Coerência espectral do eletrencefalograma em pacientes submetidos a transposição tendinosa: estudo pré e pós-operatório

Abstract

RESUMO -A transferência tendinosa do músculo tibial posterior é intervenção cirúrgica bastante utilizada na ortopedia para correção do pé caído por seqüela de hanseníase. Poucos modelos propuseram investigações mais significativas sobre os fenômenos plásticos cerebrais nas transferências tendinosas. O presente estudo teve como objetivo analisar a coerência espectral (CE) na Eletroencefalografia (EEG) em pacientes submetidos a transferência do tendão do tibial posterior pela técnica de Srinivasan através da EEG quantitativa (EEGq). A amostra foi composta de quatro sujeitos com pé caído devido a seqüela de hanseníase. Os parâmetro s de CE do EEG foram quantificados no momento pré e pós-operatório. Os resultados mostraram que houve efeito principal para o fator momento, significativo, no par de eletrodos C3-CZ, com aumento da coerência. E n t retanto, os achados da ANOVA não revelaram interação significativa entre bandas versus momento. A recuperação funcional promovida por tal cirurgia parece gerar alterações corticais.PA L AV R A S -C H AVE: EEGq, coerência, transferência tendinosa, hanseníase, pé caído, integração sensório-motora.EEG spectral coherence at patients submitted to tendon transfer surg e ry: study pre and post surgery ABSTRACT -Tendon transfer of the tibiliais posterior muscle is a surgical intervention widely employed in o rthopedics for the correction of drop foot caused by lepro s y. However, few models have proposed a t h o rough investigation of the brain plasticity phenomenon during tendon transfer. Thus, the present study aimed at analyzing EEG spectral coherence (SC) in patients submitted to tendon transfer of the tibiliais posterior muscle by Srinivasan's technique and quantitative EEG (EEGq). The sample consisted of four subjects with drop foot caused by lepro s y. The SC parameter was evaluated in two experimental moments: p re and post-surg e ry. Results demonstrated a main moment effect for the C3-CZ electrode pair. Specifically, a significant increase in coherence values was observed. However, the ANOVA did not indicate a significant band/moment interaction. It can be assumed that coherence augmentation indicates that functional rehabilitation promoted by this specific surgery yields cortical alterations.KEY WORDS: qEEG, coherence, tendon transfer, leprosy, drop foot, motor sensory integration.Srinivasan 6 para correção do pé caído em função da paralisia do músculo tibial anterior. Dentre as etiologias desta enfermidade no pé, destacam-se as paralisias por hanseníase. Assim, a transferência tendinosa para correção do pé caído é um dos tratamentos mais preconizados nas debilidades musculares proAs transferências tendinosas são procedimentos cir ú rgicos que têm o intuito de restabelecer funcionalidade do segmento acometido por lesões nervosas periféricas. Um dos pioneiros neste procedimento foi Ob e r 1 e, posteriormente, surgiram outras pro p o s t a s 2 -5 . Uma das técnicas mais utilizada foi desenvolvida por

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