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Efeitos agudos da mobilização de tecidos moles do membro inferior com o rolo de espuma, no equilíbrio de sobreviventes após AVC em fase crónica
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Abstract(s)
Introdução: Após um Acidente Vascular Cerebral (AVC) é frequente persistirem alterações que comprometem o controlo motor e a função, como é o caso do equilíbrio. Na generalidade, a médio-longo prazo estas alterações neuromotoras podem traduzir-se numa modificação das propriedades viscoelásticas dos tecidos moles periféricos, o que, por sua vez, pode condicionar ainda mais o recrutamento neuromuscular e a função. Alguns estudos recentes sugerem que, em indivíduos saudáveis, a mobilização dos tecidos moles com recurso ao rolo de espuma parece ter efeitos benéficos a nível do equilíbrio. No entanto, a literatura é escassa sobre os seus efeitos em sobreviventes de AVC. Objetivo: O objetivo deste estudo consiste em perceber os possíveis efeitos agudos da mobilização de tecidos moles da cadeia posterior do membro inferior através de um rolo de espuma, no equilíbrio de sobreviventes pós-AVC em fase crónica. Metodologia: Realizou-se um estudo randomizado crossover, duplamente cego, controlado com sham, em que participaram sobreviventes de AVC em fase crónica, recrutados por conveniência. A intervenção experimental consistiu na hétero-aplicação de um rolo de espuma com uma pressão moderada, na fáscia plantar, tríceps sural e isquiotibiais, durante 60s em cada zona. A intervenção sham seguiu o mesmo protocolo com ausência de pressão. As intervenções foram aplicadas aleatoriamente, com um intervalo de uma semana. Avaliou-se o equilíbrio estacionário e dinâmico nas tarefas sentar-para-pé e pé-para-sentado, de uma plataforma de pressão (PhysioSensing), antes e após cada intervenção. Utilizou-se o Teste de Wilcoxon e o teste de Mann-Whitney para a análise estatística (=0,05). Resultados: Participaram neste estudo 7 homens e 2 mulheres (n=9). No grupo experimental, no equilíbrio estacionário, parecem existir diferenças antes e após a intervenção, nas variáveis relacionadas com o centro de pressão (CoP), no sentido de um aumento da velocidade, deslocamento, distância, Root Mean Square e amplitude no sentido mediolateral, e no sentido anteroposterior uma diminuição da distância e Root Mean Square, sem contudo se observar significado estatístico (p>0,05). No sentado-para-pé parecem existir diferenças após a intervenção na velocidade de oscilação no sentido de um aumento e uma diminuição no tempo de transferência de peso, porém não foi observado a significância estatística (p>0,05). Na simetria entre o membro direito e esquerdo, observa-se uma diminuição significativa no grupo experimental quando comparado com o grupo sham (p=0,031). Conclusão: Os resultados do presente estudo sugerem que a hétero-aplicação do rolo de espuma, com uma pressão moderada, parece apresentar efeitos positivos em variáveis relacionadas com o CoP no equilíbrio estacionário e dinâmico aquando de tarefas funcionais como sentado-para-pé e pé-para-sentado, em sobreviventes de AVC em fase crónica.
Introduction: After a stroke, it is common that changes which compromise the motor control and function, such as balance, often persist. In general, in the medium to long term, these neuromotor alterations can translate into a modification of the viscoelastic properties of peripheral soft tissues, which, in turn, can further condition neuromuscular recruitment and function. Some recent studies suggest that, in healthy individuals, soft tissue mobilization using a foam roller seems to have beneficial effects on balance. However, the literature is scarce on its effects on stroke survivors. Objective: The aim of this study is to understand the possible acute effects of mobilization of soft tissues from the posterior chain of the lower limb using a foam roller, on the balance of post-stroke survivors in the chronic phase. Methodology: A randomized, double-blind, sham-controlled, crossover study was performed, in which survivors of chronic phase stroke, recruited by convenience, participated. The experimental intervention consisted of the hetero-application of a foam roller with moderate pressure on the plantar fascia, sural triceps and hamstrings for 60s in each area. The sham intervention followed the same protocol with no pressure. Interventions were applied randomly, with an interval of one week. The stationary and dynamic balance in the sit-to-stand and stand-to-sit tasks on a pressure platform (PhysioSensing) were evaluated before and after each intervention. The Wilcoxon test and the Mann-Whitney test were used for statistical analysis (p=0.05). Results: 7 men and 2 women participated in this study (n=9). In the experimental group, in stationary balance, there seem to be differences before and after the intervention, in the variables related to the center of pressure (CoP), in the sense of an increase in velocity, displacement, distance, Root Mean Square and range in the mediolateral direction, and in the anteroposterior direction, a decrease in the distance and Root Mean Square, however without observing statistical significance (p>0.05). In sit-to-stand, there seem to be differences after the intervention in the sway speed towards an increase and a decrease in the weight transfer time, however, statistical significance was not observed (p>0.05). In the symmetry between the right and left limb, a significant decrease was observed in the experimental group when compared to the sham group (p=0.031). Conclusion: The results of the present study suggest that the hetero-application of the foam roller, with a moderate pressure, seems to have positive effects on variables related to CoP in the stationary and dynamic balance when performing functional tasks such as sit-to-stand and stand-to-sit, in chronic phase stroke survivors.
Introduction: After a stroke, it is common that changes which compromise the motor control and function, such as balance, often persist. In general, in the medium to long term, these neuromotor alterations can translate into a modification of the viscoelastic properties of peripheral soft tissues, which, in turn, can further condition neuromuscular recruitment and function. Some recent studies suggest that, in healthy individuals, soft tissue mobilization using a foam roller seems to have beneficial effects on balance. However, the literature is scarce on its effects on stroke survivors. Objective: The aim of this study is to understand the possible acute effects of mobilization of soft tissues from the posterior chain of the lower limb using a foam roller, on the balance of post-stroke survivors in the chronic phase. Methodology: A randomized, double-blind, sham-controlled, crossover study was performed, in which survivors of chronic phase stroke, recruited by convenience, participated. The experimental intervention consisted of the hetero-application of a foam roller with moderate pressure on the plantar fascia, sural triceps and hamstrings for 60s in each area. The sham intervention followed the same protocol with no pressure. Interventions were applied randomly, with an interval of one week. The stationary and dynamic balance in the sit-to-stand and stand-to-sit tasks on a pressure platform (PhysioSensing) were evaluated before and after each intervention. The Wilcoxon test and the Mann-Whitney test were used for statistical analysis (p=0.05). Results: 7 men and 2 women participated in this study (n=9). In the experimental group, in stationary balance, there seem to be differences before and after the intervention, in the variables related to the center of pressure (CoP), in the sense of an increase in velocity, displacement, distance, Root Mean Square and range in the mediolateral direction, and in the anteroposterior direction, a decrease in the distance and Root Mean Square, however without observing statistical significance (p>0.05). In sit-to-stand, there seem to be differences after the intervention in the sway speed towards an increase and a decrease in the weight transfer time, however, statistical significance was not observed (p>0.05). In the symmetry between the right and left limb, a significant decrease was observed in the experimental group when compared to the sham group (p=0.031). Conclusion: The results of the present study suggest that the hetero-application of the foam roller, with a moderate pressure, seems to have positive effects on variables related to CoP in the stationary and dynamic balance when performing functional tasks such as sit-to-stand and stand-to-sit, in chronic phase stroke survivors.
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Keywords
Acidente vascular cerebral Rolo de espuma Miofascial Equilíbrio postural Stroke Foam rolle Myofascial Postural balance