Irradiação contralateral de força para a ativação do músculo tibial anterior em portadores da doença de Charcot-Marie-Tooth: efeitos de um programa de intervenção por FNP

Abstract

Objective: To evaluate the response of the tibialis anterior (TA) muscle following a five-week protocol with contralateral irradiation force through Proprioceptive Neuromuscular Facilitation (PNF) diagonals in patients with demyelinating polyneuropathy associated with Charcot-Marie-Tooth disease type 1A (CMT-1A). Methods: The study included 12 patients of both sexes. They were treated twice-weekly for 5 weeks. At each session, they performed the following diagonal patterns: chopping, extension-adduction with internal rotation (EAIR) and flexion-abduction with internal rotation (FAIR). The diagonals were repeated four times, in both upper and lower limbs, with each repetition lasting six seconds on average. During execution, the response of the TA muscle was recorded by a surface electromyograph disregarding the initial and final two seconds of each diagonal. The mean RMS values of the four repetitions were normalized in percentage. The initial and final data were analyzed through the t test for paired samples with significant p-values <0.05. Results: The contralateral force irradiation with the chopping diagonal to the left and to the right increased the percentage RMS values of the TA muscle in the last session when compared with the values of the first session (t=-3.94 and t=-3.87, respectively). Similarly, the EAIR diagonal increased the percentage RMS values of the TA muscle in the last session when compared with the values of the first session (t=-3.3 and t=-4.58, respectively). The only diagonal that did not produce higher values of contralateral force irradiation in the TA muscle, left and right, was the FAIR (t=-2.31 and t=-1.55). Conclusion: These results may justify the use of a treatment program with PNF diagonals in patients with CMT-1A who have difficulty activating the TA muscle. ABSTRACT FROM AUTHOR