Efeitos da eletroestimulação do músculo vasto medial oblíquo em portadores de síndrome da dor patelofemoral: uma análise eletromiográfica
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Data
2010-12-01
Autores
Garcia, Fabiana R.
Azevedo, Fábio Mícolis de [UNESP]
Alves, Neri [UNESP]
Carvalho, Augusto C. [UNESP]
Padovani, Carlos R. [UNESP]
Negrão Filho, Rúben F. [UNESP]
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ISSN da Revista
Título de Volume
Editor
Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
Resumo
CONTEXTUALIZAÇÃO: O uso da eletromiografia de superfície (EMG-S) tem sido considerado como instrumento de avaliação quantitativa na síndrome da dor patelofemoral (SDPF). Tratamentos conservadores objetivam melhorar o alinhamento patelar, e a estimulação elétrica do músculo vasto medial oblíquo (VMO) tem sido considerada por ser seletiva e não causar irritação articular. OBJETIVO: Verificar o efeito de um programa de fortalecimento muscular com estimulação elétrica do VMO na SDPF por meio da capacidade de avaliação da EMG-S. MÉTODOS: Participaram deste estudo 10 mulheres jovens (idade: 23,1±4,9 anos; massa corporal: 66,8±14,0 kg; estatura: 1,63±6,9 cm; IMC: 25,1±5,6 kg/m²) com SDPF unilateral, as quais realizaram o teste funcional de subir degrau para captação da atividade eletromiográfica dos músculos VMO e vasto lateral (VL), antes e após um programa de estimulação elétrica do VMO. A eletroestimulação foi realizada três vezes por semana, durante seis semanas. Foram consideradas, para análise entre VMO e VL, as variáveis razão do tempo do início até o pico de ativação, razão da integral do sinal (teste t para amostras dependentes) e diferença de início de ativação (teste de Wilcoxon), com nível de significância de p<0,05. RESULTADOS: Os resultados mostraram que ocorreu alteração somente no comportamento eletromiográfico relativo à razão da integral do sinal, mostrando que, após o treinamento muscular, ocorreram mudanças na capacidade de geração da força. CONCLUSÃO: O uso da eletroestimulação deve ser considerado no sentido de complementar a abordagem terapêutica conservadora em portadores da SDFP e a análise da razão da integral do sinal de EMG-S, como instrumento de avaliação. Artigo registrado no Australian New Zealand Clinical Trials Registry (ANZCTR) sob o número ACTRN 12609000079246.
BACKGROUND: The use of surface electromyography (SEMG) has been considered a tool for quantitative assessment of patellofemoral pain syndrome (PFPS). Conservative treatments aim to improve patellar alignment, and electrical stimulation of the vastus medialis obliquus (VMO) muscle has been considered effective because it is selective and does not cause joint irritation. OBJECTIVE: This study aims to investigate the efficiency of a muscle strengthening program with electrical stimulation of the VMO muscle in PFPS by SEMG. METHODS: A group of ten young women (age: 23.1±4.9 years; body mass: 66.8±14.0 kg; height: 1.63±6.9 cm; BMI: 25.1±5.6 kg/m²) with unilateral PFPS participated in the study. They performed the functional test of stair stepping to capture the electromyographic (EMG) activity of the VMO and vastus lateralis (VL) muscles, before and after a program of electrical stimulation of the VMO muscle. The electrical stimulation was performed three times per week for six weeks. For analysis between the VMO and VL muscles, we considered the variables: ratio of time of onset to peak of activation, ratio of the integrals of the signals (t-test for dependent samples), and difference between onsets of activation (Wilcoxon test), with significance level of p<0.05. RESULTS: The results only showed change in behavior in the EMG signal for the ratio of the integrals of the signals, indicating that changes occurred in the force-generating capacity of the muscle after the training. CONCLUSION: The use of electrical stimulation should be considered to complement the conservative therapeutic approach in patients with PFPS, and the analysis of the ratio of the integrals of the SEMG signals should be considered as an instrument of evaluation. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under number ACTRN 12609000079246.
BACKGROUND: The use of surface electromyography (SEMG) has been considered a tool for quantitative assessment of patellofemoral pain syndrome (PFPS). Conservative treatments aim to improve patellar alignment, and electrical stimulation of the vastus medialis obliquus (VMO) muscle has been considered effective because it is selective and does not cause joint irritation. OBJECTIVE: This study aims to investigate the efficiency of a muscle strengthening program with electrical stimulation of the VMO muscle in PFPS by SEMG. METHODS: A group of ten young women (age: 23.1±4.9 years; body mass: 66.8±14.0 kg; height: 1.63±6.9 cm; BMI: 25.1±5.6 kg/m²) with unilateral PFPS participated in the study. They performed the functional test of stair stepping to capture the electromyographic (EMG) activity of the VMO and vastus lateralis (VL) muscles, before and after a program of electrical stimulation of the VMO muscle. The electrical stimulation was performed three times per week for six weeks. For analysis between the VMO and VL muscles, we considered the variables: ratio of time of onset to peak of activation, ratio of the integrals of the signals (t-test for dependent samples), and difference between onsets of activation (Wilcoxon test), with significance level of p<0.05. RESULTS: The results only showed change in behavior in the EMG signal for the ratio of the integrals of the signals, indicating that changes occurred in the force-generating capacity of the muscle after the training. CONCLUSION: The use of electrical stimulation should be considered to complement the conservative therapeutic approach in patients with PFPS, and the analysis of the ratio of the integrals of the SEMG signals should be considered as an instrument of evaluation. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under number ACTRN 12609000079246.
Descrição
Palavras-chave
eletromiografia, estimulação elétrica nervosa transcutânea, síndrome da dor patelofemoral, electromyography, transcutaneous electrical nerve stimulation, patellofemoral pain syndrome
Como citar
Brazilian Journal of Physical Therapy. Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia , v. 14, n. 6, p. 477-482, 2010.