT
Este artigo tem como objetivo revisar a literatura sobre o uso do CFES com desfechos musculares para os indivíduos com lesão medular. Método: Foi realizada uma revisão bibliográfica sistemática nas bases eletrônicas de dados Medline, Pubmed, Lilacs, Portal SciELO, sem delimitação de tempo ou idioma. Utilizou-se da estratégia PICO para pesquisa, as palavras-chave foram selecionadas a partir dos descritores em ciências de saúde e relacionaram-se com lesão medular, estimulação elétrica e parâmentros musculares. Resultados: Foram encontrados 554 artigos. Desses, 432 foram excluídos pelo título, resultando em 122 artigos. Destes, foram excluídas as duplicidades, resultando num total de 73 artigos, 36 foram excluídos pelo resumo e 33 após a leitura do estudo. Quatro estudos foram selecionados. Dois artigos incluíram homens e mulheres em seus estudos, dois apenas homens. Três estudos incluíram tetraplégico e paraplégicos no mesmo estudo, um incluiu apenas tetraplégicos. Um dos estudos utilizou um freqüência de treinamento maior, sete vezes por semana, três fizeram uso de uma freqüência de treinamento de três vezes por semana. A duração dos estudos teve grande variação, de seis semanas até um ano. As medidas de resultado para a avaliação de força e resistência foram realizadas de diversas maneiras, por medida de área de secção transversal dos músculos circunferência do membro e a biópsia muscular, contudo todos os estudos apresentavam ao menos uma das medidas fornecidas pelo equipamento, a avaliação de potência gerada (power output) ou do trabalho realizado (work output). Em todos os estudos houve melhora da potência gerada ou do trabalho realizado. Apesar da heterogeneidade encontrada nestes estudos, os desfechos dos estudos avaliados indicam um aumento significativo de potência gerada e trabalho realizado após os períodos de treinamentos, com ganhos a partir de seis semanas e treinamentos a partir de três vezes por semana. Conclusão: Estudos futuros são necessários para avaliar as repostas em diferentes grupos de sujeitos, paraplégicos e tetraplégicos, em diferentes frequências de treinamento e em diferentes períodos de treinamento. Proporcionando assim a elaboração de protocolos de treinamento cada vez mais direcionados.
The aim of this study was to determine whether the use of FES produces muscular benefits for individuals with spinal cord injuries. Method: A review of the literature was done in the electronic database Medline, Pubmed, Lilacs and Scielo, without limitation of time or language. The PICO strategy has been used for this research. Results: 554 articles were found. From these, 432 were excluded by title, resulting in 122 articles left. Out of these articles the duplicates were excluded resulting in 73 articles; 36 were then excluded after reading the abstract and 33 more after reading the full text. Four studies were selected. Two articles included males and females in their studies and two only included males. Three studies included quadriplegics and paraplegics in the same study; one included only quadriplegics. One of the studies used a more frequent training routine, seven times a week; three trained only three times a week. The duration of the studies was varied considerably, from six weeks to one year. The resulting measurements for strength and resistance evaluation were performed in different manners, by muscle transverse section area measurement, limb circumference, and muscle biopsy; however, all studies presented at least one of the measurements provided by the equipment, power output or work output. Improvement of the power output and work output has been shown in all studies. Despite the heterogeneity encountered in these studies, the outcomes evaluated by them indicate a significant increase in the power output and work output after training periods, with gains starting from six weeks of training at least three times a week. Conclusion: Future studies are needed to assess different responses in different groups of subjects, paraplegics or quadriplegics, under different frequencies and periods of training, and thereby provide the elaboration of more directed training protocols.