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Estudo Comparativo entre a Estimulação Magnética Periférica Repetitiva e a Eletroestimulação Funcional em Cães com Lesão Toracolombar
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Advisor(s)
Abstract(s)
As lesões toracolombares da medula espinhal, podem ser classificadas como
completas, em cães sem sensibilidade à dor profunda (DPN) ou incompletas, em cães
com sensibilidade à dor profunda (DPP) e, a sua reabilitação, depende de protocolos de
neurorreabilitação intensiva (INR). Para tal, devem ser desenvolvidas modalidades que
promovam a contração muscular (MC) e a capacidade interneural (INC), sem presença
de dor. Os objetivos do presente estudo observacional prospetivo, foram avaliar a
capacidade de tolerância e segurança da electroestimulação funcional (FES) e da
estimulação magnética periférica repetitiva (RPMS), compará-las segundo MC, INC e
presença de dor e correlacioná-las com doentes DPP e DPN. 53 cães, foram admitidos
à consulta de INR e submetidos, no 3o dia em ambiente controlado, à modalidade FES
num dos membros, seguida da RPMS, após o término da FES, no membro contralateral.
Foram efetuadas 106 observações, com discordância interobservadores de 11%, das
quais, 38 relativas ao grupo A, cães DPP (GA) e 68 ao grupo B, cães DPN (GB). Na
avaliação da MC, a FES obteve maior prevalência nos tratamentos com MC>10 segundos,
e diferença significativa de p=0.002, entre as duas modalidades. Na avaliação INC, o
movimento do membro contralateral, teve prevalência de 40.6% na FES e 19.8% na RPMS
e o movimento da cauda, teve prevalência de 33.9% na FES e 9.4% na RPMS (p<0.001),
com maior evidência no GB (p<0.001). Em relação à presença de dor, foram observadas
vocalizações em 3 doentes na FES e 1 na RPMS (p=0.006), todas pertencentes a GA, e
movimento de virar a cabeça, em 8 observações na FES e 1 na RPMS (p=0.012). Em
conclusão, FES e RPMS, são modalidades seguras e toleráveis, tendo sido a FES, mais
efetiva quanto à MC e INC, mas associada à presença de dor e, a RPMS, eleita no bem-
estar animal.
Spinal cord injury, can be classified as complete, in dogs without deep pain perception (DPN) or incomplete, in dogs with deep pain perception (DPP), and their rehabilitation depend on intensive neurorehabilitation (INR) protocols. Rehabilitation modalities must be developed to promote muscle contraction (MC) and interneural capacity (INC), without pain. The objectives of the present prospective observational study were to evaluate the tolerability and safety of functional electrical stimulation (FES) and repetitive peripheral magnetic stimulation (RPMS), compare them according to MC, INC and presence of pain, as well as, correlate them with DPP and DPN patients. 53 dogs were admitted to the INR consultation and submitted in a controlled environment, on the 3rd day, to FES in one limb, followed by RPMS, in the contralateral limb, after the end of FES. 106 observations were made, with an interobserver disagreement of 11%, of which, 38 related to group A, DPP dogs (GA) and 68 to group B, DPN dogs (GB). When evaluating MC, FES had a higher prevalence in treatments with MC>10 seconds, with a significant difference of between the two modalities (p=0.002). In the INC assessment, concerning the movement of the contralateral limb, there was a prevalence of 40.6% with FES and 19.8% with RPMS. Also, in the tail movement, a prevalence of 33.9% with FES and 9.4% with RPMS (p<0.001), which had more evidence in GB (p<0.001). Regarding the presence of pain, were observed, 3 vocalizations with FES and 1 with RPMS (p=0.006), all belonging to GA, and head turning movements in 8 observations with FES and 1 with RPMS (p=0.012). In conclusion, FES and RPMS are safe and tolerable, being FES the most effective in MC and INC, but associated with the presence of pain. RPMS was the best choice regarding animal welfare.
Spinal cord injury, can be classified as complete, in dogs without deep pain perception (DPN) or incomplete, in dogs with deep pain perception (DPP), and their rehabilitation depend on intensive neurorehabilitation (INR) protocols. Rehabilitation modalities must be developed to promote muscle contraction (MC) and interneural capacity (INC), without pain. The objectives of the present prospective observational study were to evaluate the tolerability and safety of functional electrical stimulation (FES) and repetitive peripheral magnetic stimulation (RPMS), compare them according to MC, INC and presence of pain, as well as, correlate them with DPP and DPN patients. 53 dogs were admitted to the INR consultation and submitted in a controlled environment, on the 3rd day, to FES in one limb, followed by RPMS, in the contralateral limb, after the end of FES. 106 observations were made, with an interobserver disagreement of 11%, of which, 38 related to group A, DPP dogs (GA) and 68 to group B, DPN dogs (GB). When evaluating MC, FES had a higher prevalence in treatments with MC>10 seconds, with a significant difference of between the two modalities (p=0.002). In the INC assessment, concerning the movement of the contralateral limb, there was a prevalence of 40.6% with FES and 19.8% with RPMS. Also, in the tail movement, a prevalence of 33.9% with FES and 9.4% with RPMS (p<0.001), which had more evidence in GB (p<0.001). Regarding the presence of pain, were observed, 3 vocalizations with FES and 1 with RPMS (p=0.006), all belonging to GA, and head turning movements in 8 observations with FES and 1 with RPMS (p=0.012). In conclusion, FES and RPMS are safe and tolerable, being FES the most effective in MC and INC, but associated with the presence of pain. RPMS was the best choice regarding animal welfare.
Description
Keywords
neurorreabilitação lesão na medula espinhal contração muscular Dor RPMS FES neurorehabilitation spinal cord injury muscle contraction Pain