Estudo de viabilidade de um eletroestimulador brasileiro para ativar o músculo gastrocnêmio de crianças e adolescentes com paralisia cerebral

Abstract

INTRODUCTION: Cerebral Palsy (CP) is a motor impairment, and one of its features can be an equine gait pattern. A portable electrostimulator is on the market, the WalkAide®, which stimulates the anterior tibialis (AT) muscle. Due to triceps surae shortening, there is a decrease in its movement capacity. The stimulation of the triceps surae could contribute to the necessary strength gain to improve the kinematic patterns of gait, leading to an increase in impulsion in the terminal support phase, greater range of motion, generating an increase in speed and step length. Furthermore, in low-to-middle-income countries such as Brazil, WalkAide® is not easily accessible to the population. OBJECTIVES: To test the feasibility and immediate effects of a national portable electrostimulator with the aim of stimulating the gastrocnemius muscle, to evaluate the immediate effects of its use and the satisfaction of the participants regarding the equipment. METHODS: Quasi-experimental, quali-quantitative study, which tested an electrostimulator produced in partnership between students and professors from the Instituto Federal Sudeste de Minas Gerais - IFSUDESTE, MG and the Faculty of Physiotherapy of the Universidade Federal de Juiz de Fora - UFJF. The study included 2 children and 1 adolescent with normal development (ND) and 2 children and 1 adolescent with a diagnosis of unilateral CP, of the spastic type, with classification I of the GMFCS, matched by age and gender. The immediate effects of the electrostimulator prototype were analyzed using the M.P.S. Platform®, to evaluate the distribution of plantar pressures in static and semi-static postures and MyoMotion Clinical (Noraxon, USA) to evaluate angular movements. RESULTS: A descriptive analysis of the participants was performed, and the group of children/adolescents with CP were equivalent to the group of children/adolescents with normal development in terms of age, gender, weight and height. The plantar distributions in the semi-static and dynamic postures with the immediate use of the electrostimulator, demonstrated better relationships between the anterior and posterior weight bearings, to the right and to the left, both in children and adolescents with CP and ND. A slight change in the angular movements of the hip, knee and ankle can be observed, as in the spatio-temporal parameters of gait, leading to slight changes in the length of the step and stride, and in the gait speed of the participants. CONCLUSIONS: Electrostimulation of the gastrocnemius suggests that there may be an improvement in gait impulsion, making the synergy of the muscles more efficient during gait. The electrostimulator may have great applicability for increasing and/or maintaining range of joint movement. With the finalization of the production of the electrostimulator, new steps and future studies will be necessary to test and validate its applicability.