Confiabilidade da algometria como valor clínico em atletas de natação
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Data
2021-03-11
Autores
Ribeiro, Gabriela Carrion Caldeira
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
No cenário da natação, observa-se incidência significativa de dor, justificada pelos altos níveis de treinamento. Uma ferramenta muito utilizada e capaz de medir de forma padronizada o limiar pressórico de dor (LPD) é o algômetro. Entretanto os dados científicos disponíveis sobre a avaliação do LPD com algômetro em atletas são inconsistentes e contraditórios, dependendo dos examinadores, da população e pontos avaliados e da padronização da avaliação com o dispositivo. Objetivo: Avaliar a confiabilidade intra e inter-examinador e descrever o perfil das medidas do LPD avaliadas pelo algômetro em atletas de natação associando as características do esporte como especialidade, categoria, tempo de treinamento e sexo. Métodos: Composto por 48 jovens atletas membros de equipes de natação, de ambos os gêneros, com idade entre 12 e 20 anos. A avaliação foi realizada no mesmo dia e em 2 etapas: (1) Teste e (2) Reteste. Inicialmente os participantes foram submetidos a marcação dos músculos selecionados para avaliação (deltoide médio, trapézio superior, peitoral maior, bíceps braquial, reto femoral, tibial anterior, tríceps, multífido lombar, bíceps femoral e sóleo, bilateralmente) e responderam a ficha de informações e questionários. Em seguida, iniciou-se a etapa 1 de avaliação do LPD com algômetro de forma padronizada a qual contou com dois examinadores distintos e treinados. O intervalo entre cada examinador foi de cinco minutos com o participante em repouso. Após cinco minutos, foi dado início a etapa 2, que contou com os mesmos procedimentos da etapa anterior. Foi utilizado o pacote estatístico SPSS Statistics 23.0 para conduzir as análises. Resultados: A confiabilidade intra-examinador observada nos membros superiores e membros inferiores variaram de moderado à excelente para o examinador 1 CCI=0,56 à 0,81 (IC95% 0,33 a 0,88) e CCI=0,70 à 0,90 (IC95% 0,52 à 0,94) e de bom à excelente para o examinador 2 CCI=0,79 à 0,90 (IC95% 0,66 à 0,94) e CCI=0,86 à 0,92 (IC95% 0,76 à 0,95), respectivamente. A confiabilidade inter-examinadores para os membros superiores e inferiores na etapa 1 foi de moderado à excelente CCI=0,52 à 0,79 (IC95% 0,28 à 0,88) e CCI=0,68 à 0,90 (IC95% 0,50 à 0,94), já para etapa 2 de bom à excelente CCI=0,75 à 0,90 (IC95% 0,59 à 0,94) e CCI=0,85 à 0,91 (IC95% 0,75 à 0,95), respectivamente. Já as características analisadas não apresentaram diferenças estatisticamente significativas. Conclusão: A avaliação do LPD através do algômetro de forma padronizada em jovens atletas de natação saudáveis se mostra confiável e apoia o uso do dispositivo no ambiente clínico esportivo, entretanto recomenda-se cautela na interpretação dos resultados.
