Análise cinética dos distúrbios de marcha nos pacientes com esclerose múltipla: proposta de categorização e suas possíveis repercussões no desempenho
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2017-03-10
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Universidade Federal de Goiás
Resumo
Background: Multiple sclerosis (MS) causes gait disturbances that interfere in the independence
and activities of daily living. For Understand the cause of these gait disturbances this study
focused on the kinetics analysis of these patients gait, more specifically in the analysis of the
vertical component of the ground reaction force (VCGRF). It permits estimate loss in the
capacity to accelerate or decelerate the body center of mass upwards and downwards during
gait. To make the analysis of this component more objective, the Ben Lomonding classification
has been proposed. However, so far, it has only been tested in children with cerebral palsy
(CP).
Objective: To analyze the kinetics of gait disorders in MS and its repercussions on
patient performance in different levels of impairment
Method: A cross-sectional Control case study was developed and evaluated the gait in selfselected
speed of 50 healthy adult (25 women and 25 men) and 49 adult patients (42
women and 7 men) with MS and EDSS between 1.5 and 6.0. Recruited at a Reference in
MS and accomplished the three-dimensional and instrumented evaluation of the gait in a
Movement Analysis laboratory of the Rehabilitation. In which, the data collection was
accomplished through the VICON® system and 4 force platforms of the brand AMTI®. The speed
fast analysis performed through the Timed 25-foot Walk (T25FW) test. Patients’ gait was
assessed by a single rater, always in the morning, in an air-conditioned room. The VCGRF
analysis was performed through Ben Lomonding’ s classification.
Results: Analyzing VCGRF and possible decrease in FZ2 using Ben Lomonding
classification permitted categorize VCGRF of patients with MS in five of its eight levels, since
types 0, 1, 2, 3, and A were found. Of the limbs assessed, 47.0% presented alteration in
VCGRF, and of these, 19.4% presented a decrease in FZ2. In patients with worse EDSS score,
decrease in FZ2 was more frequent. Patients with more severity types of Ben Lomonding had
higher depletion in the patient’ s performance measured by the test T25FW, cadence, speed,
step and stride length, double support time and stance time. Also they presented worse
performace cerebellar.
Conclusion: Ben Lomonding classification can be applied to adults with MS. Additionally, the
decrease in FZ2 was more frequent in patients with more severe MS, which suggests
influence of MS severity on decrease in FZ2. The FZ2 reductions seem to worsen the performance
of the patient gait.
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CORRÊA, P. F. L. Análise cinética dos distúrbios de marcha nos pacientes com esclerose múltipla: proposta de categorização e suas possíveis repercussões no desempenho. 2017. 195 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2017.