A espondilólise é um defeito na pars interarticularis da vértebra com descontinuidade óssea do segmento intervertebral; a progressão do defeito resulta em deslizamento de uma vértebra sobre a outra, chamado espondilolistese, o que pode provocar dor. O tratamento não-cirúrgico é a escolha inicial na maioria dos casos de espondilolistese, mas poucos estudos verificam a eficácia dos tratamentos conservadores. O objetivo deste estudo foi realizar uma revisão da literatura sobre esses tratamentos, sobretudo no que concerne à terapia manual, a fim de ajudar os terapeutas na prescrição de intervenções eficazes. Os resultados mostram que tanto a terapia manual como a fisioterapia convencional apresentam efeitos benéficos na redução da dor lombar e na melhora funcional do paciente. As terapias manuais envolvem manipulação da coluna vertebral e articulação sacroilíaca, músculo-energia e alongamento dos músculos afetados. Exercícios de estabilização lombopélvica, fortalecimento dos músculos posturais e alongamento dos isquiotibiais e psoas também foram considerados importantes. O paciente deve ser avaliado individualmente em seu quadro clínico e radiográfico para determinação do plano de tratamento. Dentre as opções conservadoras de tratamento encontradas, nenhuma se mostrou conclusivamente superior às outras e todas podem ser incluídas no tratamento sintomático de pacientes com espondilólise/listese.
The aim of this study was to evaluate if gait training on treadmill is effective to decrease the support time in paretic limb, investigating associations between this variable and the lower limb muscle strength degree, after treadmill training. For this, we invited eight children aged between six and 14 years old, diagnosed with hemiparetic cerebral palsy. Gait was recorded and transformed in frames, with which were obtained each limb phase of stance duration. Muscle strength was evaluated manually and graded by a specific scale. Then, children underwent gait training on a treadmill for 20 sessions, twice a week. At the end of sessions, walking and strength were revalued. In data analysis we used non-parametric analyses with Wilcoxon and Spearman linear correlation tests. Significant differences were found for stance time, in both limbs, after treadmill training. Correlation test showed significant inverse association, after training, between triceps surae and iliopsoas muscles strength and the stance time percentage of non-impaired limb. Gait training on a treadmill was effective, resulting muscle strength gains and stance duration reducing, thus improving ambulation quality.
The aim of this study was to evaluate if gait training on treadmill is effective to decrease the support time in paretic limb, investigating associations between this variable and the lower limb muscle strength degree, after treadmill training. For this, we invited eight children aged between six and 14 years old, diagnosed with hemiparetic cerebral palsy. Gait was recorded and transformed in frames, with which were obtained each limb phase of stance duration. Muscle strength was evaluated manually and graded by a specific scale. Then, children underwent gait training on a treadmill for 20 sessions, twice a week. At the end of sessions, walking and strength were revalued. In data analysis we used non-parametric analyses with Wilcoxon and Spearman linear correlation tests. Significant differences were found for stance time, in both limbs, after treadmill training. Correlation test showed significant inverse association, after training, between triceps surae and iliopsoas muscles strength and the stance time percentage of non-impaired limb. Gait training on a treadmill was effective, resulting muscle strength gains and stance duration reducing, thus improving ambulation quality.Key Words: Gait, Cerebral Palsy, muscle strength, hemiplegia.
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