Avaliação e tratamento fisioterápico na doença arterial obstrutiva periférica de membro superior: um estudo de caso
2008
The aim of this paper was to present a case study proposing a protocol for assessment and rehabilitation of a patient with upper limb intermittent claudication. Case description: 50-year-old woman with obstruction of the left brachial artery secondary to catheterization performed 4 months ago. Monophasic sound was observed during continuous Doppler ultrasound assessment of both the radial and ulnar arteries. During the arm crank test, ischemic pain started at 2 minutes and 30 seconds of cranking, while maximal pain was reached at 9 minutes and 26 seconds. The patient was treated by arm cranking exercises performed three times a week for 8 weeks. After the treatment, arm crank time increased: ischemic pain onset was at 5 minutes and 7 seconds and maximal pain was reached at 18 minutes. The patient reported disappearance of cyanosis and improvement in performance of daily activities. The assessment protocol comprehended both subjective (validated Brazilian Portuguese version of SF-36 questionnaire) and objective (arm crank) measurements and was well tolerated, besides being able to detect changes in the patient's functional capacity. Changes detected at pain onset and at maximal pain may have occurred spontaneously, but it cannot be ruled out that this intervention can be potentially beneficial for individuals with upper limb claudication. The results observed in this case study warrant further studies involving larger sample size.
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