Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/10031 |
Resumo: | A high percentage (50% to 70%) of post-stroke patients have loss of upper limb function (MS). The hemiparesis that occurs after stroke generates a range of alterations such as atrophy and muscle weakness impairing the function and daily life activities of these individuals. These changes may be related to the central nervous system (CNS) and also to skeletal muscle. Factors such as learned non-use may also aid in both neural and musculoskeletal changes leading to a maladaptive cycle and exacerbating limb function. Although it is known about the neural adaptations, little is known about the musculoskeletal mainly in upper limbs. A large part of the studies evaluate lower limb and the heterogeneity of comorbidities found in these patients hinder the conclusions of the results. Thus, the thesis studies were performed in order to respond if there is a musculoskeletal alteration after the stroke and if through learned non-use we can generate a model of atrophy or worsen functional deficits and musculoskeletal atrophy. Objectives: Both studies aimed to evaluate the neuromuscular and functional alterations after stroke. Methods: In study 1 a systematic review was conducted with search in December 2017 using the Medline, PubMed, Scopus, Cinahl and Web of Science databases. We investigated studies that performed image analysis in order to evaluate musculoskeletal adaptations after stroke. In study 2, a model of ischemic injury induced by endothelin-1 was performed, as well as training of the reach of the less affected forelimb of rats. Functional performance tests and morphometric analysis of the muscles were performed. Results: For the systematic review we included 7 studies with a wide variety of distal muscles evaluated, which obtained a reduction in the cross-sectional area, density, fascicle length and increase of pennation angle and variables responsible by the amount of connective tissue on the paretic side compared to non-paretic. In study 2, endothelin-1 induced ischemia impaired the paretic upper limb performance during the reach task without musculoskeletal alteration. Training of the non-paretic upper limb accentuated the learning non-use and induced atrophy of the finger extensors in the paretic upper limb. Conclusion: study 1 showed studies with poor to fair quality of evidence showing musculoskeletal changes in a paretic limb after stroke, however, the paretic and non-paretic side comparisons may be inappropriate and error-inducing, so well-designed studies addressing this issue are necessary. In study 2, it was concluded that ischemic injury induced by endothelin-1 causes dysfunction of the forelimbs without muscular alteration and late recovery of function is associated with compensatory movements and without atrophy. Non-paretic upper limb training impairs the recovery of the paretic limb and causes selective atrophy of the paretic side. |
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Faturi, Fernanda MariaRusso, Thiago Luiz dehttp://lattes.cnpq.br/2755480908047791Gianlourenço, Anna Carolyna Lepesteurhttp://lattes.cnpq.br/3861050459671690http://lattes.cnpq.br/842913883186642111c70072-d46f-47b3-a366-62415526dd6b2018-05-15T19:51:39Z2018-05-15T19:51:39Z2018-02-28FATURI, Fernanda Maria. Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10031.https://repositorio.ufscar.br/handle/ufscar/10031A high percentage (50% to 70%) of post-stroke patients have loss of upper limb function (MS). The hemiparesis that occurs after stroke generates a range of alterations such as atrophy and muscle weakness impairing the function and daily life activities of these individuals. These changes may be related to the central nervous system (CNS) and also to skeletal muscle. Factors such as learned non-use may also aid in both neural and musculoskeletal changes leading to a maladaptive cycle and exacerbating limb function. Although it is known about the neural adaptations, little is known about the musculoskeletal mainly in upper limbs. A large part of the studies evaluate lower limb and the heterogeneity of comorbidities found in these patients hinder the conclusions of the results. Thus, the thesis studies were performed in order to respond if there is a musculoskeletal alteration after the stroke and if through learned non-use we can generate a model of atrophy or worsen functional deficits and musculoskeletal atrophy. Objectives: Both studies aimed to evaluate the neuromuscular and functional alterations after stroke. Methods: In study 1 a systematic review was conducted with search in December 2017 using the Medline, PubMed, Scopus, Cinahl and Web of Science databases. We investigated studies that performed image analysis in order to evaluate musculoskeletal adaptations after stroke. In study 2, a model of ischemic injury induced by endothelin-1 was performed, as well as training of the reach of the less affected forelimb of rats. Functional performance tests and morphometric analysis of the muscles were performed. Results: For the systematic review we included 7 studies with a wide variety of distal muscles evaluated, which obtained a reduction in the cross-sectional area, density, fascicle length and increase of pennation angle and variables responsible by the amount of connective tissue on the paretic side compared to non-paretic. In study 2, endothelin-1 induced ischemia impaired the paretic upper limb performance during the reach task without musculoskeletal alteration. Training of the non-paretic upper