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Comparison of functional performance and muscle activation pattern trunk between paraplegic physically assets and sedentary individuals

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Author(s):
Paola Errera Magnani
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Flávia Roberta Faganello Navega
Advisor: Daniela Cristina Carvalho de Abreu
Abstract

Spinal cord injury results in loss or decrease of mobility and sensibility below the lesion level. This loss brings numberless sequels and many of them can be minimised with physical activities. The objective of the present study was to assess the functional independence and trunk control during anterior- and lateral- reaching tasks in physically-active and sedentary paraplegic individuals. The subjects were divided into sedentary (SSCI, n = 10) and physically active (ASCI, n = 10) groups. Control group (C) consisted of 10 individuals without spinal cord injury. Anthropometric measures were obtained from the groups of spinal cord injured individuals before neurological examination for identification of lesion level and type by using ASIA protocol (American Spinal Injury Association) and functional independence measurement (FIM) questionnaire. For the reaching and grasping tasks, the subject was instructed to carry the object in the arms by using both hands when the object was anteriorly located and by using the right hand when the object was on the side, but without using the left hand. Muscle activation was concomitantly assessed during the anterior- and lateral-reaching and grasping tasks by performing surface electromyography of dorsal longissimus, iliocostalis, and multifidus muscles bilaterally. Statistical analysis was carried out by using Student t-test for independent samples and Wilcoxon-Mann-Whitneys test for comparisons between the mean FIM scores. One-way ANOVA was used for comparison of the mean values of electromyographic activation values and, whenever necessary, univariate and Bonferronis post-hoc tests were applied. The pattern of muscular behaviour was analysed considering the time-series formed by representative values of EMG signals obtained every 5 percent of time. Significance level for rejection of null hypothesis was set at 5% (p 0.05), with the results being expressed in mean and standard deviation. Results: Significant differences were found between ASCI and SSCI groups regarding self-care, transfers and total FIM score, with active subjects having higher score. As for the reaching tasks, only significant differences were found between spinal cord injured individuals and control subjects, with the latter presenting wider reach than the former. Analyses of variance (ANOVA) indicated that the muscles evaluated showed different activation in the reaching tasks as different patterns of muscle activation were observed in the groups of paraplegic individuals compared to the control group. This happened because the majority of the control subjects activated significantly more the dorsal longissimus muscles, whereas the paraplegic subjects of both experimental groups activated the iliocostalis muscles. Conclusion: These results indicate that sport activity has beneficial effects on functional independence of spinal cord injured individuals, mainly regarding motor tasks. In addition, one can note a different pattern of muscle activation in the trunk of paraplegic individuals compared to control subjects during performance of anterior- and- lateral reaching tasks. Further studies with greater sample size and higher number of muscles are necessary to assess the strategies used by paraplegic individuals, thus allowing a guiding training to be specifically developed to improve postural control, balance, function, and quality of movement. (AU)

FAPESP's process: 13/15547-5 - Comparison of functional performance and osteometabolic alterations among active and sedentary physically paraplegic subjects
Grantee:Paola Errera Magnani
Support Opportunities: Scholarships in Brazil - Master