Functional and Biomechanical Outcomes of Proprioceptive Neuromuscular Facilitation Associated to the contralateral hemibody of Patients with Charcot Marie Tooth Disease.

Abstract

The Charcot Marie Tooth disease is a hereditary progressive neuromuscular disorder which has an autosomal dominant pattern. A peroneal muscular atrophy, caused by a reduction of the nerve conduction velocity, is one of the functional alterations that are characteristic of this pathology. The functional inability of these patients increase with the progression of the disease. Proprioceptive Neuromuscular Facilitation (PNF) can be mentioned as one of the common methods of physiotherapy treatment in neurology, although, despite all of the clinical evidences, there are few scientific evidences that support the use of PNF. Therefore, the aim of this project is to advance in knowledge relative to the rehabilitation of the paretic inferior member of patients bearing the CMT disease, through PNF techniques. The participants of this study must have functional alterations in the inferior member resulting of the CMT disease. The criteria for admission include: good cognition, no articular blockades, gait with and without aid. The exclusion criteria include: cardiac arrhythmia, uncontrolled arterial hypertension, other cardiovascular problems and severe respiratory problems. The use of medicines proper to the treatment of the CMT disease will be accepted. The admitted subjects will be arranged in a single group of PNF treatment. The evaluation will precede the treatment protocol. Re-evaluations will be done each 12 sessions, until the end of the protocol. The patients will be treated three times a week, for four weeks. The PNF diagonals will be chosen according to the functionality of the other segments, which will not be the inferior members, and will be specific to each patient. The functionality of the inferior members will be analyzed through the Berg Balance Scale and the Rivermead Mobility Index. The gait analysis will be done through the 10 meter test and the Timed Up & Go Test , both documented by filming. To quantify the muscular activation, pre and post PNF therapy, there will be a superficial electromyographic analysis, and the electrodes will be positioned on the motor points of the the iliopsoas and the anterior tibial muscles. The statistical analysis comparing the pre and post therapy data will be done through the Student T test.