Coluna/Columna (Dec 2009)
Perfil funcional de locomoção em um grupo de pacientes com lesão medular atendidos em um centro de reabilitação Perfil funcional de locomoción en un grupo de pacientes con lesión medular atendidos en un centro de rehabilitación Functional ambulation profile in a group of spinal cord injured patients attended at a rehabilitation center
Abstract
OBJETIVO: descrever o perfil de locomoção de um grupo de pacientes com lesão medular (LM), correlacionando-o com as características da amostra. MÉTODOS: setenta pacientes (50 com LM traumática e 20 com LM não-traumática). Instrumentos: Classificação Funcional da Marcha Modificada (CFMM), WISCI-II, Escala de Ashworth Modificada (EAM), Classificação AIS, Lower Extremities Muscle Score (AIS-LEMS). Estatística: descritiva, comparação entre grupos, testes de correlação considerando pOBJETIVO: describir el perfil de locomoción de un grupo de pacientes con lesión medular (LM), correlacionándolo con las características de la muestra. MÉTODOS: setenta pacientes (50 con LM traumática y 20 con LM no traumática). Instrumentos: Clasificación Funcional de la Marcha Modificada (CFMM), WISCI-II, Escala de Ashworth Modificada (EAM), Clasificación AIS, AIS Lower Extremities Muscle Score (AIS-LEMS). Estadística: descriptiva, comparación entre grupos, testes de correlación considerando un pOBJECTIVE: to describe the locomotion profile of a group of spinal cord injured (SCI) patients and its correlation with the sample features. METHODS: seventy patients (50 with traumatic SCI and 20 non-traumatic) were assessed. Instruments: Modified Functional Ambulation Classification (MFAC), Walking Index for Spinal Cord Injury II (WISCI-II), Modified Ashworth Scale (MAS), American Spinal Injury Association Impairment Scale (AIS) and AIS Lower Extremities Muscle Score (AIS-LEMS). Statistics: descriptive, comparison between groups, correlation tests (considering p<0,05). RESULTS: average values were: age: 36 years, 72.9% males, average time of lesion 4.7 years. AIS A, 38.6%; AIS B, 10%; AIS C, 22.8%; AIS D, 28.6%. Level of lesion: 32.8% cervical, 52.9% thoracic, 14.3% lumbar. More prevalent etiologies: gunshot wounds 30% and car accidents 18%. MFAC: Non-ambulation, 34.3%; Therapeutic ambulation 20%, Household ambulation 12.8%, community ambulation (32.9%); WISCI-II: 7.5, AIS-LEMS: 13.4. There were differences between traumatic and non-traumatic groups concerning age, sex, AIS, AIS-LEMS, MFAC and WISCI-II. Significant correlations: AIS positively correlated to MFAC, WISCI-II and AIS-LEMS. Level of lesion negatively correlated to MAS. AIS-LEMS positively correlated to AIS, MFAC, WISCI-II and negatively correlated to support and orthosis during ambulation. Time of lesion and presence of disabling pain were not correlated to the studied variables. CONCLUSIONS: traumatic SCI group was composed by younger patients with higher prevalence of complete lesion. Age was correlated to the use of orthosis and walking devices. Functional performance of gait was correlated with AIS and AIS-LEMS, and a AIS-LEMS of at least 32 points was needed to achieve community gait.
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