Avaliação do equilíbrio, da força muscular e da funcionalidade de indivíduos com a doença de Charcot-Marie-Tooth

• Autor(a) principal: Costa, Iandra Maria Pinheiro de França
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/3615
• topic: Ciências da saúde; Neuropatia Hereditária Motora e Sensorial; Doença de Charcot-Marie-Tooth; Equilíbrio postural; Avaliação da incapacidade; Postural balance; Hereditary Sensory and Motor Neuropathy; Charcot-Marie-Tooth disease; Assessment of disability; CIENCIAS DA SAUDE

The Charcot-Marie-Tooth disease (CMT) is peripheral neuropathy genetically inherited most common worldwide. The most cases of CMT can be classified into two major categories of the nature of the primary nerve injury: CMT type 1 and type 2. The main clinical symptoms are muscle weakness and decreased sensation in the legs and feet, changes in gait and balance. The objectives of this study were to conduct a systematic review of the balance and functionality of individuals with the disease of Charcot-Marie-Tooth (CMT), as well as assess the muscle strength, balance and functionality of individuals with the disease of Charcot-Marie-Tooth type 2 ( CMT2). Methods: A comprehensive literature search was performed using as a database MEDLINE, PubMed, Web of Science, Scopus (1980- 2015). Furthermore, an observational and cross-sectional study was conducted through interviews and clinical evaluation of individuals with CMT2 disease in the city Tobias Barreto. The sample consisted of a group of 15 patients with CMT2 (GCMT2) and a control group (CG), with healthy subjects matched for age and gender with CMT2 group. Individuals with CMT were classified by Neuropathic scale of Charcot-Marie-Tooth disease (Neuropathy Scale Charcot-Marie-Tooth - CMTNS) that assesses the degree of severity of the disease. The muscle strength of the lower limbs was evaluated by a hand dynamometer. The balance was measured through footwork stabilometer and Berg Balance Scale. Functional assessment was measured by the Timed Up Go test (TUG). Results: In the systematic review were selected 18 articles, most of the cross-sectional and performed in Europe. The types of study were prevailed on assessment of balance and functionality, rehabilitation treatment and natural evolution of CMT disease. The number of participants per study ranged 6-211 affected individuals. In the second article, there was a statistically significant difference between the GCMT2 and GC for muscle strength of all assessed muscles (ankle extensor: p = <0.0001, plantarflexors: p = <0.0001, inverters: p = <0.0001, eversors: p = 0.0016).For the VCoPAP and DCopAP parameters stabilometry for open and closed eyes, respectively (p = 0.0123, p = 0.0183, p = 0.0132, p = 0.0129) for the Berg balance scale (p = 0.0066) and the TUG (p = 0.0003) test. The most evident correlations were between all variables and CMTNS. In addition, individuals with CMT2 have loss of balance in the anteroposterior direction and with increasing severity of the disease these individuals need more vision for maintaining balance. Conclusion: Most studies of the systematic review evaluating balance and /or functionality also included in their assessments to measure muscle strength and sensitivity. Furthermore, studies have shown that the distal muscle weakness, especially ankle extensor plantar flexors and is associated with loss of balance and dynamic activities in the stop position, respectively. Clinical evaluations, conducted in CMT2 group and control group, showed that patients with Charcot-Marie-Tooth have less balance and loss of functional activity as compared to healthy subjects.