Confiabilidade da miotonometria em atletas de natação
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Data
2021-03-12
Autores
Espinoza, Rafael Moreira de Castro Pereira Perez
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A miotonometria, é uma avaliação capaz de medir quantitativamente o tônus, rigidez, elasticidade, tempo de relaxamento do estresse mecânico e creep. Sua confiabilidade tem sido testada em várias populações mostrando variações nos resultados, além dos valores da miotonometria diferirem de acordo com a especificidade da amostra e das propriedades biomecânicas de cada músculo. Objetivo: Avaliar a confiabilidade intra- e inter-avaliadores da miotonometria em atletas de natação e caracterizar o perfil do estado de tensão e das propriedades biomecânicas e viscoelásticas dos músculos nesta amostra associando por subgrupos como sexo, categoria, tempo de prática e estilo do nado. Métodos: Estudo teste e reteste composto por 48 jovens atletas de natação do sexo masculino e feminino, com idade entre 12 e 20 anos. A miotonometria foi realizada de forma randomizada por dois avaliadores e os parâmetros medidos foram: tônus, rigidez, elasticidade, tempo de relaxamento do estresse mecânico e creep. Na etapa teste, o primeiro avaliador realizou as mensurações de forma bilateral nos músculos deltoide médio, trapézio superior, peitoral maior, bíceps braquial, reto femoral, tibial anterior, tríceps braquial, multífido lombar, bíceps femoral e sóleo, o segundo avaliador realizou o mesmo processo na mesma ordem imediatamente após o primeiro. Após 15 minutos de intervalo, realizou-se o reteste seguindo a mesma ordem dos avaliadores da etapa teste. Para caracterização da amostra foi utilizada estatística descritiva por meio de tendência central e variabilidade, para todas as variáveis coletadas. A confiabilidade relativa foi testada pelo Coeficiente de Correlação Intraclasse (CCI). A confiabilidade absoluta foi verificada por meio do erro padrão da medida (EPM), valores de mínima mudança detectável (MMD) e coeficiente de variação (CV). Resultados: Os valores CCI para confiabilidade intra-avaliador de todos os músculos analisados, variaram entre moderado a excelente no tônus (CCI: 0,643- 0,934), rigidez (CCI: 0,611-0,969), elasticidade (CCI: 0,557-0,954) e baixo a excelente no tempo de relaxamento do estresse mecânico (CCI: 0,412-0,962) e creep (CCI: 0,466-0,917), apenas o músculo tibial anterior direito (tempo de relaxamento e creep) apresentaram baixa confiabilidade para o avaliador 2. Para confiabilidade inter-avaliadores, os valores variam entre moderada a excelente no tônus (CCI: 0,513-0,915), baixa a excelente na rigidez (CCI: 0,425- 0,935), tempo de relaxamento (CCI: 0,419-0,951), creep (CCI: 0,289-0,933) e baixa a boa para elasticidade (CCI: 0,386-0,868), apenas os músculos deltoide médio direito, tibial anterior direito e tríceps braquial bilateral apresentaram baixa confiabilidade. Com relação às xi características da amostra, meninos apresentaram maior tônus, rigidez e menor tempo de relaxamento e creep do que meninas na maioria dos músculos do membro superior, inferior e tronco. Conclusão: O MyotonPRO® é uma ferramenta confiável e aceitável para avaliação em jovens atletas de natação, respaldando o uso do equipamento no ambiente clínico esportivo. Recomendamos cautela ao generalizar os resultados, devido as variações de CCI em relação ao músculo e parâmetro analisado. Além disso, meninos possuem maior tônus, rigidez e menor tempo de relaxamento e creep do que meninas na maioria dos músculos analisados. Para os subgrupos categoria, estilo de nado e tempo de prática, a maioria dos músculos e parâmetros não apresentaram diferenças.
