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Abstract(s)
Introdução: O crescente impacto da dor e da incapacidade na disfunção lombopélvica justifica análises objetivas e inovadoras sobre a efetividade da intervenção, nomeadamente a cirurgia. A avaliação do controlo postural permite estudar a integração sensoriomotora sob o efeito da disfunção, sendo um instrumento objetivo na medição da sua reversão com a cirurgia. Metodologia: Um grupo experimental (GE) com 37 utentes (21M, 16F) submetidos a cirurgia da coluna descompressiva (17) ou de fusão (20) por patologia degenerativa ou para correção de deformidade severa, com idades entre 14 e 80 anos (média 53,4 ± 18,1), e um grupo de controlo emparelhado (37 sujeitos, 21M, 16F, idade média 53,4± 17,8) foram selecionados. Foi avaliada a oscilação corporal na posição de pé estática numa plataforma de força Bertec® 4060-NC em sete diferentes condições durante 180s cada, sendo os utentes testados no dia de alta hospitalar, após a cirurgia. Os valores de entropia amostral, amplitude, velocidade, e área do deslocamento do centro de pressão foram analisados por estatística paramétrica. Compararam-se os resultados entre grupos em termos de efeitos da cirurgia, tipo de procedimento cirúrgico, nível de dor e presença de radiculopatia. Resultados: Na condição de base (olhos abertos), os utentes do GE mostraram uma maior área de oscilação (p=0,016) e amplitude na direção ântero-posterior [AP] (p=0,010), com valores de entropia mais baixos (p=0,031/AP). As diferenças não foram significativas na direção médio-lateral e a velocidade não distinguiu os participantes. Os testes realizados com olhos fechados, sobre espuma de alta densidade, ou a segurar uma caixa demonstraram maior capacidade discriminativa. Conclusões: Na alta hospitalar, os utentes submetidos a cirurgia da coluna mostraram um aumento significativo na magnitude da oscilação corporal e um padrão postural marcadamente regular, com baixa complexidade. Estudos com amostras maiores usando medidas não lineares são necessários para caracterizar a interação dos padrões motores com o tipo de cirurgia, o nível de dor e a presença residual de radiculopatia, após a cirurgia da coluna
Introduction: The increasing burden of pain and disability in lumbopelvic dysfunction calls for objective and innovative analysis on the intervention's effectiveness, particularly surgery. Postural control analysis apprises sensorimotor integration status correlated to spine impairments, being an objective tool in measuring its reversal with surgery. Methodology: A experimental group (EG) with 37 patients (21M, 16F) who underwent decompression (17) or fusion (20) spine surgery due to degenerative pathology or severe deformity, aged 14 to 80 years (mean 53, 4 ± 18,1), and a matched control group with 37 subjects (21M, 16F, mean age 53,4 ± 17,8). A Bertec® 4060-NC force platform measured body sway in the standing position under seven different conditions for 180 seconds each. Patients were tested on the day of hospital discharge after surgery. Parametric statistics analysed sample entropy, range, velocity, and area values of the centre of pressure's displacement. Results were compared between groups in terms of the effects of surgery, type of surgical procedure, level of pain, and the presence of radiculopathy. Results: EG patients showed a larger sway area (p = 0,016) and range in the anteroposterior [AP] direction (p = 0,010) at baseline task (eyes open), with lower entropy values (p = 0,031 / AP). The differences were not significant in the mediolateral direction, and the mean velocity did not distinguish the participants. Tests performed with eyes closed, standing on high-density foam, or holding a box exhibited a higher discriminative ability. Conclusions: Patients who underwent spine surgery showed a significant increase in body sway with a markedly regular and low complex postural pattern when measured at hospital discharge. Studies with larger samples using non-linear measures are necessary to characterise the underlying motor patterns and the impact of surgical technique, pain level, and residual radiculopathy after spine surgery.
Introduction: The increasing burden of pain and disability in lumbopelvic dysfunction calls for objective and innovative analysis on the intervention's effectiveness, particularly surgery. Postural control analysis apprises sensorimotor integration status correlated to spine impairments, being an objective tool in measuring its reversal with surgery. Methodology: A experimental group (EG) with 37 patients (21M, 16F) who underwent decompression (17) or fusion (20) spine surgery due to degenerative pathology or severe deformity, aged 14 to 80 years (mean 53, 4 ± 18,1), and a matched control group with 37 subjects (21M, 16F, mean age 53,4 ± 17,8). A Bertec® 4060-NC force platform measured body sway in the standing position under seven different conditions for 180 seconds each. Patients were tested on the day of hospital discharge after surgery. Parametric statistics analysed sample entropy, range, velocity, and area values of the centre of pressure's displacement. Results were compared between groups in terms of the effects of surgery, type of surgical procedure, level of pain, and the presence of radiculopathy. Results: EG patients showed a larger sway area (p = 0,016) and range in the anteroposterior [AP] direction (p = 0,010) at baseline task (eyes open), with lower entropy values (p = 0,031 / AP). The differences were not significant in the mediolateral direction, and the mean velocity did not distinguish the participants. Tests performed with eyes closed, standing on high-density foam, or holding a box exhibited a higher discriminative ability. Conclusions: Patients who underwent spine surgery showed a significant increase in body sway with a markedly regular and low complex postural pattern when measured at hospital discharge. Studies with larger samples using non-linear measures are necessary to characterise the underlying motor patterns and the impact of surgical technique, pain level, and residual radiculopathy after spine surgery.
Description
Keywords
Análise não linear Dor lombar Medidas de resultados Pós operatório imediato Posturografia Low back pain Immediate postoperative period Nonlinear analysis Outcome measures Posturography