Analysis of the Effective Dosage of Extracorporeal Shock Waves Therapy to Reduce Spasticity

  • Claudio Fracisco Kluppel Bieszczad Universidade Internacional Iberoamericana
  • Rodrigo Florência da Silva Universidade Internacional Iberoamericana
  • Renata R. Rothenbuhler
  • Angelo Contar Palmar Universidade Federal do Paraná
  • José Carlos Ludwig

Resumo

Abstract
The required dosages in shock waves are investigated for a safe and effective therapy in muscle spasticity. The objective was to analyze the shock waves application in spastic individuals considering their dosage, energy cycles, safety margin capable of reducing spasticity. Measurements were performed on 23 individuals in two different groups. The first group has 10 normal individuals (20-50 years old). Muscle resistance is verified against the shock waves application in high doses in which inspection is used for analysis. The second group consists of 13 individuals with moderate and severe spasticity (50-70 years), in which the application of lithotripsy will be performed to analyze the effectiveness of the equipment, using the inspection, Ashworth scale, digital goniometer and accelerometer with an electrical stimulator. The spasticity and muscular resistance reduction in relation to the equipment is proven, using high doses and intensities. (Dosage: 0.060 mJ / mm² at 1000 cycles / s). There was a reduction in the mean in the four measurements, for example, in elbow flexion the average dropped from 2.85 to 1.46 (p-value <0.001). In the Ashworth scale there was a difference of 2 points in the median. In accelerometry, there was significance for maximum acceleration (p <0.001), acceleration time (p = 0.128) and there was no significance for dilation time (p = 0.003). No skin irritation was found after using the equipment. High doses do not harm patients. Physiotherapy is important for the success of this equipment. Muscle preparation is proportional to the effectiveness of the method.

Keywords: Muscle Spasticity Lithotripsy. High-Energy Shock Waves. Walk Test.

Resumo
As dosagens necessárias em ondas de choque são investigadas para uma terapia segura e eficaz na espasticidade muscular. O objetivo foi analisar a aplicação das ondas de choque em indivíduos espásticos considerando sua dosagem, ciclos de energia, margem de segurança capaz de reduzir a espasticidade. As mensurações foram realizadas em 23 indivíduos em dois grupos diferentes. O primeiro grupo apresenta 10 indivíduos normais (20-50 anos). Verifica-se a resistência muscular frente a aplicação das ondas de choque em doses elevadas no qual utiliza-se a inspeção para análise. O segundo grupo compõe-se de 13 indivíduos com espasticidade moderada e severa (50-70 anos), no qual se efetuará a aplicação da litotripsia para analisar a eficácia do equipamento, utiliza-se a inspeção, escala de Ashworth, goniômetro digital e acelerômetro com um estimulador elétrico. Comprova-se a redução da espasticidade e a resistência muscular frente ao equipamento, utilizando doses e intensidades elevadas. (Dose: 0,060 mJ/mm² á 1000 ciclos/s). Houve redução da média nas quatro mensurações, como por exemplo, na flexão do cotovelo a média caiu de 2,85 para 1,46 (p-valor <0,001). Na escala de Ashworth houve diferença de 2 pontos na mediana. Na acelerometria houve significância para a aceleração máxima (p<0,001), tempo de aceleração (p=0,128) e não houve significância para o tempo de dilatação (p= 0,003). Não foram constatados nenhuma irritação na pele após a utilização do equipamento. As dosagens elevadas não causam danos aos pacientes. A fisioterapia é importante para o sucesso deste equipamento. O preparo muscular é proporcional à eficácia do método.

Palavras-chave: Espasticidade Muscular. Litotripsia. Ondas de Choque de Alta Energia. Teste de Caminhada.

Biografia do Autor

Claudio Fracisco Kluppel Bieszczad, Universidade Internacional Iberoamericana
Fisioterapêuta, mestre em gerontologia social, doutorando em projetos

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Publicado
2020-12-21
Seção
Artigos