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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2022.tde-09092022-091517
Document
Author
Full name
Thabata Pasquini Soeira
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2022
Supervisor
Committee
Herrero, Carlos Fernando Pereira da Silva (President)
Chaves, Thais Cristina
Daher, Murilo Tavares
Garcia, Luis Vicente
Title in Portuguese
Análise tridimensional da marcha em pacientes com mielopatia cervical submetidos a procedimento cirúrgico
Keywords in Portuguese
Análise da marcha
Cirurgia
Funcionalidade
Mielopatia
Mielopatia cervical
Paraparesia espástica
Abstract in Portuguese
A mielopatia espondilótica cervical (MEC) é a degeneração da coluna cervical caracterizada pelo estreitamento do canal medular e pela compressão da medula espinal. A progressão da MEC, pode levar à compressão grave da medula espinal e paraparesia, influenciando diretamente no padrão de marcha do indivíduo e, pode ser evitada pelo tratamento cirúrgico precoce, que visa a descompressão e, frequentemente, a estabilização dos níveis da coluna afetados para prevenir degeneração adicional e evitar a progressão do comprometimento neurológico. O objetivo desse estudo é avaliar e correlacionar o impacto da cirurgia descompressiva na melhora da qualidade da marcha pré e pós procedimento cirúrgico, em indivíduos diagnosticados com MEC. A avaliação tridimensional da marcha foi realizada em indivíduos pré procedimento cirúrgico, 3 meses, 6 meses e 1 ano após o procedimento cirúrgico. Os indivíduos foram avaliados através de um sistema de oito câmeras de emissão infravermelha e duas plataformas de força. Para a captura do movimento, o sistema faz uso de dois tipos de marcadores: os marcadores de referência ou anatômicos e os marcadores de rastreamento, totalizando 17 marcadores. Pode-se observar que a grande maioria dos segmentos avaliados apresentaram diferenças entre a amostra comparada, em todos os tempos, porém os segmentos pelve inclinação, quadril abdução e adução e pelve rotação são os que menos apresentaram diferença em relação ao tempo e a amostra comparada. Concluindo que análises da marcha em indivíduos diagnosticados com MCE foram úteis para descrever a recuperação funcional da marcha.
Title in English
Three-dimensional analysis of the gait in patients with cervical myelopathy undergoing surgical treatment
Keywords in English
Cervical myelopathy
Functioning
Gait analysis
Myelopathy
Spastic paraparesis
Surgery
Abstract in English
Cervical spondylotic myelopathy (CSM) is degeneration of the cervical spine characterized by narrowing of the spinal canal and compression of the spinal cord. The progression of CSM can lead to severe spinal cord compression and paraparesis, directly influencing the individual's gait pattern, and can be avoided by early surgical treatment, which aims at decompression and, often, stabilization of the affected spine levels to prevent further degeneration and prevent progression of neurological impairment. The objective of this study is to evaluate and correlate the impact of decompressive surgery on improving the quality of gait before and after the surgical procedure, in individuals diagnosed with CSM. Three-dimensional gait assessment was performed in individuals before the surgical procedure, 3 months, 6 months and 1 year after the surgical procedure. Subjects were evaluated using a system of eight infrared emission cameras and two force platforms. For motion capture, the system makes use of two types of markers: reference or anatomical markers and tracking markers, totaling 17 markers. It can be observed that the vast majority of the evaluated segments showed differences between the compared sample, at all times, but the segments pelvis inclination, hip abduction and adduction and pelvis rotation are the ones that showed less difference in relation to time and the compared sample. Concluding that gait analyzes in individuals diagnosed with CSM were useful to describe the functional recovery of gait.
 
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Publishing Date
2022-11-03
 
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