Associação entre sinais da lesão do neurônio motor superior e o desempenho no ciclismo de indivíduos no pós-acidente vascular cerebral: um estudo transversal

Abstract

The motor sequelae of stroke resulting from upper motor neuron (UMN) lesion impose deficits in cardiorespiratory capacity, functional limitations and restriction of participation with economic impact on the lives of post-stroke individuals. In this context, clinical guidelines recommend aerobic exercise as a positive strategy in the rehabilitation of this patient profile, in which cycling fits as one of the possible and promising options for cardiorespiratory and functional improvement. However, it is necessary to understand how the UMN lesion related to the post-stroke interfere in the performance of these individuals during the cycling activity. The aim of the present study was to investigate the association between UMN lesion signs (muscle weakness, spasticity and passive muscle stiffness) and cycling performance of post-stroke individuals. This is an observational, cross-sectional study. The target population were individuals of both sexes, aged 18 years or older who were in the chronic phase of stroke. Measurements were taken over three days. In the first two, clinical and sociodemographic information was collected, as well as measures of muscle strength using a manual dynamometer, spasticity using the Modified Tardieu Scale and passive muscle stiffness using an isokinetic dynamometer. On the third day, the individual was submitted to the cycling test on the cycle ergometer. To assess the association between UMN lesion signs and cycling performance, Spearman's correlation matrix was used. Seven individuals participated in the study with a mean age of 57.6 (±7.8) years and mean time since the last stroke of 46.6 (±33.5) months. Statistical analysis revealed a negative association between the cycling performance measure (mean rotations per minute) and the representative variables of muscle strength and spasticity, and a positive association between passive stiffness and the same outcome (rho = -0.107; p = 0.840; rho = -0.204; p = 0.661 and rho = 0.357; p = 0.444), respectively. However, considering that the sample size was insufficient for a more robust analysis, this result should be considered cautiously, since the sample size does not allow considering that there is in fact no significant association between the variables. Therefore, considering the importance of the subject in the rehabilitation of cardiorespiratory capacity and general mobility after stroke, new studies should be carried out with a larger sample to bring results capable of better guiding the clinician regarding the factors contributing to cycling performance and post-stroke rehabilitation.