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PRACTICE OF MECHAOTHERAPEUTIC EXERCISES STIMULATES

BRAIN NEUROPLASTICITY IN A POST-ACCIDENT PATIENT

BRAIN VASCULAR

Luciana Marques Barros1

Abstract: Cerebrovascular accident (CVA) is a disease that aects motor functionality and quality of

life in patients. This article explores the ecacy and safety of physical therapy approaches through

the practice of resistance exercises with mechanotherapeutic equipment in post-stroke rehabilitation,

nutrients for the proper functioning of this entire area, a vast network of blood vessels is needed that

branch throughout this region (BALDIN, 2009).

The consequence of the alteration in the ow of blood to the nervous system, specically

to the brain, causes Cerebrovascular Accident (CVA), which can be ischemic in nature (CVA) or

hemorrhagic in nature (ALVES et al., 2022).

In Brazil, it is considered the rst cause of death and disability; in the world, it is the second

most prevalent neurological disease and also in mortality. In addition, it is the third leading cause of

disability (DIENER; HANKEY, 2020).

Depending on the region and extent of the brain injury caused by the stroke, the patient

DISEASES, 2018; BENJAMIN et al., 2019).

Stroke is the second leading cause of death and the third leading consequence of disability in

the world. It is one of the major global health problems, resulting in permanent disabilities and high

hospital costs (DIENER; HANKEY, 2020).

The concept of neuroplasticity leads to the understanding that, in the presence of an injury, the

Central Nervous System (CNS), through intact neurons, seeks alternative ways to perform the impaired

motor response, performing synapses with neurons that change in relation to their eectiveness and,

subsequently, dierentiated circuits and nerve paths are sought (MAGALHÃES, 2013).

To this end, there is an area of the nervous tissue, known as the ischemic penumbra zone,

located around the lesion, whose blood supply is sucient for the survival of neurons, but not enough

also enables the reorganization of cortical maps, favoring neurological recommunication in the face

of a given lesion (ZILLI; DE LIMA, KOBLER, 2014).

Such forms can occur both in existing structures, which in this case will become capable

of performing functions in other areas, and they can stimulate neural cells to have a plastic power,

recomposing useful and functional connections, thus allowing desired functions to be exercised

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Regarding the rehabilitation plan, it should always be individualized, varying according

to the commitment, and the degree to which the patient has developed compensatory strategies. In

general, the main treatment objectives consist of adjusting tone, gaining muscle strength, improving

sensitivity, training the patient to perform postural transfers and activities of daily living, improving

coordination and balance, stimulating standing and gait (Shumway-Cook et al., 2002, Umphred, 2004).

Scientic and technological evolution has provided changes in neurofunctional rehabilitation

and contribution to physiotherapy, allowing a greater understanding of brain reorganization and motor

control mechanisms (CARR, PASTOR, 2006).

One of the therapeutic resources proposed by the physiotherapist in the prevention of falls to

the elderly is mechanotherapy, which is a clinical tool that provides advantages to patients, as it presents

2021). Equipment that stimulates movement response through technologies that provide real-time

response and improve the precision of movements (LIMA et al., 2020).

In this work, data on the subject will be presented, as well as scientic evidence, which

document the application and eects of the use of resistance exercise equipment on the functional

recovery of post-stroke patients.

It was a literature review, using books and articles. A bibliographic survey was carried

out in the following databases: LILACS, MEDLINE, PEDRO and SCIELO. Articles published in

Portuguese and English, from 2006 to 2023, which addressed neurological rehabilitation techniques

for after stroke, were selected. The descriptors used were: Stroke, Rehabilitation, neuroplasticity,

Physiotherapy has several therapeutic approaches in post-stroke rehabilitation, each with its

particularities and benets, mechanotherapy is one of them and proves to be an indispensable resource.

Approximately 70% of patients do not resume work, 50% need help with ADL and 30% need help

walking (BRAZILIAN SOCIETY OF CEREBROVASCULAR DISEASES, 2018; BENJAMIN et al.,

It is recommended that rehabilitation be a multidisciplinary process in order to promote

maximum eectiveness and eciency in treatment (SCHIMIDT et al., 2019). Conventional physical

therapy in the rehabilitation of patients with stroke sequelae often becomes limited. Other techniques

aimed at promoting the ability to withstand exertion, gait performance and general physical abilities,

such as muscle strengthening, should be included (OVANDO et al., 2010; CASTRO et al., 2011)

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as the pathologies present, the degree of impairment, physical size, history of injuries, level of muscle

mobility, physical losses such as muscle mass, blood tests, and the guidance of other professionals to

plan the program of activities according to the functionality and capacity of each one, to achieve the

proposed objective (CUNHA, 2011; Oliveira et al. 2019; ).

Ovando et al. (2010), during a literature review, found that the most used protocols for the

execution of muscle strengthening exercises for the lower limbs (LLLL) used in these clients are similar

to those used in training for the elderly: exercises with a minimum load of 50% of the maximum load,

with 8-12 repetitions. All studies cited by the authors reported positive results in gait speed, the ability

to climb stairs, to stand up and to perform ADL.

In the study conducted by Oliveira et al. (2019) evaluated the functional capacity and muscle

The equipment used to perform resistance exercises after stroke can be separated into

equipment for upper and lower limbs and devices for the trunk, head and neck.

The purpose and need of mechanotherapy work are identied, primarily, by the characteristics

of the type of mobility and muscle contraction desired by the physiotherapist, meeting a certain

Figure 1: The Cross SmithLFR@ equipment is a professional device that acts on strengthening and

dening the muscles. With possibilities in the execution of mobility and body balance exercises.

For this, it is important that the professional always takes into account the individuality of

that allows adaptations to dierent experiences, contributing to learning or motor relearning. Future

research should focus on the optimization of treatment protocols and the analysis and use of new

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References

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