O desempenho nos testes clínicos da função objetiva pode estar associado e predizer as características clínicas e da força muscular na dor femoropatelar?
Data
2023-01-26
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Universidade Estadual Paulista (Unesp)
Resumo
Indivíduos com dor femoropatelar (DFP) apresentam pior capacidade funcional, nível de atividade física e qualidade de vida, e também podem apresentar alterações do torque muscular de joelho, sendo esta medida associada à força muscular. Por apresentar sintomas persistentes, estudos especulam que a DFP seja precursora da Osteoartrite Femoropatelar (OAFP), contudo poucos estudos investigaram à longo prazo a variação do quadro clínico dessa população. Investigar características associadas à DFP e com capacidade de predizer mudanças no quadro clínico sintomatológico e do torque muscular de membros inferiores a longo prazo podem contribuir para o entendimento do curso natural da DFP. Por tanto, o objetivo geral desta dissertação foi investigar a relação (estudo I) e a capacidade de predição a longo prazo (estudo II) que o desempenho nos testes clínicos da função objetiva apresenta sobre as características clínicas sintomatológicas e de torque do joelho. Avaliações de baseline e follow-up foram coletadas. As avaliações foram realizadas em dois dias, e foram coletados dados antropométricos, medidas autorreportadas, medidas objetivas e dados de torque muscular de flexores e extensores de joelho. Análise de correlação de Pearson e Equações Estimadoras Generalizadas (GEE) foram utilizadas para a obtenção dos resultados. Os resultados no primeiro estudo demonstraram associação entre o torque e a flexibilidade dos flexores de joelho com o nível de dor atual em mulheres e homens com DFP. Os resultados também demonstraram associação do torque dos flexores de joelho e TDT com o desempenho no Single leg bridge test (SLBT) em mulheres e homens com DFP. No segundo estudo desta dissertação, foi identificado que o desempenho no Single leg hop test (SLHT) Forward step down test (FSDT), avaliados inicialmente, apresenta capacidade de predizer mudanças ao longo do tempo de 15 meses sobre o nível de dor no joelho, torque máximo dos músculos flexores e extensores de joelho dos indivíduos com DFP. No geral, os achados desta dissertação apresentam que o uso de testes clínicos da função objetiva, como o SLBT, pode ser uma opção viável, de baixo custo e efetividade para a avaliação das características clínicas e de torque muscular de joelho para indivíduos com DFP. Além disso, utilizar os testes clínicos SLHT e FSDT para a avaliação do paciente parece contribuir para um melhor entendimento do curso natural do quadro clínico de dor e torque dos flexores e extensores de joelho dos indivíduos com DFP.
Individuals with patellofemoral pain (PFD) have worse functional capacity, physical activity level, and quality of life, and may also present changes in knee muscle torque, which is a measure associated with muscle strength. Because it presents persistent symptoms, studies speculate that PFP is a precursor of Patellofemoral Osteoarthritis (OAFP), but few studies have investigated the long-term variation in the clinical picture of this population. Investigating characteristics associated with PFP and with the ability to predict changes in the clinical symptomatology and muscle torque of the lower limbs in the long term can contribute to understanding the natural course of PFP. Therefore, the general objective of this dissertation was to investigate the relationship (study I) and the long-term predictive capacity (study II) that the performance in clinical tests of objective function presents on the clinical symptomatologic and torque characteristics of the knee. Baseline and follow-up assessments were collected. Estimates were performed over two days, and anthropometric data, self-reported measurements, objective measurements, and muscle torque data from knee flexors and extensors were collected. Pearson transfer analyses and Generalized Estimating Equations (GEE) were used to obtain the results. The first study's results provoked an association between the torque and flexibility of the knee flexors and the current pain level in women and men with PFP. The results also provoked an association of knee flexor torque and DTT with the single leg bridge test (SLBT) performance in women and men with PFP. In the second study of this dissertation, it was identified that performance in the Single leg hop test (SLHT) Forward step down test (FSDT), initially, presents the ability to predict changes over a period of 15 months on the level of knee pain, torque maximum of the knee flexor and extensor muscles of individuals with PFP. In general, the findings of this dissertation show that the use of clinical tests of objective function, such as the SLBT, can be a viable, low-cost, and monitored option for the evaluation of clinical characteristics and knee muscle torque for individuals with PFP. In addition, using the SLHT and FSDT clinical tests for patient assessment seems to contribute to a better understanding of the natural course of the clinical picture of pain and torque of the knee flexors and extensors of individuals with PFP.
Individuals with patellofemoral pain (PFD) have worse functional capacity, physical activity level, and quality of life, and may also present changes in knee muscle torque, which is a measure associated with muscle strength. Because it presents persistent symptoms, studies speculate that PFP is a precursor of Patellofemoral Osteoarthritis (OAFP), but few studies have investigated the long-term variation in the clinical picture of this population. Investigating characteristics associated with PFP and with the ability to predict changes in the clinical symptomatology and muscle torque of the lower limbs in the long term can contribute to understanding the natural course of PFP. Therefore, the general objective of this dissertation was to investigate the relationship (study I) and the long-term predictive capacity (study II) that the performance in clinical tests of objective function presents on the clinical symptomatologic and torque characteristics of the knee. Baseline and follow-up assessments were collected. Estimates were performed over two days, and anthropometric data, self-reported measurements, objective measurements, and muscle torque data from knee flexors and extensors were collected. Pearson transfer analyses and Generalized Estimating Equations (GEE) were used to obtain the results. The first study's results provoked an association between the torque and flexibility of the knee flexors and the current pain level in women and men with PFP. The results also provoked an association of knee flexor torque and DTT with the single leg bridge test (SLBT) performance in women and men with PFP. In the second study of this dissertation, it was identified that performance in the Single leg hop test (SLHT) Forward step down test (FSDT), initially, presents the ability to predict changes over a period of 15 months on the level of knee pain, torque maximum of the knee flexor and extensor muscles of individuals with PFP. In general, the findings of this dissertation show that the use of clinical tests of objective function, such as the SLBT, can be a viable, low-cost, and monitored option for the evaluation of clinical characteristics and knee muscle torque for individuals with PFP. In addition, using the SLHT and FSDT clinical tests for patient assessment seems to contribute to a better understanding of the natural course of the clinical picture of pain and torque of the knee flexors and extensors of individuals with PFP.
Descrição
Palavras-chave
Dor femoropatelar, Avaliação, Função objetiva, Desempenho, Patellofemoral pain, Assessment, Objective function, Performance