Myotonometry is an assessment capable of quantitatively measuring tone, stiffness, elasticity, mechanical stress relaxation time and creep. Its reliability has been tested in several populations showing variations in the results, in addition to the values of myotonometry differ according to the specificity of the sample and the biomechanical properties of each muscle. Aims: To evaluate the intra- and inter-rater reliability of myotonometry in swimming athletes and to characterize the profile of the state of tension and biomechanical and viscoelastic properties of the muscles in this sample, associating by subgroups such sex, category, practice time and swimming stroke. Methods: Test and retest study composed of 48 young male and female swimming athletes, aged between 12 and 20 years. Myotonometry was performed randomly by two evaluators and the parameters measured were: tone, stiffness, elasticity, mechanical stress relaxation time and creep. In the test stage, the first evaluator performed the measurements bilaterally in the middle deltoid, upper trapezius, pectoralis major, biceps brachii, rectus femoris, anterior tibialis, triceps brachii, lumbar multifidus, biceps femoris and soleus muscles, the second evaluator performed the same process in the same order immediately after the first one. After 15 minutes interval, the retest was carried out following the same order of evaluators in the test. To characterization of sample were used descriptive statistic through central tendency and variability for all variables collected. Relative reliability was tested by the Intraclass Correlation Coefficient (ICC). Absolute reliability was verified by means of standard error of measurement (SEM), values of minimal detectable change (MDC) and coefficient of variation (CV). Results: The ICC values for intra-rater reliability for all muscles analyzed, ranged from moderate to excellent in tone (ICC: 0.643-0.934), stiffness (ICC: 0.611-0.969), elasticity (ICC: 0.557- 0.954) and low to excellent in the mechanical stress relaxation time (ICC: 0.412-0.962) and creep (ICC: 0.466- 0.917), only the right anterior tibial muscle (time of relaxation and creep) showed low reliability for rater 2. For inter-rater reliability, values range from moderate to excellent in tone (ICC: 0.513-0.915), low to excellent in stiffness (ICC: 0.425-0.935), mechanical stress relaxation time (ICC: 0.419-0.951), creep (ICC: 0.289-0.933) and low to good for elasticity (ICC: 0.386-0.868), only the right middle deltoid, right anterior tibialis and bilateral brachial triceps muscles showed low reliability. Regarding the characteristics of the sample, boys have greater tone, stiffness and shorter time of relaxation and creep than girls in most of the muscles of the upper, lower xiii and trunk. Conclusion: MyotonPRO® is a reliable and acceptable tool for evaluation in young swimming athletes, supporting the use of the equipment in the clinical sports environment. We recommend caution when generalizing the results, due to the variations of ICC in relation to the muscle and parameter analyzed. Moreover, boys have greater tone, stiffness and shorter time of relaxation and creep than girls in most of the analyzed muscles. For the subgroups category, swimming stroke and practice time, most muscles and parameters did not differ.
Myotonometry is an assessment capable of quantitatively measuring tone, stiffness, elasticity, mechanical stress relaxation time and creep. Its reliability has been tested in several populations showing variations in the results, in addition to the values of myotonometry differ according to the specificity of the sample and the biomechanical properties of each muscle. Aims: To evaluate the intra- and inter-rater reliability of myotonometry in swimming athletes and to characterize the profile of the state of tension and biomechanical and viscoelastic properties of the muscles in this sample, associating by subgroups such sex, category, practice time and swimming stroke. Methods: Test and retest study composed of 48 young male and female swimming athletes, aged between 12 and 20 years. Myotonometry was performed randomly by two evaluators and the parameters measured were: tone, stiffness, elasticity, mechanical stress relaxation time and creep. In the test stage, the first evaluator performed the measurements bilaterally in the middle deltoid, upper trapezius, pectoralis major, biceps brachii, rectus femoris, anterior tibialis, triceps brachii, lumbar multifidus, biceps femoris and soleus muscles, the second evaluator performed the same process in the same order immediately after the first one. After 15 minutes interval, the retest was carried out following the same order of evaluators in the test. To characterization of sample were used descriptive statistic through central tendency and variability for all variables collected. Relative reliability was tested by the Intraclass Correlation Coefficient (ICC). Absolute reliability was verified by means of standard error of measurement (SEM), values of minimal detectable change (MDC) and coefficient of variation (CV). Results: The ICC values for intra-rater reliability for all muscles analyzed, ranged from moderate to excellent in tone (ICC: 0.643-0.934), stiffness (ICC: 0.611-0.969), elasticity (ICC: 0.557- 0.954) and low to excellent in the mechanical stress relaxation time (ICC: 0.412-0.962) and creep (ICC: 0.466- 0.917), only the right anterior tibial muscle (time of relaxation and creep) showed low reliability for rater 2. For inter-rater reliability, values range from moderate to excellent in tone (ICC: 0.513-0.915), low to excellent in stiffness (ICC: 0.425-0.935), mechanical stress relaxation time (ICC: 0.419-0.951), creep (ICC: 0.289-0.933) and low to good for elasticity (ICC: 0.386-0.868), only the right middle deltoid, right anterior tibialis and bilateral brachial triceps muscles showed low reliability. Regarding the characteristics of the sample, boys have greater tone, stiffness and shorter time of relaxation and creep than girls in most of the muscles of the upper, lower xiii and trunk. Conclusion: MyotonPRO® is a reliable and acceptable tool for evaluation in young swimming athletes, supporting the use of the equipment in the clinical sports environment. We recommend caution when generalizing the results, due to the variations of ICC in relation to the muscle and parameter analyzed. Moreover, boys have greater tone, stiffness and shorter time of relaxation and creep than girls in most of the analyzed muscles. For the subgroups category, swimming stroke and practice time, most muscles and parameters did not differ.
Descrição
Palavras-chave
Tônus muscular, Elasticidade, Rigidez, Natação, Confiabilidade, Reprodutibilidade dos testes, Atletas, Sistema musculoesquelético, Muscle tone, Elasticity, Stiffness, Swimming, Reliability