TERAPIA ESPELHO COM SMARTPHONE: ANÁLISE FUNCIONAL DO HEMICORPO PÓS-ACIDENTE VASCULAR ENCEFÁLICO
DOI:
https://doi.org/10.56238/arev8n4-054Palavras-chave:
Terapia-Espelho, AVE, Reabilitação, Eletromiografia, Óculos de Realidade VirtualResumo
As sequelas causadas por um AVE são inúmeras, podendo ocasionar hemiparesia ou hemiplegia em um dos lados do corpo. Dentre os tratamentos atuais para intervenção, a terapia espelho é uma proposta que visa a reorganização do córtex e recuperação da funcionalidade, além de reduzir o quadro álgico. Portanto objetiva-se desenvolver um método de treinamento/ reabilitação de membros através de óculos de realidade virtual adaptados para o uso com smartphone para aplicar a terapia espelho de maneira mais independente. Para a avaliação, foram utilizados o dinamômetro de preensão palmar, a escala de Fugl Meyer, o teste Time Get Up And Go, o teste de habilidade motora para membro superior e a eletromiografia de superfície nos membros pré e pós-intervenção terapêutica para avaliação da função motora e força muscular. Na análise estatística, foram realizados os testes T de student para parâmetros normais e os de Wilcoxon para parâmetros não normais, onde foi considerando o p-valor de 0,05 para rejeição da hipótese de nulidade; para os dados da eletromiografia de superfície, as variáveis em estudo foram submetidas à análise com ajustes de tendência para as variáveis quantitativas e teste T pareado para comparação das medições. Conclui-se que houve uma melhora expressiva em todos os testes avaliativos nos membros superiores, porém, nos membros inferiores foi observada uma evolução apenas na amplitude de movimento e na ativação elétrica muscular para os testes avaliativos.
Downloads
Referências
Arya K, Pandian S, Puri V. Mirror Illusion for Sensori-Motor Training in Stroke: A Randomized Controlled Trial. Journal of Stroke and Cerebrovascular Diseases. 2018. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.07.012
Arya KN. Underlying neural mechanisms of mirror therapy: implications for motor rehabilitation in stroke. Neurol India 2016;64:38-44. 10.4103/0028-3886.173622
Brito R., Lins L., Almeida C., et al..Specific Functional Assessments For Stroke. RevNeurocienc 2013;21(4):593-599. doi: 10.4181/RNC.2013.21.850.7p
Carregosa A., Santos L., Masruha M. et al..Virtual Rehabilitation through Nintendo Wii in Poststroke Patients: Follow-Up. Journal of Stroke and Cerebrovascular Diseases. 2017. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.09.029
Chae J, Labatia I, Yang G: Upper limb motor function in hemiparesis: Concurrent validity of the arm motor ability test. Am J PhysMedRehabil2003;82:1–8. 10.1097/00002060-200301000-00001
Chancel M, Kavounoudias A, Guerraz M. What's Left Of the mirror illusion when the mirror can no longer be seen? Bilateral integration of proprioceptive afferents!.Neuroscience. 2017 Oct 24; 362:118–26. https://doi.org/10.1016/j.neuroscience.2017.08.036 PMID: 28843995
Cherni Y, et al. Use of electromyography to optimize Lokomat® settings for subject-specific gait rehabilitation in post-stroke hemiparetic patients: A proof-of-concept study. Neurophysiologie Clinique/Clinical Neurophysiology (2017), http://dx.doi.org/10.1016/j.neucli.2017.01.008
Crivelli D, Polimeni E, Crotti D, Bottini G, Salvato G. Bilateral skin temperature dropandwarm sensibility decrease following modulation of body part ownership through mirror-box illusion. Córtex. Volume 135, February 2021, Pages 49-60. https://doi.org/10.1016/j.cortex.2020.11.015
Diers M, Kamping S, Kirsch P, Rance M, Bekrater-Bodmann R, Foell J, et al. Illusion-related brain activations: A new virtual reality mirror box system for use during functional magnetic resonance imaging. Brain Research 1594; 173–182. (2015) doi: 10.1016/j.brainres.2014.11.001 PMID: 254464533.770882
Egsgaard L., Petrini L., Christoffersen G., Nielsen l. Cortical responses to the mirror box illusion: a high-resolution EEG study. ExpBrain Res (2011) 215:345–357 DOI 10.1007/s00221-011-2902-x
Fong K, Ting K, Zhang J, Yau C, Li L. Event-Related Desynchronization During Mirror Visual Feedback: A Comparison of Older Adults And People After Stroke. Front. Hum. 2021. Neurosci. 15:629592. https://doi.org/10.3389/fnhum.2021.629592.
Franciulli P., Bigongiari A., Grilletti J., et al.. The effect of aquatic and treadmill exercise in individuals with chronic stroke. FisioterPesqui. 2019;26(4):353-359. DOI: 10.1590/1809-2950/17027326042019
Gandhi D, Sterba A, Khatter H, Pandian J. Mirror Therapy in Stroke Rehabilitation: Current Perspectives. Therapeutics and Clinical Risk Management. 2020:16 75–85. http://doi.org/10.2147/TCRM.S206883.
