Adaptação à prótese híbrida de extremidade superior: estudo termográfico de um caso

Abstract

O objetivo do estudo foi verificar, por meio de termografia, a adaptação à prótese híbrida de extremidade superior de um sujeito do sexo masculino, 42 anos, amputado proximal de braço esquerdo. Imagens termográficas foram captadas por uma câmara de infravermelho imediatamente após a retirada da prótese, que vinha sendo usada por 8 horas ininterruptas, e 20 minutos de repouso mais tarde, quando foi alcançado equilíbrio térmico em ambiente a 21°C. As imagens foram adquiridas nos planos frontal anterior, sagital direito e esquerdo, tendo sido definidas e analisadas regiões de interesse em cada uma. Os resultados mostram que as temperaturas das regiões avaliadas reduziram-se em média 0,79°C (p<0,05) após a estabilização térmica. Na região do tórax e na axila contralateral ao coto, por onde passa o tirante de fixação da prótese, constataram-se elevadas temperaturas, coincidindo com queixa de desconforto do sujeito e indicando atrito; temperatura mais alta no ombro anterior homolateral à amputação caracterizou sobrecarga; e baixa temperatura no segmento residual à amputação indicou pouca circulação, assinalando dificuldade de adaptação. Os resultados sugerem que a avaliação termográfica pode contribuir para identificar desconforto de amputados com prótese de membro superior e ser utilizada no acompanhamento de sua reabilitaçao; no caso, sugere-se ainda o desenvolvimento de materiais de modo a aumentar o conforto na fixação das próteses de extremidade superior.

Thermographic: a tool of aid in physical therapy diagnosis – literature review

“…Through these features becomes a relevant method to perform preventive activities and early intervention. (6,7,(12)(13)(14)(15)(16) Considering the detection of muscle injuries, the first study cited in the Table 1 In the above research it can be seen that small changes in temperature between the control group (low-intensity exercise) and experimental group (high-intensity exercise)…”

“…Concurrently with results regarding overload at work, a case study concerning the adjustment of the hybrid prosthesis (16) notes were made relevant to the applicability of thermography in physical therapy diagnosis. Noting that the anterior shoulder region had the highest temperature of the images, which may characterize some sort of overload in this region, then, being a hybrid prosthesis, the whole mass, especially the myoelectric hand, is in need of greater support, overloading the proximal region to fitting the amputation stump.…”

“…The identification of these regions is fundamental for the correct fit of the prosthesis and preparation stump, since these areas with circulation deficit should be worked in order to avoid concomitant injuries. (16) Monitoring the amputee patient should be done from the immediate postoperative period until full rehabilitation, however, errors in this process can cause ischemic compression, inflammation and/or wear on the joint member not amputated by excessive or even use the joint part above the level of amputation. (16) Through this analysis it was found that thermography is useful in recognition of joint overload, inflammation and ischemia (featuring or not a good fit the prosthesis).…”

“…(16) Monitoring the amputee patient should be done from the immediate postoperative period until full rehabilitation, however, errors in this process can cause ischemic compression, inflammation and/or wear on the joint member not amputated by excessive or even use the joint part above the level of amputation. (16) Through this analysis it was found that thermography is useful in recognition of joint overload, inflammation and ischemia (featuring or not a good fit the prosthesis). (16) To confirm the effectiveness of the discussed instrument, one study compared the thermographic evaluation results of two researchers (inter examiners) and the same researcher at different times (intra examiner).…”

“…(16) Through this analysis it was found that thermography is useful in recognition of joint overload, inflammation and ischemia (featuring or not a good fit the prosthesis). (16) To confirm the effectiveness of the discussed instrument, one study compared the thermographic evaluation results of two researchers (inter examiners) and the same researcher at different times (intra examiner). The results…”