limb accentuated the learning non-use and induced atrophy of the finger extensors in the paretic upper limb. Conclusion: study 1 showed studies with poor to fair quality of evidence showing musculoskeletal changes in a paretic limb after stroke, however, the paretic and non-paretic side comparisons may be inappropriate and error-inducing, so well-designed studies addressing this issue are necessary. In study 2, it was concluded that ischemic injury induced by endothelin-1 causes dysfunction of the forelimbs without muscular alteration and late recovery of function is associated with compensatory movements and without atrophy. Non-paretic upper limb training impairs the recovery of the paretic limb and causes selective atrophy of the paretic side.Uma alta porcentagem (50% a 70%) dos indivíduos pós-Acidente Vascular Cerebral (AVC) apresentam perda de função do membro superior (MS). A hemiparesia que ocorre após o AVC gera inúmeras alterações tais como, atrofia e fraqueza muscular prejudicando a função e as atividades de vida diária destes indivíduos. Estas alterações podem estar relacionadas ao sistema nervoso central (SNC) e também ao musculoesquelético. Fatores como o não uso aprendido podem também auxiliar nas mudanças tanto neurais como musculoesqueléticas, gerando um ciclo mal adaptativo e exacerbando a disfunção do membro. Embora se conheça sobre as adaptações neurais, pouco é conhecido sobre as musculoesqueléticas principalmente em membros superiores. Grande parte dos estudos avaliam membro inferior e a heterogeneidade de comorbidades encontradas nestes pacientes dificultam as conclusões dos resultados. Objetivos: Os dois estudos tiveram por objetivo avaliar as alterações neuromusculares e funcionais no membro superior após o AVC. Métodos: No estudo 1 foi realizada uma revisão sistemática com busca em Dezembro de 2017 utilizando as bases Medline, PubMed, Scopus, Cinahl e Web of Science. Foram investigados estudos que realizaram análise de exame de imagem no intuito de avaliar adaptações musculoesqueléticas no MS após o AVC. No estudo 2 foi realizado um modelo de lesão isquêmica induzida por endotelina-1, bem como treino de alcance da pata anterior menos afetada de ratos. Foram realizados testes de desempenho funcional e análises morfométricas dos músculos da pata dianteira parética. Resultados: Para a revisão sistemática foram incluídos 7 estudos com uma ampla variedade de músculos distais avaliados, que obtiveram redução na área de secção transversa, densidade, comprimento de fascículo e aumento de ângulo de penação do músculo e variáveis responsáveis pela quantidade de tecido conjuntivo do lado parético comparado ao não parético. No estudo 2 a isquemia induzida por endotelina-1 prejudicou o desempenho do membro anterior parético durante a tarefa de alcance sem alteração musculoesquelética. Treino do membro anterior não parético acentuou o não uso aprendido e induziu atrofia dos extensores dos dedos no membro parético. Conclusão: estudo 1 mostrou evidência de qualidades moderada com alterações musculoesqueléticas em membro parético após o AVC, porém as comparações do lado parético e não parético podem ser inapropriadas e induzir a erros, assim estudos bem desenhados abordando esta questão são necessários. O estudo 2, concluiu que lesão isquêmica induzida por endotelina-1 causa disfunção das ´pata anterior de rato sem alteração muscular e recuperação tardia da função é associado a movimentos compensatórios, porém, sem atrofia. Treino do membro não parético prejudica a recuperação e causa atrofia seletiva do membro parético.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP: 2013/21621-3engUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Fisioterapia - PPGFtUFSCarAcidente vascular cerebralIsquemia cerebralReabilitaçãoExtremidade superiorParesiaNão uso aprendidoAlteração musculoesqueléticaAtrofiaCIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::NEUROFISIOLOGIAAdaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendidoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisOnline60069248a3f-f906-42f9-a3e2-f8bc31ca78afinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARLICENSElicense.txtlicense.txttext/plain; charset=utf-81957https://repositorio.ufscar.br/bitstream/ufscar/10031/6/license.txtae0398b6f8b235e40ad82cba6c50031dMD56ORIGINALFATURI_Fernanda_2018.pdfFATURI_Fernanda_2018.pdfapplication/pdf1494379https://repositorio.ufscar.br/bitstream/ufscar/10031/7/FATURI_Fernanda_2018.pdf43e7e655a349bd5a373ed7e584ae2f7aMD57TEXTFATURI_Fernanda_2018.pdf.txtFATURI_Fernanda_2018.pdf.txtExtracted texttext/plain102900https://repositorio.ufscar.br/bitstream/ufscar/10031/8/FATURI_Fernanda_2018.pdf.txtb971964191b0d499cb8b711ff8958e15MD58THUMBNAILFATURI_Fernanda_2018.pdf.jpgFATURI_Fernanda_2018.pdf.jpgIM Thumbnailimage/jpeg6269https://repositorio.ufscar.br/bitstream/ufscar/10031/9/FATURI_Fernanda_2018.pdf.jpgcf2904d1b5a261c35a3b42ab9b41e251MD59ufscar/100312023-09-18 18:31:14.617oai:repositorio.ufscar.br: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Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:31:14Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
title |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
spellingShingle |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido Faturi, Fernanda Maria Acidente vascular cerebral Isquemia cerebral Reabilitação Extremidade superior Paresia Não uso aprendido Alteração musculoesquelética Atrofia CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::NEUROFISIOLOGIA |
