INFLUÊNCIA DA FISIOTERAPIA AQUÁTICA NA FUNCIONALIDADE, DOR E EQUILÍBRIO POSTURAL EM INDIVÍDUOS COM AMPUTAÇÃO UNILATERAL DO MEMBRO INFERIOR (AUMI): ENSAIO CLÍNICO RANDOMIZADO

Abstract

Introduction: In Brazil, the rate of lower limb amputation is 13.9 per 100,000 inhabitants, 59.1% of which are male, generating repercussions on balance and on the projection of the center of gravity, increasing the risk of falls and fractures. Interventions with floor exercises have been reported to be effective in improving these variables, but there is a lack of quality scientific data, so far, on the use of Aquatic Physical Therapy (AP) in individuals with unilateral lower limb amputation (ULLA). Objective: To evaluate the influence of AP on functionality, pain, and postural balance in individuals with SCI. Methodology: This is a single-blind, randomized, controlled and balanced (1:1) clinical trial, in which 14 adult individuals with SCI (transtibial or transfemoral) were randomly allocated to blocks in a convenience sampling. The subjects were divided into 2 groups: the Ground Physical Therapy Group (GPG) (n=7) and the Aquatic Physical Therapy Group (APG) (n=7). The intervention was performed for a period of 8 weeks, twice a week and 30 minutes. Functionality was assessed by the Functional Independence Measure (FIM), balance by the Berg Balance Scale (BBS) and K Force Plates, and pain by the Denis Pain Scale (DPS). Data were presented as mean, standard deviation, and confidence interval. The Kolmogorov- Smirnov test was used to test the normality of the data, and the groups were compared using Student's t test for parametric variables and the Mann-Whitney test for non-parametric variables. A significance level of 5% was considered. Results: The mean age of the participants was 39±18, 79% male, 21% female. 72% of amputations were due to traumatic etiology and 28% to complications of Diabetes Mellitus, 79% at the transtibial level and 21% transfemural. Both treatments were effective in improving functional balance measured by BBS, but without superiority between floor exercise and aquatic exercises. All other variables showed improvements in their scores, in both groups, but without statistically significant differences within or between groups. Conclusion: Physical exercise performed on land and in aquatic environment were equally effective in improving functional balance measured by BBS in individuals with ULLA. However, in this frequency, duration and intensity did not show significant differences in the improvement of functionality, pain and CoP variables. Keywords: aquatic exercise; amputation; postural balance.