Title:	Dosimetria para evocar músculos paralisado e esforço físico na pedalagem estacionária assistida por eletroestimulação para pessoas com lesão medular em estudos quasi-experimental por série de casos
Other Titles:	Dosimetry to evoke paralyzed muscles and physical effort in FES-assisted cycling for people with spinal cord injury in a quasi-experimental study through a series of cases
Authors:	Santos, Bruno Flamarion dos
metadata.dc.contributor.email:	brunoflamarion@gmail.com
Orientador(es)::	Martins, Emerson Fachin
Assunto::	Medula espinhal Eletrodiagnóstico Estimulação elétrica Equipamentos de autoajuda
Issue Date:	18-Feb-2022
Data de defesa::	6-May-2022
Citation:	SANTOS, Bruno Flamarion dos. Dosimetria para evocar músculos paralisado e esforço físico na pedalagem estacionária assistida por eletroestimulação para pessoas com lesão medular em estudos quasi-experimental por série de casos. 2022. 129 f., il. Dissertação (Mestrado em Ciências da Reabilitação) — Universidade de Brasília, Brasília, 2022.
Abstract:	Introduction: FES–assisted cycling is an environmental facilitator for the activity and participation of people with spinal injuries, coordinating the control of paralyzed muscles in the zones of loss and partial preservation (below the injury level) with muscles in the preservation zone. As a device for long-term assistance, it adds effects to the metabolism, if properly dosed, including safety measures to compensate for the deficiency in the perception of the effort. Objective: Recognize and discover potential effects resulting from the physical effort generated in the FESassisted cycling, following the dose-response of the intervention through contractions evoked by electric currents to achieve a kinematic pattern in pedaling, which would allow for modeling clinical trial protocols and options for urban mobility, sports, and leisure. Methods: We designed a quasi-experimental study through a non-randomized and uncontrolled clinical trial, in a series of five cases – following a two-step protocol: pre-cycling (10 to 13 sessions, twice a week) and FES-assisted cycling (10 to 11 sessions, twice a week). Each session holds up to eight procedures, according to the participant's tolerance. The variables of interest describe the informational base to understand the requirements for practice, dosage, and effort control. Descriptive and non-parametric inferential processing included an estimate to identify the Minimal Detectable Change (MDC) between sessions, with estimated statistical power equal to or greater than 60% (α = 0.05, using the two-tailed method and considering a confidence interval of 95 %). Results: Amongst the recruited, five formed sample, prevailing adult, obese, osteopenic and physically active males, with neuromuscular electric behavior compatible with the electrodiagnosis for partially injured peripheral intervention. During the pre-cycling phase, the MDC in the dosage (pulse width and intensity) resulted in quadriceps' muscular strengthening, with harder progression towards the hamstrings. Neuromuscular adaptation and reinforcement appear not to demand effort capable of changing the heart rate in a remotely detectable way – an effort monitoring measure apparently safe for reproduction on protocols. Equally, during the actual cycling, the variation of the dosage parameters did not infer in the effort parameters' MDC, when comparing the ending to the beginning of the protocol. However, the arterial pression MDC pointed to altered effort between the start and ending of each session, revealing itself as appropriate measure to follow performance in real time. Conclusion: Pre-pedaling proved to be effective in adapting neuromuscular recruitment, electrically powered with less energy, for increasingly efficient evoked contractions – suggestive of beneficial adaptation in the dose-response controlled by electrodiagnosis. Around a dozen sessions were needed to transition to the cycling phase, where effort measured by heart rate and blood pressure proved to be adequate – as commonly used in exercise tests.
metadata.dc.description.unidade:	Faculdade de Ciências e Tecnologias em Saúde (FCTS) – Campus UnB Ceilândia
Description:	Dissertação (mestrado) — Universidade de Brasília, Programa de Pós-Graduação em Ciências da Reabilitação, 2022.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Ciências da Reabilitação
Agência financiadora:	Fundação de Apoio à Pesquisa do Distrito Federal (FAP/DF); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
Appears in Collections:	Teses, dissertações e produtos pós-doutorado

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