Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/2835 |
Resumo: | Introduction: Painful shoulder is a common consequence after stroke, being considered a challenge in the rehabilitation of patients. Transcranial Direct Current Stimulation (tDCS) has been cited and used as an additional tool for analgesic effects in individuals with chronic pain. Objective: To evaluate the analgesic and functional effects of concomitant tDCS with physical therapy (TF) in patients with painful shoulder post stroke. Methods: Twenty-six hemiparetic adults with chronic shoulder pain were assessed before, after treatment, and 30 days after the end of treatment: Pain assessed by visual analog scale (VAS); motor impairment by the Fugl-meyer scale, hand grip strength with dynamometer, range of motion with goniometer, motor function by the Shoulder Pain and Disability Index, Disabilities of the Arm-Sholuder and Hand and quality of life by Stroke Specific Quality of Life Scale. Randomization for the two treatment groups: 1 (physical therapy associated active tDCS), 2 (physical therapy associated sham tDCS). Physiotherapy: passive mobilization and upper limb stretching (20 minutes) plus 20 minutes of active upper limb exercise of with associated cycle ergometer tDCS (2 mA); 5 sessions per week for 2 weeks totaling 10 sessions. Anode over injured C3 or C4 and supraorbital cathode contralateral to the anode.Results: There was a clinically significant decrease (<3 points) of pain for both groups, remaining at follow-up. There were no significant intergroup differences (p = 0,3). There was no difference after treatment and follow up for motor impairment and hand grip strength in both groups. The flexion, abduction, and external rotation range of motion best for the active ETCC group only. Motor function and quality of life improved after treatment and follow-up only intragroups without significant intergroup differences. Conclusion: Physical therapy was effective in reducing pain and improving the function and quality of life of patients with chronic post-stroke pain; however, the TDCS did not enhance these results. |
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Corrêa, Fernanda IshidaDall' Agnol, LetizziaCorrêa, Fernanda IshidaDias, Raphael Mendes RittiBaptista, Abrahão Fonteshttp://lattes.cnpq.br/2368388751976375Souza, Janaina Andressa de2022-02-21T21:31:14Z2019-08-29Souza, Janaina Andressa de. Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego. 2019. 88 f. Dissertação( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/2835Introduction: Painful shoulder is a common consequence after stroke, being considered a challenge in the rehabilitation of patients. Transcranial Direct Current Stimulation (tDCS) has been cited and used as an additional tool for analgesic effects in individuals with chronic pain. Objective: To evaluate the analgesic and functional effects of concomitant tDCS with physical therapy (TF) in patients with painful shoulder post stroke. Methods: Twenty-six hemiparetic adults with chronic shoulder pain were assessed before, after treatment, and 30 days after the end of treatment: Pain assessed by visual analog scale (VAS); motor impairment by the Fugl-meyer scale, hand grip strength with dynamometer, range of motion with goniometer, motor function by the Shoulder Pain and Disability Index, Disabilities of the Arm-Sholuder and Hand and quality of life by Stroke Specific Quality of Life Scale. Randomization for the two treatment groups: 1 (physical therapy associated active tDCS), 2 (physical therapy associated sham tDCS). Physiotherapy: passive mobilization and upper limb stretching (20 minutes) plus 20 minutes of active upper limb exercise of with associated cycle ergometer tDCS (2 mA); 5 sessions per week for 2 weeks totaling 10 sessions. Anode over injured C3 or C4 and supraorbital cathode contralateral to the anode.Results: There was a clinically significant decrease (<3 points) of pain for both groups, remaining at follow-up. There were no significant intergroup differences (p = 0,3). There was no difference after treatment and follow up for motor impairment and hand grip strength in both groups. The flexion, abduction, and external rotation range of motion best for the active ETCC group only. Motor function and quality of life improved after treatment and follow-up only intragroups without significant intergroup differences. Conclusion: Physical therapy was effective in reducing pain and improving the function and quality of life of patients with chronic post-stroke pain; however, the TDCS did not enhance these results.Introdução: Ombro doloroso é comum pós Acidente Vascular Cerebral (AVC). Estimulação Transcraniana por Corrente Contínua (ETCC) tem sido citada como terapia analgésica para indivíduos com dor crônica. Objetivo: Avaliar os efeitos analgésicos e funcionais da ETCC concomitante à fisioterapia (FT) em pacientes com ombro doloroso pós AVC. Métodos: 26 adultos hemiparéticos, com dor crônica em ombro foram avaliados pré, pós tratamento e após 30 dias do término do tratamento: Dor avaliada pela escala analógica visual(VAS); comprometimento motor(CM) pela escala Fugl-meyer, força de preensão palmar(FPP) com dinamômetro, amplitude de movimento(ADM) com goniômetro, função motora(FM) pela Shoulder Pain and Disability Index, Disabilities of the Arm-Sholuder and Hand e qualidade de vida(QV) pela Stroke Specific Quality of Life Scale. Randomização para os dois grupos de tratamento: 1(ETCC ativa associada à FT), 2(ETCC sham associada à FT). Fisioterapia: mobilizações passivas e alongamento de membros superiores (MMSS) (20 minutos), mais 20 minutos de exercícios ativos de MMSS com cicloergômetro associado a ETCC (2 mA); 5 sessões por semana, durante 2 semanas, totalizando 10 sessões. Anodo sobre C3 ou C4 lesionado e catodo supraorbital contralateral ao anodo. Resultados: Houve diminuição clinicamente importante (< 3 pontos) da dor para ambos os grupos, mantendo-se no follow-up. Não houve diferença significante intergrupos (p=0,3). Não houve diferença após tratamento e follow up para CM e FPP em ambos os grupos. ADM de flexão, abdução e rotação externa melhorou apenas para o grupo ETCC ativa. A FM e QV melhorou intragrupos após tratamento e follow up sem diferença significante intergrupos. Conclusão: A Fisioterapia foi eficaz para diminuir a dor e melhorar a função e QV dos pacientes com dor crônica pós AVC, no entanto a ETCC não potencializou esses resultados.