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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2012.tde-27022012-144535
Document
Author
Full name
Denise Caldeira Troise Mesquita
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2012
Supervisor
Committee
Vilibor, Renata Hydee Hasue (President)
Baldo, Marcus Vinicius Chrysostomo
Sacco, Isabel de Camargo Neves
Title in Portuguese
Avaliação da somestesia e coordenação motora em crianças com distrofia muscular de Duchenne
Keywords in Portuguese
Atividade motora
Criança
Distrofia muscular de Duchenne
Sistema nervoso central/anormalidades
Abstract in Portuguese
OBJETIVO: Pacientes com distrofia muscular de Duchenne apresentam alterações neuronais em regiões do sistema nervoso central como no giro pós-central e cerebelo. Para entender a sua influência sobre o controle motor, nós investigamos a somestesia e destreza manual, com e sem a informação visual. MÉTODO: Participaram deste estudo quarenta meninos com diagnóstico confirmado de distofia muscular de Duchenne (idade média = 9,68; DP = 2,23 anos), sem comprometimento dos membros superiores, e quarenta e nove meninos saudáveis (idade média = 8,14 anos; DP = 1,94 anos). Para avaliar a somestesia foi utilizado o teste de discriminação entre dois pontos e o teste de estereognosia, e para avaliar a destreza manual, foi utlilizado o Pick up test de Moberg com olhos abertos e olhos fechados e o teste do erro de localização. Os resultados foram submetidos pela análise de variância (ANOVA), sendo considerado estatisticamente significante p<0,05. RESULTADOS: Os resultados demonstraram que em meninos com distrofia muscular de Duchenne, a estereognosia estava comprometida em ambas as mãos (p<0,001), no entanto não houve diferença significativa no teste de discriminação entre dois pontos (p=0,313) quando comparado aos meninos saudáveis. A destreza manual estava pior nos meninos com distrofia muscular de Duchenne quando dependia de informações somestésicas, ou seja, no Pick up test de Moberg de olhos fechados e no teste do erro de localização (p<0,001). INTERPRETAÇÃO: Os resultados demonstraram que a discriminação tátil estava intacta em meninos com distrofia muscular de Duchenne, sugerindo que a via sensorial não está prejudicada. Ao contrário, tarefas que envolviam a função cerebelar, ou seja, a percepção sensorial durante o reconhecimento ativo do objeto e o controle de alcançar e agarrar, estavam prejudicadas. Abordagens terapêuticas específicas devem ser delineadas para melhorar o controle motor e, portanto, a funcionalide de pessoas com distrofia muscular de Duchenne
Title in English
Evaluation of somesthetic and manual dexterity in children with Duchenne muscular dystrophy
Keywords in English
Central nervous system/abnormalities
Child
Duchenne muscular distrophy
Motor activity
Abstract in English
AIM: Neuronal alterations were reported in the postcentral gyrus and cerebellum of patients with Duchenne muscular dystrophy. To understand their influence over motor control, we investigated somesthesis and manual dexterity, with and without visual information. METHOD: Forty boys with Duchenne muscular dystrophy (mean age = 9.68; SD = 2.23 years), with no upper limb dysfunction, and 49 healthy boys (mean age = 8.14; SD = 1.94 years) participated in the study. To assess somesthesis we used the twopoint discrimination test and the six-object stereognosis test, and to assess manual dexterity, the Moberg Pick up test with the eyes opened and closed and the localization error test. The results were submitted to ANOVA, considering statistically significant a value of p<0.05. RESULTS: Boys with Duchenne muscular dystrophy had impaired stereognosis with both hands (p<0.001), but two-point discrimination did not differ between the groups (p=0.313). Manual dexterity was much worse in Duchenne muscular dystrophy boys when somesthesic information was necessary, i.e., during the Pick up test with the eyes closed and the localization error test (p<0.0001). INTERPRETATION: Tactile discrimination is intact in children with Duchenne muscular dystrophy, suggesting that the somatic pathway may not be impaired. Unlike, tasks involving cerebellar function, i.e., sensory perception during active object recognition and reach and grasp control, are impaired. Specific therapies should be delineated to improve motor control, and therefore functionality, of people with Duchenne muscular dystrophy
 
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Publishing Date
2012-02-28
 
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