Stroke. Spasticity. Hemiplegia
Conditions
Interventions
Individuals selected for the study will be randomly assigned
into two groups, one control group and an experimental group. The group
experimental receive 30 sessions of neuromuscular electrical stimul
frequency of 30 Hz, pulse width of 250 ms, the contraction time of 6 seconds and rest time of 6 seconds for 30 minutes, and the amount of application depend on the threshold patient discomfort and mus
Other
Sponsors
Faculdade de Ciências e Tecnologia da Universidade Estadual Paulista "Julio de Mesquita Filho"
Faculdade de Ciências e Tecnologia da Universidade Estadual Paulista "Julio de Mesquita Filho"
Eligibility
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: Will be included in the study, volunteers of both gender; with the diagnosis of stroke that may be hemorrhagic or ischemic, regardless of age. The stroke should have occurred for at least six months and spasticity of at least one point on the modified Ashworth scale.
Exclusion criteria
Exclusion criteria: Volunteers will be excluded from the study if they: Don´t have spasticity according to the Modified Ashworth Scale, present expression aphasia and comprehension (reported in medical records),cognitive and behavioral alteration (reported in medical records)and have a deficit of surface sensitivity (detected through assessment before the intervention).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Increase in the amount of reciprocal inhibition. To evaluate the amount of reciprocal inhibition is used a tool for investigating changes in the excitability of motoneurons. This tool includes the uptake of H-reflex conditioning of the soleus muscle. Will be used Electromyography (EMG) to capture the wave from the H reflex and the use of electrical stimulators for stimulation of afferent nerve common peroneal and posterior tibial. EMG signals will be captured in the soleus and tibialis anterior leg with higher degree of spasticity, with adhesive electrodes model Meditrace ® 3M ® brand, with catchment surface Ag / AgCl with 10 mm diameter. The distance between two electrodes attached is from 1.5 to 2 cm (center to center). Will be used a signal conditioner brand Lynx ® model MSC 1000 v3, and recording of signals is done through software Labview, National Instruments ® brand. For the conditioning of Reflection H soleus muscle will be stimulated afferent common peroneal nerve and after a programmed interval, the afferent nerve and posterior tibial H reflex captured by EMG. For stimulation of the posterior tibial nerve and common peroneal stimulators are used two model 990 Diapulsi Quark ® brand. For analysis via reciprocal inhibition is assumed interval of 3 ms and 100 ms between the conditioning stimulus applied to the common peroneal nerve, and the test stimulus applied to the tibial nerve.;Increase in the amount of post-activation depression. To assess the amount of post-activation depression tool will be used to investigate changes in the excitability of motoneurons. This tool includes the uptake of H reflex of the soleus muscle. Will be used Electromyography (EMG) to capture the wave from the H reflex and the use of electrical stimulators for stimulation of afferent posterior tibial nerve. EMG signals will be captured in the soleus muscles of the leg with a greater degree of spasticity, with adhesive electrodes model Meditrace ® 3M ® brand, with catchment surface | — |
Secondary
| Measure | Time frame |
|---|---|
| Decrease the degree of spasticity observed through the modified Ashworth scale that will be used following the guidelines described by Bohanoon, with the subject positioned supine and passive movement held constant velocity in the direction of ankle dorsiflexion classifying the degree of resistance to movement 0,1,1+,2,3,4 (attached).;Increase in the subscale score lower limb Scale Fugel-Meyer. To evaluate this score will be used to lower limb subscale of the Scale-meyer Fugel which aims to measure the lower limb motor recovery after stroke. Herein were evaluated movement, coordination and reflex action of the hip, knee and ankle in the supine, sitting and standing. Each item is scored on a scale up to three points. And the score goes 0-34, with higher scores indicating better performance lower limb motor (attached).;Increased distance test of two-minute walk. The walk test is a two-minute short version of the test exercise tolerance and provides information about the distance in feet during a two-minute walk. In this test, patients are advised to travel a marked distance of 20 meters, at a comfortable speed for two minutes. The results indicate the distance that the patient is able to go in the stipulated period (attached). | — |
Countries
Brazil
Contacts
Public ContactAnna Amélia Oishi
Faculdade de Ciências e Tecnologia da Universidade Estadual Paulista "Julio de Mesquita Filho"
Outcome results
None listed