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2022-02-21T21:31:14Z No. of bitstreams: 1 Janaina Andressa de Souza.pdf: 6077488 bytes, checksum: 5098e0a7299e44419d736b2aa08a2ef6 (MD5)Made available in DSpace on 2022-02-21T21:31:14Z (GMT). No. of bitstreams: 1 Janaina Andressa de Souza.pdf: 6077488 bytes, checksum: 5098e0a7299e44419d736b2aa08a2ef6 (MD5) Previous issue date: 2019-08-29application/pdfporUniversidade Nove de JulhoPrograma de Pós-Graduação em Ciências da ReabilitaçãoUNINOVEBrasilSaúdeAVCETCCombro dolorosoreabilitaçãostroketDCSpainful shoulderrehabilitationCIENCIAS DA SAUDEEfeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cegoEffects of transcranial direct current stimulation comsined with physical therapy on shoulder pain in stroke victims – randomized, controlled, double-blind, clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALJanaina Andressa de Souza.pdfJanaina Andressa de Souza.pdfapplication/pdf6077488http://localhost:8080/tede/bitstream/tede/2835/2/Janaina+Andressa+de+Souza.pdf5098e0a7299e44419d736b2aa08a2ef6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/2835/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/28352022-06-30 18:15:08.278oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2022-06-30T21:15:08Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
dc.title.alternative.eng.fl_str_mv |
Effects of transcranial direct current stimulation comsined with physical therapy on shoulder pain in stroke victims – randomized, controlled, double-blind, clinical trial |
title |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
spellingShingle |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego Souza, Janaina Andressa de AVC ETCC ombro doloroso reabilitação stroke tDCS painful shoulder rehabilitation CIENCIAS DA SAUDE |
title_short |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
title_full |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
title_fullStr |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
title_full_unstemmed |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
title_sort |
Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego |
author |
Souza, Janaina Andressa de |
author_facet |
Souza, Janaina Andressa de |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Corrêa, Fernanda Ishida |
dc.contributor.advisor-co1.fl_str_mv |
Dall' Agnol, Letizzia |
dc.contributor.referee1.fl_str_mv |
Corrêa, Fernanda Ishida |
dc.contributor.referee2.fl_str_mv |
Dias, Raphael Mendes Ritti |
dc.contributor.referee3.fl_str_mv |
Baptista, Abrahão Fontes |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2368388751976375 |
dc.contributor.author.fl_str_mv |
Souza, Janaina Andressa de |
contributor_str_mv |
Corrêa, Fernanda Ishida Dall' Agnol, Letizzia Corrêa, Fernanda Ishida Dias, Raphael Mendes Ritti Baptista, Abrahão Fontes |
dc.subject.por.fl_str_mv |
AVC ETCC ombro doloroso reabilitação |
topic |
AVC ETCC ombro doloroso reabilitação stroke tDCS painful shoulder rehabilitation CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
stroke tDCS painful shoulder rehabilitation |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Introduction: Painful shoulder is a common consequence after stroke, being considered a challenge in the rehabilitation of patients. Transcranial Direct Current Stimulation (tDCS) has been cited and used as an additional tool for analgesic effects in individuals with chronic pain. Objective: To evaluate the analgesic and functional effects of concomitant tDCS with physical therapy (TF) in patients with painful shoulder post stroke. Methods: Twenty-six hemiparetic adults with chronic shoulder pain were assessed before, after treatment, and 30 days after the end of treatment: Pain assessed by visual analog scale (VAS); motor impairment by the Fugl-meyer scale, hand grip strength with dynamometer, range of motion with goniometer, motor function by the Shoulder Pain and Disability Index, Disabilities of the Arm-Sholuder and Hand and quality of life by Stroke Specific Quality of Life Scale. Randomization for the two treatment groups: 1 (physical therapy associated active tDCS), 2 (physical therapy associated sham tDCS). Physiotherapy: passive mobilization and upper limb stretching (20 minutes) plus 20 minutes of active upper limb exercise of with associated cycle ergometer tDCS (2 mA); 5 sessions per week for 2 weeks totaling 10 sessions. Anode over injured C3 or C4 and supraorbital cathode contralateral to the anode.Results: There was a clinically significant decrease (<3 points) of pain for both groups, remaining at follow-up. There were no significant intergroup differences (p = 0,3). There was no difference after treatment and follow up for motor impairment and hand grip strength in both groups. The flexion, abduction, and external rotation range of motion best for the active ETCC group only. Motor function and quality of life improved after treatment and follow-up only intragroups without significant intergroup differences. Conclusion: Physical therapy was effective in reducing pain and improving the function and quality of life of patients with chronic post-stroke pain; however, the TDCS did not enhance these results. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-08-29 |
dc.date.accessioned.fl_str_mv |
2022-02-21T21:31:14Z |
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dc.identifier.citation.fl_str_mv |
Souza, Janaina Andressa de. Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego. 2019. 88 f. Dissertação( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/2835 |
identifier_str_mv |
Souza, Janaina Andressa de. Efeitos da estimulação transcraniana por corrente continua associada à fisioterapia na reabilitação do ombro doloroso pós acidente vascular cerebral – ensaio clínico, controlado, randomizado, duplo-cego. 2019. 88 f. Dissertação( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo. |
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