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Silva F.A.1, Marafon N.L.1, Lima V.M.1, Devetak G.F.2, Manffra E.F.2, Loureiro A.P.C.1
1Pontifícia Universidade Católica do Paraná, Physiotherapy Department, School of Health and Biosciences, Curitiba, Brazil, 2Pontificia Universidade Católica do Paraná, Program on Health Technology, Curitiba, Brazil
Background: The sensory information captured by plantar cutaneous receptors contributes to postural control and the maintenance of balance. Among the most common clinical manifestations of stroke, we can mention the changes of sensory functions.
Purpose: Verify if the use of a sensory track within a circuit for locomotor training with partial body weight support (BWS), improves plantar sensitivity of post-stroke hemiparetic patients.
Methods: Twenty-eight hemiparetic volunteers were distributed by convenience in control group (CG) and experimental group (EG). CG had 13 participants (6 men, 7 women, 57.4± 14.1 years old; injury time of 6.4 ± 4.5 months; 5 with right and 8 with left hemiparesis) and EG had 15 participants (8 men, 7 women, 62.8 ± 13.5 years old; injury time of 7.5 ± 6.1 months; 11 with right and 4 with left hemiparesis). Both groups completed 10 conventional physiotherapy sessions of 40 minutes each. EG received 20 additional minutes of balance gait training with BWS on a circuit at the ground. The sensory track consisted in five different textures on which the patients walked barefoot. The Semmes-Weinstein® were used to test the plantar sensitivity of the participants in three different sites of the paretic foot: (1) the head of first metatarsal; (2) head of the fifth metatarsal; and (3) heel. The filament 2 gram force (gf) was set as the cut line for sensitivity classification in normal (0.05 gf, 0.2 gf and 2 gf) or altered (4 gf, 10 gf, 300 gf or lack of response).The data were statistically analyzed using the SPPS IBM v 20.0 software. McNemar test was used to compare results pre and post intervention in each group. The level of significance was 0.05.
Results: The statistical results showed a significant difference to points 1 and 2 of EG, whose p values were 0.008 and 0.031 respectively. In the CG, p values for points 1 and 2 were respectively 0.375 and 0.063. At point 3, there was no statistically significant difference for any group.
Conclusion(s): The patients submitted to the circuit with sensory track showed improved sensitivity plantar paretic foot in points 1 and 2, while those in the control group didn´t.
Implications: Studies show the importance of the sensitivity of the feet sole and ankles for balance control because their skin and joint receptors have an essential role to ensure that postural movements are adapted to each type of surface.
Funding acknowledgements: We would like to thank Araucaria Foundation for financial support (grant number 07/2012).
Topic: Neurology: stroke
Ethics approval: Approved by the Ethics and Research Committee of the Pontifical Catholic University of Paraná, by report 1329177/2015, Brazil.
All authors, affiliations and abstracts have been published as submitted.
