Análise do movimento funcional do membro superior na atividade de beber água de acordo com o lado da hemiparesia em pacientes pós-acidente vascular cerebral

Abstract

Introduction: Stroke results in a range of neurological impairments that compromise the patients’ functional capacity. Objective: To carry out an analysis of the functional movement of the upper limb in the activity of drinking water, in order to identify motor changes according to the side of the hemiparesis. Methods: The sample consisted of 12 post-stroke patients, 6 with right hemiparesis (RP) and 6 with left hemiparesis (LP), and 12 healthy individuals, of whom 6 performed the activity with the right hand (RH) and 6 with the left hand (LH). Participants were submitted to a kinematic assessment of the activity of drinking water by the Qualisys System, which included reaching for and grasping the glass, transporting it to the mouth, returning the glass to the table, and repositioning the hand to the initial location. Shoulder and elbow angles were calculated along the frames (time fractions). Data were analyzed using the Student’s t-test (p<0.05) and Pearson’s correlation coefficient. Results: A significant difference was observed between RP and LP in the shoulder angles in frames 9 to 14 (p<0.05), corresponding to the initial phase of reaching the cup, and at frame 91, at the end of the return of the cup to the cup table (p=0.039), with the LP group presenting lower angulation. There was no difference between the RP and LP groups in the elbow angles (p>0.05) and in the shoulder angles between RH and LH (p>0.05). A significant difference was observed in elbow angles between RH and LH in frames 22 to 31 (p<0.05), with the SD group presenting greater angle in the cup reaching phase. Atypical correlation patterns between shoulder and elbow angles were observed in RP and LP patients, indicating impaired motor coordination. Trajectory analysis revealed impaired motor control during specific phases of the drinking task, particularly in the LP group during the initial movement of bringing the glass to the mouth. Conclusion: The present study demonstrates that a kinematic evaluation of the drinking task allows the identification of distinct spatiotemporal alterations in shoulder and elbow movements patterns, depending on the side of the cerebral lesion in post-stroke patients. These results highlight the need for tailored planning in neurorehabilitation strategies.