Análise cinemática do membro superior espástico de pacientes pós acidente vascular cerebral submetidos à terapia com toxina botulínica

Abstract

In order to investigate the impact of botulinum toxin type A treatment on the spastic upper limb kinematics in post-stroke patients, 8 patients were evaluated before (V1) and after (V2) the toxin injection. Standardized scales were used to assess spasticity and motor function of upper limb (Tardieu, MAS and FMA). The "hand to mouth" functional movement was recorded through an optoelectronic image capture system. For control, 4 healthy volunteers were submitted to the same registry in a single visit. The kinematic analysis was based on the times of movement (TF1 = Time of Phase 1, TF2 = Time of Phase 2 and TTM = Total Time of Movement); the number of movement units in each phase and total (NUM1 = Phase 1, NUM2 = Phase 2 and NUMT = Total); and peak angular velocity of elbow (PVAC). The mean values of each patient’s registry and the overall mean of each parameter in V1 and V2, were computed and compared using the “Wilcoxon signed rank paired” test. Significant differences were found in the Elbow MAS (p = 0.0369); the fist Tardieu (p = 0.0477) and FMA (p = 0.0142). The kinematic parameters TF1, TF2, TTM, NUM1, NUM2 and NUMT decreased in V2, while PVAC increased. Values of these parameters normalized by means of healthy, indicated a decrease in the difference between patients and healthy in V2. The results indicate, that there was a positive impact of the treatment on the spastic upper limb kinematics of poststroke patients.