title_short |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
title_full |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
title_fullStr |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
title_full_unstemmed |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
title_sort |
Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido |
author |
Faturi, Fernanda Maria |
author_facet |
Faturi, Fernanda Maria |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/8429138831866421 |
dc.contributor.author.fl_str_mv |
Faturi, Fernanda Maria |
dc.contributor.advisor1.fl_str_mv |
Russo, Thiago Luiz de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/2755480908047791 |
dc.contributor.advisor-co1.fl_str_mv |
Gianlourenço, Anna Carolyna Lepesteur |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/3861050459671690 |
dc.contributor.authorID.fl_str_mv |
11c70072-d46f-47b3-a366-62415526dd6b |
contributor_str_mv |
Russo, Thiago Luiz de Gianlourenço, Anna Carolyna Lepesteur |
dc.subject.por.fl_str_mv |
Acidente vascular cerebral Isquemia cerebral Reabilitação Extremidade superior Paresia Não uso aprendido Alteração musculoesquelética Atrofia |
topic |
Acidente vascular cerebral Isquemia cerebral Reabilitação Extremidade superior Paresia Não uso aprendido Alteração musculoesquelética Atrofia CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::NEUROFISIOLOGIA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::NEUROFISIOLOGIA |
description |
A high percentage (50% to 70%) of post-stroke patients have loss of upper limb function (MS). The hemiparesis that occurs after stroke generates a range of alterations such as atrophy and muscle weakness impairing the function and daily life activities of these individuals. These changes may be related to the central nervous system (CNS) and also to skeletal muscle. Factors such as learned non-use may also aid in both neural and musculoskeletal changes leading to a maladaptive cycle and exacerbating limb function. Although it is known about the neural adaptations, little is known about the musculoskeletal mainly in upper limbs. A large part of the studies evaluate lower limb and the heterogeneity of comorbidities found in these patients hinder the conclusions of the results. Thus, the thesis studies were performed in order to respond if there is a musculoskeletal alteration after the stroke and if through learned non-use we can generate a model of atrophy or worsen functional deficits and musculoskeletal atrophy. Objectives: Both studies aimed to evaluate the neuromuscular and functional alterations after stroke. Methods: In study 1 a systematic review was conducted with search in December 2017 using the Medline, PubMed, Scopus, Cinahl and Web of Science databases. We investigated studies that performed image analysis in order to evaluate musculoskeletal adaptations after stroke. In study 2, a model of ischemic injury induced by endothelin-1 was performed, as well as training of the reach of the less affected forelimb of rats. Functional performance tests and morphometric analysis of the muscles were performed. Results: For the systematic review we included 7 studies with a wide variety of distal muscles evaluated, which obtained a reduction in the cross-sectional area, density, fascicle length and increase of pennation angle and variables responsible by the amount of connective tissue on the paretic side compared to non-paretic. In study 2, endothelin-1 induced ischemia impaired the paretic upper limb performance during the reach task without musculoskeletal alteration. Training of the non-paretic upper limb accentuated the learning non-use and induced atrophy of the finger extensors in the paretic upper limb. Conclusion: study 1 showed studies with poor to fair quality of evidence showing musculoskeletal changes in a paretic limb after stroke, however, the paretic and non-paretic side comparisons may be inappropriate and error-inducing, so well-designed studies addressing this issue are necessary. In study 2, it was concluded that ischemic injury induced by endothelin-1 causes dysfunction of the forelimbs without muscular alteration and late recovery of function is associated with compensatory movements and without atrophy. Non-paretic upper limb training impairs the recovery of the paretic limb and causes selective atrophy of the paretic side. |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-05-15T19:51:39Z |
dc.date.available.fl_str_mv |
2018-05-15T19:51:39Z |
dc.date.issued.fl_str_mv |
2018-02-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
FATURI, Fernanda Maria. Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10031. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/10031 |
identifier_str_mv |
FATURI, Fernanda Maria. Adaptações neuromusculares e funcionais em decorrência da isquemia cerebral e do não uso aprendido. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/10031. |
url |
https://repositorio.ufscar.br/handle/ufscar/10031 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.confidence.fl_str_mv |
600 |
dc.relation.authority.fl_str_mv |
69248a3f-f906-42f9-a3e2-f8bc31ca78af |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Carlos Câmpus São Carlos |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Fisioterapia - PPGFt |
dc.publisher.initials.fl_str_mv |
UFSCar |
publisher.none.fl_str_mv |
Universidade Federal de São Carlos Câmpus São Carlos |
dc.source.none.fl_str_mv |
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Universidade Federal de São Carlos (UFSCAR) |
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