Fisioterapia aquática no tratamento de criança com distrofia muscular congênita merosina negativa: relato de caso

Este relato de caso descreve um programa de fisioterapia aquática para uma criança com distrofia muscular congênita (DMC) merosina negativa. Objetivo: Verificar a interferência da fisioterapia aquática na velocidade e no índice de gasto energético durante o deslocamento sentado em superfície plana, e no alcance funcional com os membros superiores devido a fraqueza proximal que acomete estes pacientes visando maior independência. Métodos: Como instrumentos de avaliação foram utilizados a Medida da Função Motora (MFM); o Functional Reach Test (FRT); foi verificado o Índice de Gasto Energético (IGE) no deslocamento sentado; assim como o tempo gasto neste deslocamento e a ativação muscular com a eletromiografia (EMG). O programa durou 12 semanas e a intervenção incluiu atividades para melhorar a mobilidade e a agilidade no deslocamento sentado e o alcance na postura sentada. Resultados: Na MFM a variação no escore das duas dimensões (D2 e D3) focadas na terapia foi de 6,8%. O alcance funcional melhorou 16 centímetros (cm) e o tempo do deslocamento sentado diminuiu 19 segundos (s). O gasto energético diminuiu 252,31 batimentos por minuto (bpm). Conclusão: A fisioterapia aquática foi eficaz para melhora da agilidade no deslocamento sentado e na funcionalidade de membros superiores (MMSS) de uma criança com DMC merosina negativaThis case report describes an aquatic therapy program for a child with Merosin-Deficient Congenital Muscular Dystrophy. Objective: This study sought to investigate the effect of aquatic physical therapy on the speed and the rate of energy expenditure while moving around on a flat surface, in addition to the functional reach of the upper limbs suffering from the proximal weakness that affects these patients seeking greater independence. Methods: The Motor Function Measurement (MFM) and the Functional Reach Test (FRT) were used as assessment tools; the Energy Expenditure Index (EEI) was measured in seated locomotion, as well as the time spent, and muscle activation was measured via electromyography (EMG). The program lasted 12 weeks and included activities to improve mobility and agility as well as reaching from the seated position. Results: In the MFM the change in the score of the two dimensions (D2 and D3) that the treatment focused on was 6.8%. The functional reach improved by 16 centimeters (cm) and the amount of time moving while sitting decreased by 19 seconds (s). Energy expenditure decreased by 252.31 beats per minute (bpm). Conclusion: The aquatic physical therapy was effective for agility improvement in seated locomotion and upper limb functionality of a 6-year-old child with Merosin-Deficient Congenital Muscular Dystroph

Fisioterapia Aquática na Transferência do Sentado para Ortostatismo no Paciente com AVC: Relato de Caso

Introduction. Studies show that 70% of body weight in patients with stroke during the transfer from sitting to standing position is transferred to the uninvolved limb. Significantly interfering with activities of daily living. Objective. The influence of aquatic therapy on eight in the affected hemisphere during the transition from sitting to standing. Method. Participated in this study a patient with right hemiparesis, the protocol lasted eight sessions in a liquid medium. The data of activation of the gluteus muscle were collected from surface electromyography and data as the weight transfer was examined by baropodometry platform. Results. Initial electromyography (151.1uv right gluteus maximus and left gluteus maximus 229.1uv) and Final electromyography (113.6 uv right gluteus maximus and left gluteus maximus113.3uv). Evolution was 19% in weight transferin paretic hemibody compared the pre and post intervention. Conclusion. The results showed that treatment was favorable to the patient, because at the end of application of the observed activation of the gluteus maximus and improved weight-bearing, and consequently these factors interfered positively in the security and independe in transferring from sitting to standing position