Punctual mechanical oscillation in modulation of muscular tonus in children with spasticity

Stéphani de  Pol; Eduardo Borba Neves; André Eugenio  Lazzaretti; Suhaila Mahmoud  Smaili; Eddy  Krueger

doi:10.14393/BJ-v37n0a2021-53574

Authors

Stéphani de Pol Universidade Tecnológica Federal do Paraná https://orcid.org/0000-0002-0903-9206
Eduardo Borba Neves Universidade Tecnológica Federal do Paraná https://orcid.org/0000-0003-4507-6562
André Eugenio Lazzaretti Universidade Tecnológica Federal do Paraná https://orcid.org/0000-0003-1861-3369
Suhaila Mahmoud Smaili Universidade Estadual de Londrina https://orcid.org/0000-0002-9048-9799
Eddy Krueger Universidade Estadual de Londrina https://orcid.org/0000-0003-3890-1595

DOI:

https://doi.org/10.14393/BJ-v37n0a2021-53574

Keywords:

Cerebral Pals, Mechanomyography, Modified Ashworth Scale, Muscle belly, Muscle tendon.

Abstract

Spasticity is a motor condition present in 75 to 88% of children with Cerebral Palsy (CP). One form of treatment is called punctual mechanical oscillation (PO). The current study aimed to study different protocols for the application of PO and the magnitude of their effects. In total, 7children with medical diagnosis of CP and ICD (International Classification of Diseases) were included. The first intervention protocol (Int¹) consisted of the application of PO to the spastic muscle tendon and the second intervention protocol (Int²) to the muscle belly ofthe spastic antagonist muscle. For evaluation, the Modified Ashworth Scale (MAS) was used, while simultaneously capturing the mechanomyography (MMG) signals. Data were collected pre-intervention and 1 (Post₁), 15 (Post₁₅), 30 (Post₃₀), 45 (Post₄₅), and60 (Post₆₀) minutes after the interventions. The MAS values (median ± interquartile range) post intervention were statistically lower when compared to the pre values in the 2 protocols studied; in Int¹between Pre (2 ± 0) andPost₁₅ (0 ± 1.75), Post₃₀ (0 ± 1), Post₄₅ (1 ± 1),and Post₆₀ (1 ± 1), and in Int²only between Pre (2 ± 1) and Post₁ (0 ± 1).The values found in the MMG in both its temporal and spectral domains did not follow a pattern (p>0.05). The comparison between the protocols did not demonstrate statistical differences in any characteristics (MAS, MMG_MF, and MMG_RMS). However, PO was shown to be a therapeutic resource that modulated spasticity for up to 60 minutes after its application, and PO could contribute as a tool to aid the treatment of spasticity.

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