Dados do Trabalho

Título

Avaliação da força proximal, da marcha, equilíbrio, da funcionalidade e da qualidade de vida em pacientes com Polirradiculopatia Desmielinizante Inflamatória Crônica

Resumo

Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is an acquired disorder of the Peripheral Nervous System (PNS) where the myelin sheath is affected. Its etiology is still unknown and in most cases its evolution is progressive and symmetrical, with proximal and distal involvement of the upper and lower limbs, causing changes in gait, balance, functionality and quality of life. Several assessment scales have been proposed aiming to improve patient follow-up and management of secondary complications. The aim of this study was to evaluate the impact of proximal lower limb strength on gait, balance, functionality and consequently in quality of life in patients with CIDP. Scales that aid in the clinical assessment of gait, balance, functionality, muscle function and quality of life were used, such as: Dynamic Gait Index (DGI), Performace Oriented Mobility Assessment (POMA); Modified Rankin Scale (mRS), Medical Research Council (MRC) and The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) respectively, all in their Brazilian versions. Seven patients participated in the research, most of them males (71.4%), mean age of 48 years (median 41 years). According to the MRC, the patients had proximal muscle weakness (hip flexors) ranging in score from 3 to 4 (mean 3.57) and distal crural muscle weakness ranging from 2 to 4 (mean 3.29). According to the DGI scale, all participants were at risk of falling with a score equal to or below 19 points (mean of 17.43). According to the POMA scale, one patient (14.2%) had a high risk of falls with a score of 19, five participants (71.6%) had a moderate risk of falls, with scores between 20 and 24, and only one participant (14.2%) had no risk of falls, with a score of 25. The average among individuals was 22.71 points on the POMA scale.It was observed that the physical aspects obtained the lowest score in the average of the population under study in relation to the components of the SF-36, impacting more significantly on the sample. It can be concluded from this study that proximal and distal paresis in the lower limbs in individuals diagnosed with typical CIDP affects normal gait and balance patterns, according to the DGI and POMA scales, and these scales can be a risk predictor of falls in this population.It was also observed that functionality in this population, despite being a chronic and progressive disease, is not severely affected, according to the mRS scale.