Estudo de georreferenciamento da hanseníase em Várzea Grande (MT) e da aplicação da fisioterapia associada ou não a laserterapia em pacientes com lesão dos nervos periféricos

Abstract

Brazil has high detection rates of leprosy, being considered a chronic infectious disease with high potential for infectivity and low pathogenicity. The spatial distribution of leprosy can be mapped and analyzed to better understand the risk to the population. Leprosy affects the skin and peripheral nerves, and may present with lesions and neural thickening. Physiotherapy has techniques that are able to reduce the consequences caused by neural injuries. The use of laser therapy aims to reduce the inflammatory process, restoring motor and sensory functions. In this dissertation, we had two objectives. The first was to analyze the spatial distribution of leprosy cases reported in a reference center in the city of Várzea Grande - MT from 2016 to 2019. For this, an observational study was used, descriptive of the spatial distribution of new leprosy cases diagnosed in the said municipality. The information was extracted from the SINAN notification form, with a total of 710 notifications. A detection rate of 38.4/100 thousand inhabitants was observed, with a predominance of the borderline clinical form (70.8%), cases with more than 6 skin lesions (62.4%), 45.2% had no neural involvement, degree 0 of incapacity at diagnosis (36.3%), most new cases (85.4%) and 50.7% did not undergo smear microscopy. The second objective was to compare the evolution of neural status, pain and functionality of leprosy patients with neuritis after conventional physical therapy and laser therapy. Therefore, a randomized controlled clinical trial was carried out, which selected 55 patients diagnosed with leprosy. parsley scale before and after the intervention. It was observed that the GFL had a reduction in the pain scale (p<0.003), in the palpation of the median, radial and common fibular nerves, in the muscle strength of abduction of the fifth finger and ankle dorsiflexion and in the sensitivity of the dermatomes of the ulnar nerves. and posterior tibial. In conclusion, the first study pointed out that the spatial distribution of leprosy cases in Várzea Grande was associated with a low quality of life for the population, which includes basic sanitation and access to basic health units. While the second study showed that the use of low-level laser therapy in neural lesions resulting from leprosy was able to reduce the inflammatory process, improving the conduction of the neural impulse, consequently, improving muscle strength, sensitivity and pain, demonstrating that associating laser therapy with conventional physiotherapy is to enhance physiotherapeutic treatment.