In the swimming scenario, there is a significant incidence of pain, justified by the high levels of training. A widely used tool capable of measuring the pain threshold (PPT) in a standardized way is the algometer. However, the available scientific data on the assessment of PPT using an algometer in athletes are inconsistent and contradictory, depending on the examiners, the population and points assessed and the standardization of the assessment with the device. Aim: To assess intra- and inter-examiner reliability and describe the profile of pain threshold measures assessed by the algometer in swimming athletes, associating sport characteristics such as specialty, category, training time and sex. Methods: Composed of 48 young athletes members of swimming teams, of both genders, aged between 12 and 20 years old. The evaluation was carried out on the same day and in 2 stages: (1) Test and (2) Retest. Initially, the participants underwent marking of the selected muscles for evaluation (middle deltoid, upper trapezius, pectoralis major, biceps brachii, rectus femoris, anterior tibialis, triceps, lumbar multifidus, biceps femoris and soleus, bilaterally) and answered the information sheet and questionnaires. Then, step 1 of pain threshold assessment with a standardized algometer was initiated and had two distinct and trained examiners. The interval between each examiner was five minutes with the participant at rest. After five minutes, step 2 was initiated, which had the same procedures as the previous step. The SPSS Statistics 23.0 statistical package was used to conduct the analyzes. Results: The intra-examiner reliability observed in the upper and lower limbs varied from moderate to excellent for the examiner 1 ICC = 0.56 to 0.81 (95% CI 0.33 to 0.88) and ICC = 0.70 to 0.90 (95% CI 0.52 to 0.94) and good to excellent for examiner 2 ICC = 0.79 to 0.90 (IC95% 0.66 to 0.94) and ICC = 0.86 to 0.92 (95% CI 0.76 to 0.95), respectively. Inter-examiner reliability for the upper and lower limbs in step 1 was moderate to excellent ICC = 0.52 to 0.79 (95% CI 0.28 to 0.88) and ICC = 0.68 to 0.90 (95% CI 0.50 to 0.94), for stage 2 from good to excellent ICC = 0.75 to 0.90 (95% CI 0.59 to 0.94) and ICC = 0.85 to 0.91 (95% CI 0.75 to 0.95), respectively. The analyzed characteristics did not present statistically significant differences. Conclusion: The assessment of PPT using a standardized algometer in swimming athletes is reliable and supports the use of the device in the clinical sports environment.
In the swimming scenario, there is a significant incidence of pain, justified by the high levels of training. A widely used tool capable of measuring the pain threshold (PPT) in a standardized way is the algometer. However, the available scientific data on the assessment of PPT using an algometer in athletes are inconsistent and contradictory, depending on the examiners, the population and points assessed and the standardization of the assessment with the device. Aim: To assess intra- and inter-examiner reliability and describe the profile of pain threshold measures assessed by the algometer in swimming athletes, associating sport characteristics such as specialty, category, training time and sex. Methods: Composed of 48 young athletes members of swimming teams, of both genders, aged between 12 and 20 years old. The evaluation was carried out on the same day and in 2 stages: (1) Test and (2) Retest. Initially, the participants underwent marking of the selected muscles for evaluation (middle deltoid, upper trapezius, pectoralis major, biceps brachii, rectus femoris, anterior tibialis, triceps, lumbar multifidus, biceps femoris and soleus, bilaterally) and answered the information sheet and questionnaires. Then, step 1 of pain threshold assessment with a standardized algometer was initiated and had two distinct and trained examiners. The interval between each examiner was five minutes with the participant at rest. After five minutes, step 2 was initiated, which had the same procedures as the previous step. The SPSS Statistics 23.0 statistical package was used to conduct the analyzes. Results: The intra-examiner reliability observed in the upper and lower limbs varied from moderate to excellent for the examiner 1 ICC = 0.56 to 0.81 (95% CI 0.33 to 0.88) and ICC = 0.70 to 0.90 (95% CI 0.52 to 0.94) and good to excellent for examiner 2 ICC = 0.79 to 0.90 (IC95% 0.66 to 0.94) and ICC = 0.86 to 0.92 (95% CI 0.76 to 0.95), respectively. Inter-examiner reliability for the upper and lower limbs in step 1 was moderate to excellent ICC = 0.52 to 0.79 (95% CI 0.28 to 0.88) and ICC = 0.68 to 0.90 (95% CI 0.50 to 0.94), for stage 2 from good to excellent ICC = 0.75 to 0.90 (95% CI 0.59 to 0.94) and ICC = 0.85 to 0.91 (95% CI 0.75 to 0.95), respectively. The analyzed characteristics did not present statistically significant differences. Conclusion: The assessment of PPT using a standardized algometer in swimming athletes is reliable and supports the use of the device in the clinical sports environment.
Descrição
Palavras-chave
Confiabilidade, Limiar pressórico de dor, Natação, Limiar da dor, Reliability, Pressure pain threshold, Swimming