A liberação miofascial direta reduz a espasticidade muscular do ombro após acidente vascular cerebral: um estudo quase experimental
DOI:
https://doi.org/10.17267/2238-2704rpf.2025.e6249Palavras-chave:
AVC, Terapia de Libertação Miofascial, Espasticidade Muscular, Qualidade de VidaResumo
INTRODUÇÃO: O AVC, uma complicação que afeta a função motora e reduz a qualidade de vida, pode levar à espasticidade. A liberação miofascial (LMF) é uma técnica de alongamento protegida com baixa carga, utilizada para reduzir a espasticidade e a tensão muscular. OBJETIVO: O objetivo deste estudo é avaliar a eficácia da técnica de liberação miofascial direta (RMF) na espasticidade muscular do ombro, nas funções sensório-motoras e na qualidade de vida em pacientes com AVC crônico (≥6 meses). MÉTODOS E MATERIAIS: Este estudo quase experimental, pré-teste e pós-teste unigrupo, envolveu 14 pacientes com AVC crônico que apresentavam espasticidade muscular do ombro. Os participantes foram submetidos a RMF direta aplicada ao subescapular, peitoral maior, redondo maior e grande dorsal, com sessões com duração de 30 a 35 minutos, 3 vezes por semana, durante 2 semanas. As avaliações pré e pós foram realizadas através da Escala de Ashworth Modificada (MAS) para a espasticidade, da Escala de Fugl-Meyer para a Extremidade Superior (FMA-UE) para a função motora e da Escala Indiana de AVC (ISS) para a qualidade de vida. RESULTADOS: A idade média dos participantes foi de 49,9 ± 7,96 anos, com um tempo médio desde o AVC de 24,93 ± 29,11 meses. O teste de Wilcoxon indicou melhorias estatisticamente significativas em todas as medidas de resultados: MAS (p = 0,001), FMA-UE (p = 0,001) e ISS (p = 0,001). Correspondentemente, a análise do tamanho do efeito utilizando o d de Cohen demonstrou alterações clinicamente significativas, tendo sido observados grandes tamanhos de efeito para MAS (d = 1,4), FMA-UE (d = 1,86) e ISS (d = 1,07). CONCLUSÃO: Os nossos resultados demonstraram que a terapia de liberação miofascial direta durante duas semanas é eficaz na redução da espasticidade e na melhoria da função motora e da qualidade de vida em participantes com AVC crônico. No entanto, o pequeno tamanho da amostra e a ausência de um grupo de controle devem ser interpretados com cautela. Mais ensaios clínicos randomizados são necessários.
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