Banca de DEFESA: THIAGO BEZERRA WANDERLEY E LIMA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : THIAGO BEZERRA WANDERLEY E LIMA
DATE: 16/12/2024
TIME: 14:30
LOCAL: Hibrido
TITLE:

METHODS OF NORMALIZATION AND ANALYSIS OF ELECTRICAL
ACTIVITY OF RESPIRATORY MUSCLES IN PATIENTS WITH
AMYOTROPHIC LATERAL SCLEROSIS AND HEALTHY SUBJECTS

KEY WORDS:

Respiratory muscles; Amyotrophic lateral sclerosis; Surface electromyography 

PAGES: 67
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Surface electromyography (sEMG) is one of the
methods used to assess the electrical activity of a person's muscles,
whether at rest or during activity. sEMG can be used to evaluate
skeletal and respiratory muscles in healthy individuals and those with
pathologies, allowing for analysis across different days, individuals,
and situations. Amyotrophic lateral sclerosis (ALS) is a progressive
neurodegenerative disease characterized by generalized muscle
weakness. One of the main causes of death in these patients is
respiratory muscle weakness, and consequently ventilatory failure.
sEMG becomes an important tool for monitoring respiratory muscles in
ALS patients, allowing an understanding of muscle recruitment patterns
and potential muscle dysfunctions in these subjects. The
electromyographic signal can be influenced by intrinsic and extrinsic
factors. Therefore, it is important to seek methods that aim to minimize
the interference of these factors, making the results as accurate as possible. One of the alternatives used for this process is normalization.
There is still no consensus in the literature on the best way to perform
normalization. Objective 1: Compare different normalization methods
for the sEMG signal of respiratory muscles in ALS patients and healthy
subjects; Objective 2: Analyse the electrical activity and the
contraction and relaxation variables of the ster-nocleidomastoid and
scalene muscles during the SNIP manoeuvre in patients with ALS and
healthy subjects using surface electromyography. Methods: This is a
cross-sectional study, approved by the University Ethics Committee
under opinion number 3.127.064, in which 67 subjects participated,
with 50 in the healthy group and 17 in the ALS group. The electrical
activity of the sternocleidomastoid (SCM), scalene (SC), diaphragm
(DIA), parasternal (PS), external intercostal (EI), external oblique
(EO), and rectus abdominis (RA) muscles was analyzed during
maximum inspiratory pressure (MIP), sniff nasal inspiratory pressure
(SNIP), maximum expiratory pressure (MEP), and maximum voluntary
isometric contraction of the SCM and SC (MVICSCM/SC) and RA
(MVICRA). sEMG comparisons were made considering the division of
maneuvers and muscles into inspiratory and expiratory categories.
Additionally, during the SNIP maneuver, the electrical activity of the
SCM and SC muscles was analyzed, as well as the variables of
contraction time (CT), relaxation time (RT), total time (TT), and
pressure/time ratio from the sEMG in 24 subjects (12 ALS group and
12 healthy). Results: In the healthy group, inspiratory and expiratory
muscles showed greater electrical activity in the MVICSCM/SC and
MVICRA maneuvers, respectively (p<0.05). In the ALS group, this
activity was higher in the SNIP maneuver only when compared with
MIP for inspiratory muscles, while for expiratory muscles it was higher
in MVICRA compared to MEP (p<0.05). During the SNIP maneuver, a
difference was observed between groups regarding the electrical
activity (RMS) of the SCM and SC, with healthy subjects showing
higher RMS values (p<0.05). Additionally, ALS patients presented a
higher CT, lower RT, and a decreased pressure/time ratio in the SCM
muscle. Conclusion: The normalization method based on MVIC was the one in which the respiratory muscles presented the greatest
electrical muscle activity, for both the set of inspiratory and expiratory
maneuvers in healthy subjects. In ALS patients, the SNIP maneuver
appears to be the most suitable for normalizing inspiratory muscles and
MVIC for expiratory muscles. Furthermore, ALS patients showed an
increase in CT and a decrease in RT in the SCM muscle, indicating that
sEMG evaluation of this muscle may help monitor disease progression.

COMMITTEE MEMBERS:
Externo à Instituição - ANTONIO JOSÉ SARMENTO DA NÓBREGA
Interna - 3358154 - GIANE AMORIM RIBEIRO SAMORA
Presidente - 1545315 - GUILHERME AUGUSTO DE FREITAS FREGONEZI
Externa à Instituição - JESSICA DANIELLE MEDEIROS DA FONSECA - EBSERH
Interna - 2211046 - LUCIEN PERONI GUALDI