Análise da espasticidade pós intervenção de vibração do corpo inteiro em indivíduos com lesão medular: uma série de casos

Abstract

Introduction: Spasticity is a common symptom in people suffering from spinal cord injury (SCI). Whole-body vibration (WBV) has been widely used lately as a promising treatment approach for reducing spasticity, as the effects of WBV on the reflex activity and mechanical properties of muscles may have therapeutic implications for people with central nervous system disorders. Objective: To verify whether the patient's qualitative self-report is compatible with the quantitative data from the Modified Ashworth Scale (MAS) at the end of the vibrating platform protocol to reduce spasticity in people with SCI. Methodology: A randomized clinical trial was carried out, with a qualitative and quantitative approach. Adults with spinal cord injury from the Specialized Rehabilitation Center of the Santos Dumont Institute were recruited by convenience. The patients who participated in the research had lower limb spasticity assessed by EAM before and after intervention on the Vibrating Platform (PV). The PV intervention consisted of two protocols, one of continuous whole-body vibration (VCIc) and the other of intermittent whole-body vibration (VCIi). The data were analyzed using the GraphPad Prism software version 8. In addition to this assessment, the research participants also participated in a semi-structured interview, with a qualitative approach based on the figure of the Collective Subject Discourse. Results: 5 subjects participated in the research, with an average age of 30.4 (± 7.1) years, the average time of injury for the subjects was 4.2 (± 2.3) years. There was no statistical significance in the ADE data comparing pre and post PV intervention. The participants' interview identified two themes: “The perception of spasticity in everyday life” and “Perception of spasticity after a vibrating platform” which verified that patients with spinal cord injury (SCI) noticed an important reduction in the perception of spasticity. Conclusion: Although the ADE measurement does not bring a significant difference post-intervention with PV, the users' perception through self-report portrays the direct benefit of this use. The EAM scale may not have been sensitive to changes in the electrical activity of the assessed muscle groups. However, it is not possible to draw definitive conclusions about the use of IVC to reduce spasticity, as in the perception of users after the PV intervention, an important improvement in general well-being was described as a result of the reduction in spasticity. Therefore, studies are proposed that investigate higher doses of IVC to reduce spasticity.