Comparative analysis of aerobic capacity, power and muscle strength of healthy children and children with myelomeningocele

Abstract

Myelomeningocele (MMC) refers to a failure in the neural tube that occurs during gestation, resulting in protrusion of the meninges associated with herniation of the spinal cord and nerve roots. Despite widespread knowledge of the clinical manifestations of MMC, little is known about the cardiorespiratory alterations determined by neuromuscular and orthopedic abnormalities usually observed in this disease. Objectives: To verify the aerobic capacity, muscle strength and power of wheelchair children users, comparing with healthy children, matched by age, sex and body composition. Methods: To this cross-sectional study it will participate children and adolescents, both sexes, ages 5 to 15 years, divided into two groups: wheelchair users: (G1) - composed of 11 non ambulatory individuals with myelomeningocele, that are monitored by the Ambulatório Neurológico Infantil (NRI) of the Hospital das Clínicas FMRP-USP, and Control group (G2) - composed of 22 healthy children selected randomly. The first evaluation in G1 and G2 will be composed by: anthropometric data, body composition, bioelectrical impedance, evaluation of isometric muscle strength of the shoulder and elbow flexors and extensors using Hand-Held dynamometer; measurement of active range of motion of the shoulders and elbows, evaluation of grip strength by Bulb dynamometer; and evaluation the level of spinal cord injury, through the protocol Hoffer et al. (1973) (just for G1). Next, both groups will develop the aerobic capacity test by upper limb ergospirometry with gas analyzer and cardiac monitoring with 12-lead ECG; and isometric torque evaluation by maximum voluntary contraction through the shoulder and elbow flexor and extensor muscles and isokinetic concentric contraction through the shoulder and elbow flexion and extension in two speeds, 60°s-¹ and 120°s-¹, using isokinect Biodex System 3®. Statistical analysis: It will be used correlation measures (Correlationm of Pearson, Correlation of Spearman), calculating statistics center position (mean, median, mode) and dispersion (standard deviation, quartile deviation), hypothesis testing t (Student), Wilcoxon-Mann-Whitney test, F (ANOVA), Kruskal-Wallis, and graphical methods description and comparison. (AU)