Efeitos imediatos do uso de órteses tornozelo-pé́ na cinemática da marcha e nas reações de equilíbrio na doença de Charcot-Marie-Tooth

Abstract

Charcot-Marie-Tooth (CMT) disease is a hereditary motor and sensory neuropathy that generally results in progressive weakness and atrophy muscles distal of the lower limb. Ankle-foot orthoses (AFO) are commonly prescribe for to treat musculoskeletal disorders at the ankle joint to patients with CMT. The objective of the study was to evaluate the immediate effects of using AFO in the gait’s kinematics and the balance reactions in CMT. Was conducted a review of the main results of scientific studies of the use of orthoses in CMT, analyzing their effects on the rehabilitation of this population. In quasi-experimental study nine individuals with CMT, mean age (±SD) 41±11 years, mean weight 71±14 Kg and mean height 1,64±0,07 m had their balance and the gait assessed by Tinetti scales and Dynamic Gait Index and gait’s kinematics parameters with a motion capturing system. These evaluations were executed before and during the use of AFO. Data were statistically analyzed using SPSS software and the level of significance was P<0,05. The relationship between variables was assessed by Spearman’s correlation coefficient. Two-Way repeated analysis of variance was conducted to test for main or interaction effects related to “orthoses” and “repetition”. A significant interaction effect was observed between the gait cycle and use the AFO to the average velocity (Wilks’ Lambda = 0,156, P=0,030, η2=0,844) and a significant main effects in the ankle joint to the gait cycle (Wilks’ Lambda = 0,091, P=0,008, η2=0,909) and the use of AFO (Wilks’ Lambda = 0,444, P=0,013, η2=0,556). Was observed a significant increase in the DGI scale during the use of AFO (P<0,05). The use AFO promoted immediate effects on gait kinematics and in balance reactions. The results suggest that the use of AFO is an immediate efficient strategy to stabilize the ankle joint, managing foot drop and improving postural stability in patients with CMT.