Efeitos da Fotobiomodulação Transcraniana na funcionalidade de membros superiores após Acidente Vascular Encefálico crônico : estudo randomizado de viabilidade

Abstract

Introduction: Stroke, also known as Cerebral Vascular Accident (CVA), is a neurological disease with complex and multicausal pathophysiology that results in motor, cognitive and/or emotional changes, with consequent impairment of functionality in individuals affected by illness. Transcranial Photobiomodulation is one of the interventions with great potential and has been tested in several studies. However, no data were found in the literature on the use of this resource for upper limb functionality after chronic stroke. Objective: To evaluate the feasibility and effectiveness of Transcranial Photobiomodulation on the functionality of the upper limbs in individuals affected by chronic stroke. Method: This is a randomized pilot study,

carried out at the outpatient clinic of Hospital das Clínicas Samuel Libânio, in Pouso Alegre- MG. Telephone contact was made with patients who were admitted to the hospital's Stroke Unit

(UAVC) or who were on the waiting list for physiotherapeutic care. 5 individuals participated, diagnosed with a stroke 6 months or more ago, 3 women and 2 men, with an average age of 57.8 years and an average stroke time of 2.6 years, all hypertensive. Participants were selected according to previously defined inclusion and exclusion criteria, being randomly divided into a control group (n=2), which received guidance, and an intervention group (n=3), which received Transcranial Photobiomodulation. The intervention was carried out using a low-intensity laser, with a wavelength of 830 nanometers. 6 Joules were applied bilaterally to points F3 and F4 to stimulate regions of motor function and FP1 (left side) and FP2 (right side) to stimulate areas of cognition, following the points of the International System 10-20. The interventions were carried out for 30 days, totaling 20 sessions. Patients were evaluated before and after the interventions, using the following assessments: Box and Block Test, Canadian Occupational Performance Measure, Montreal Cognitive Assessment, and Stroke-Specific Quality of Life Scale. Results: No statistical differences were found in intra- and intergroup comparisons for the analyzed variables, both in the primary outcomes of gross manual dexterity and functional gain, and in the secondary outcomes of cognitive aspects and quality of life. The sample calculation, carried out using the Box and Block Test variable – most affected side, with a power value of 0.95 and alpha of 0.05, showed an estimated value of n=12 for the control group and n=12 for the intervention group, to carry out a randomized controlled clinical trial. Conclusion: The application of transcranial photobiomodulation in regions of motor function and cognition of five patients with a clinical diagnosis of chronic stroke in this pilot study did not result in significant effects on the primary outcomes of gross manual dexterity and

functional gain, nor on the secondary outcomes of cognitive aspects. and quality of life. The sample size calculation showed an estimated value of n=12 in each group to carry out a randomized controlled clinical trial.