Efeitos da bandagem elástica na propriocepção do ombro e desempenho sensório-motor durante atividade de beber em indivíduos hemiparéticos crônicos

Abstract

Around 50 to 70% of subjects post-stroke presented reduction of upper limb (UL) function even during chronic phase. Therefore, several therapeuticstrategies have been proposed. Anadjuvant technique widely used in neurorehabilitation istheapplication of elastic tape (taping). However, its efficacy in the treatment of post-stroke subjects still require further investigation. Objectives: Toverify the immediate effects of taping applied on paretic shoulder on proprioception (joint position sense -JPS) and sensorimotor performance of UL during functional task (drinking). Methods: Thirteen subjects with chronic hemiparesis were randomly allocated into two groups: 1) those who received Sham Tape (ST) first and after one month they received Elastic Tape (ET); 2) those who received Elastic Tape (ET) first and after one month they received Sham Tape (ST). JPS was assessed using a dynamometer and quantified by absolute error of shoulder at 30° e 60° of abduction and flexion. Sensorimotor performance during drinking task was assessed using tridimensional analysis and quantified by spatiotemporal and scalar kinematic parameters (starting angles, rangeof motion, and angles at the end) as well as by study of time-normalized kinematic waveforms of trunk, scapula, shoulder and elbow through Statistical Parametric Mapping analysis. Tapes were applied on deltoid muscle (anterior, middle, and posterior)without tension followingthe muscle facilitation direction. All assessments were performed before and 10 minutes aftertapes application. Results: No differences were observedbetween groups at baseline for all variables. In the taping condition, both groups decreased absolute error for all movements and angles (moderate effect), improved shoulder position (moretomidline), reduced scapula protraction and trunk flexion with no changes in spatiotemporal parameters. In addition, taping provided an improvement in shoulder elevation, scapula lateral rotationand elbow extension (small to medium effects). No effects of sham tape were observed for both groupsin any variable. Conclusion: Taping provided an improvement in the shoulder JPS and UL joint motions during functional activity, pointing to its role as adjuvant therapy.