Órteses plantares e capacidade funcional em indivíduos pós-acidente vascular encefálico

Abstract

INTRODUCTION: One of the main changes present in individuals post-stroke is the motor impairment. Different types of orthoses are used for this purpose, highlighting the use of fixed and articulated orthoses. Whereas the postural insoles aims to reorganize postural mechanics and reorganize muscle tone, this may play a similar role of the conventional orthoses. OBJECTIVE: To evaluate the effect of plantar orthoses on functional capacity in individuals post-stroke. METHODOLOGY: Initially a systematic review of the literature on the use of rigid and articulated orthoses on gait cadence and speed post-stroke subjects was performed. Then, a literature review was performed to demonstrate the use of a new tool for postural control, postural insoles. After these two reviews, two randomized controlled clinical trials were conducted, analyzing the influence of insoles on gait and balance in patients with stroke. 20 adults were randomly divided into control group (8) and experimental group (12). The control group used placebo insole and the experimental group of postural insoles. These insoles were made in etilvenilacetato, which in the case of postural insoles, thermoforming received for fixing parts of foot-related postural correction proposed pathology (equine-varus) and in case of not receiving placebos insoles parts of correction. With respect to evaluation, this consisted of mobility tests and functional balance (Time Up & Go and Berg Balance Scale), static balance and three-dimensional gait analysis was used, being performed before, immediately after and three months after using the application of insoles. The gait evaluation was performed using the SMART-D 140® system - BTS Engineering with eight cameras, and for the assessment of static balance the force platform Kistler 9286BA model was used. Data analysis considered the adherence to the bell curve, the Kolmogorov-Smirnov test and showed how these parametric, were expressed as mean (standard deviation). Statistical analysis the separate multivariate analyses of variance (MANOVAs). RESULTS: In the systematic review, we found that although both as articulated rigid orthoses suggest an improvement in the functionality of these patients, particularly gait speed, the impact of this type of bracing in cadence remains inconclusive; compared to static balance, postural insoles can bring significant benefits in static postural control analyzed by computer stabilometry, mainly in medial-lateral sway; and for the improvement of gait can be observed that the postural insoles showed significant benefits in gait kinematics, particularly in the range of movement of the ankle and knee, and the dorsiflexion of the ankle and Knee flexion movement. CONCLUSION: It is concluded that the technique of using this type of bracing classified as postural insoles can bring beneficial sensory inference for body balance and gait of individuals post-stroke.