Giroux M, Barra J, Zrelli I, Barraud P, Cian C, Guerraz M. The respective contributions of visual and proprioceptive afferents othemirrorillusion in virtual reality. PLOS ONE | August 30, 2018. https://doi.org/10.1371/journal.pone.0203086.
Ishihara Y,Kodaka K. Vision-Driven Kinesthetic Illusion in Mirror Visual Feedback. i-Perception 2018 Vol. 9(3), 1–11. DOI: 10.1177/2041669518782994.
Lin KC, Huang PC, Chen YT, Wu CY, Huang WL. Combining Afferent Stimulation And Mirror Therapy for rehabilitating motor function, motor control, ambulation, and daily functions after stroke. Neurorehabil Neural Repair. 2014;28(2):153–162. doi:10.1177/ 1545968313508468
Liu, Y., Medina, J., Influence of the Body Schema on Multisensory Integration: Evidência da ilusão da caixa do espelho. 2017. https://doi.org/10.1038/s41598-017-04797- 0.
Michaelsen S., Rocha A., Knabben R., et al. Translation, adaptation and inter-rater reliability of the administration manual for the Fugl-Meyer assessment. RevBrasFisioter, São Carlos, v. 15, n. 1, p. 80-8, jan./fev. 2011. 10.1590/S1413-35552011000100013.
Milde C, Rance M, Kirsch P, Trojan J, Fuchs X, Foell J, et al . Do mirror glasses have the same effecton brain activity as a mirror box? Evidence from a functional magnetic resonance imaging study with healthy subjects. PLoSOne 2015;10:e0127694.
Nighoghossian N. Potential of Mirror RehabilitationTherapy in Stroke Outcome. Neuroscience. 390 (2018). https://doi.org/10.1016/j.neuroscience.2018.07.013
Pérez-Cruzado D, Merchán-Baeza JA, González-Sánchez M, Cuesta-Vargas AI. Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors. AustOccupTher J. 2017;64(2):91–112. https://doi.org/10.1111/1440-1630.12342
Persch A., Wagner A., Fleming M., et al.. Ohio Modified Arm–Motor Ability Test (OMAAT): An Optimized Measure of Upper Extremity Functional Limitation in Hemiparetic Stroke. The American Journal of Occupational Therapy, 2018, Vol. 72(4), https://doi.org/10.5014/ajot.2018.025445
Rajendran V, Jeevanantham D, Larivière C, Singh R, et al. Effectiveness of self-administered mirror therapy on upper extremity impairment and function of acute stroke patients: study protocol.Trials (2021) 22:439 https://doi.org/10.1186/s13063-021-05380-9
Romano D, Tosi G, Gobbetto V, et al. Back in control ofintentionalaction: Improvementofideo motor apraxia by mirror box treatment. Neuropsychologia 160 (2021) 107964. https://doi.org/10.1016/j.neuropsychologia.2021.107964
Thieme H, Morkisch N, Mehrholz J, et al. Terapia de espelho para melhorar a função motora após o acidente vascular cerebral. Cochrane DatabaseSyst Rev. 2018; 7 (7): CD008449. Publicado em 11 de julho de 2018. https://doi.org/10.1002/14651858.CD008449.pub3.
Thieme, H., Morkisch, N., Mehrholz, J., Pohl, M., Behrens, J., Borgetto, B., Dohle, C.. Mirror therapy for improving motor function after stroke: update of a Cochrane review. Stroke 50 (2), e26–e27. 2019. https://doi.org/10.1161/ STROKEAHA.118.023092.
Tosi, G., Romano, D., Maravita, A.. Mirror box training in hemiplegic stroke patient saffects body representation. Front. Hum. Neurosci. 11 (2018), 1–10. https://doi.org/10.3389/fnhum.2017.00617.
Vinstrup J., CalatayudJ.,Jakobsen M., et al.. Hand strengthening exercises in chronic stroke patients: Dose-response evaluation using electromyography. Journal of Hand Therapy journal 2017. http://dx.doi.org/10.1016/j.jht.2017.01.004.
Woellner D., Araujo A., Heiss F., et al.. Balance tests in patients with hemiparesis after stroke. Neurociências • Ano 2015 • Volume 11 • Nº 1.
Zhang, J. J. Q., Fong, K. N. K., Welage, N., and Liu, K. P. Y. (2018). The activation of the mirror neuron system during action observation and action execution with mirror visual feedback in stroke: a systematic review. Neural Plast. 2018:2321045. doi: 10.1155/2018/2321045
Zúñiga R., Leciñana M., Díez A., et al..A New Software for Quantifying Motor Deficit After Stroke: A Case–Control Feasibility Pilot Study. Front. Neurol., 11 February 2021 | https://doi.org/10.3389/fneur.2021.603619