The effects of medium and long-term spinal cord circuitry of hemiplegic patients after treatment protocol of neuromuscular electrical stimulation

• Grant number: 13/05501-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2013
• End date: June 30, 2014
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Fábio Mícolis de Azevedo
• Grantee: Sofia Pagoto Salles
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil

Abstract

Spasticity is a disorder of sensorimotor control, resulting of an injury to the upper motor neuron, one of the features present after cerebrovascular accident (CVA). It is characterized by hyper excitability of the stretch reflex with exacerbation of deep tendon reflexes and increased muscle tone. Its pathophysiology is related to injuries in central control means interfering with modulation of specific circuitry medullary generating a decrease in the degree of reciprocal inhibition and inhibition of presynaptic afferent to the Ia. Among various therapeutic resources to be used for reduction of spasticity, Neuromuscular Electrical Stimulation (NMES) is considered as an effective alternative and can be used in multiple ways. The objective of the study is to evaluate whether the effects obtained in the modulation of spinal inhibitory pathways specific (reciprocal inhibition, presynaptic inhibition and depression after activation) after NMES protocol in spastic hemiplegic patients, remain for a long period. For this, patients who already underwent a protocol proposed by an electrical master's project in progress will be reassessed using quantitative and qualitative measures after three months and six months. Quantitative measures are related to the H-reflex amplitude, obtained under different constraints. Furthermore, correlations between measures of different degrees of inhibition and parameters obtained by applying qualitative scales such as modified Ashworth Scale, Fugl-Meyer Scale (FMS) and test walks of 2 minutes (TC2 '), may provide important information about the influence of levels of reciprocal Inhibition, Inhibition Pre synaptic depression Post Activation in the degree of spasticity. (AU)