Abordagem da neurorreabilitação funcional à espasticidade muscular
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2016
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A espasticidade muscular é um sinal clínico limitativo da função motora e da qualidade
de vida e, portanto, extremamente importante na área da Reabilitação Animal. Surge na
síndrome neurónio motor superior, acompanhado de outros sinais como dor, fraqueza muscular
e descoordenação motora, denominando-se este conjunto de Desordem de Movimento
Espástica.
O objetivo central deste estudo foi a implementação da Escala de Ashworth
Modificadada Medicina Humana na Medicina Veterinária, no sentido de se obter informação
sobre a avaliação inicial do doente e evolução perante a abordagem multidisciplinar de um
protocolo de neurorreabilitação funcional .
Para tal, recorreu-se a uma amostra de 19 cães com espasticidade muscular,
submetidos ao mesmo protocolo terapêutico, em regime de internamento no Centro de
Reabilitação Animal da Arrábida. Estes, foram sujeitos a uma classificação inicial e
monitorizações quinzenais da sua evolução, segundo a escala supracitada.
Os resultados obtidos revelaram uma diminuição acentuada do grau de classificação
da escala à entrada e à saída do centro, demonstrando a eficácia do protocolo de
neurorreabilitação funcional na abordagem à espasticidade. Em relação ao tempo de
internamento, observou-se significância estatística na relação entre esta variável e a
classificação da escala, sugerindo que graus mais graves estão associados a períodos de
recuperação prolongados.
Desta forma, conclui-se que a aplicabilidade clínica da Escala de Ashworth
Modificada existe na Medicina Veterinária, como metodologia eficaz de avaliação e
monitorização do grau de espasticidade e como indicativo de prognóstico do tempo necessário
para o doente atingir a funcionalidade. O que torna esta escala extremamente útil na prática
clínica dos centros de Reabilitação Animal.
Muscular spasticity is a clinical sign that restricts the motor skills and quality of life, thus extremely important when addressed from an Animal Rehabilitation point of view. It occurs in under motor neuron syndrome, accompanied with other physical signs such as pain, muscular weakness and lack of muscular coordination, such that this set of symptoms is commonly denominated as Spastic Movement Disorder. The main goal of this study was the adaptation and implementation of the Modified Ashworth Scale (MAS) of Human Medicine to Veterinary Medicine, being the prime objective the gathering of information regarding the initial patient assessment’ and its evolution when faced with a multidisciplinary approach of a functional neurorehabilitation protocol. For such, a sample of 19 dogs with muscular spasticity was subject to the aforementioned therapeutic protocol, in an internment regime in the Centro de Reabilitação Animal da Arrábida (CRAA). The subjects were then submitted to an initial classification and bimonthly monitoring according to the scale. The results revealed a rapid decrease on the entry and exit (of the center) classification scale marks, thus proving the effectiveness of the neurorehabilitation protocol on spasticity treatment. Regarding the internment time, it was observed statistical significance in the relation between this variable and the classification scale, which suggests that more serious levels are associated with longer recovering periods. In conclusion, this study has shown that the clinical applicability of the Modified Ashworth Scale in fact exists, as an effective methodology of both assessment and monitoring of the level of spasticity as well as an indicative of the prognosis that will take for the patient to achieve functionality. Therefore, this scale is extremely useful in the clinical practice of animal rehabilitation centers.
Muscular spasticity is a clinical sign that restricts the motor skills and quality of life, thus extremely important when addressed from an Animal Rehabilitation point of view. It occurs in under motor neuron syndrome, accompanied with other physical signs such as pain, muscular weakness and lack of muscular coordination, such that this set of symptoms is commonly denominated as Spastic Movement Disorder. The main goal of this study was the adaptation and implementation of the Modified Ashworth Scale (MAS) of Human Medicine to Veterinary Medicine, being the prime objective the gathering of information regarding the initial patient assessment’ and its evolution when faced with a multidisciplinary approach of a functional neurorehabilitation protocol. For such, a sample of 19 dogs with muscular spasticity was subject to the aforementioned therapeutic protocol, in an internment regime in the Centro de Reabilitação Animal da Arrábida (CRAA). The subjects were then submitted to an initial classification and bimonthly monitoring according to the scale. The results revealed a rapid decrease on the entry and exit (of the center) classification scale marks, thus proving the effectiveness of the neurorehabilitation protocol on spasticity treatment. Regarding the internment time, it was observed statistical significance in the relation between this variable and the classification scale, which suggests that more serious levels are associated with longer recovering periods. In conclusion, this study has shown that the clinical applicability of the Modified Ashworth Scale in fact exists, as an effective methodology of both assessment and monitoring of the level of spasticity as well as an indicative of the prognosis that will take for the patient to achieve functionality. Therefore, this scale is extremely useful in the clinical practice of animal rehabilitation centers.
Descrição
Orientação : Pedro Faísca ; co-orientação : Ângela Martins
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, NEURORREABILITAÇÃO, DOENÇAS NEUROMUSCULARES, VETERINARY MEDICINE, NEUROREHABILITATION, NEUROMUSCULAR DISEASES, REABILITAÇÃO FUNCIONAL, FUNCTIONAL REHABILITATION