Confiabilidade de um teste de reprodução de movimento assistido por ponteira-laser em atletas de natação
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Data
2021-03-10
Autores
Lima, Heloisa Paes de
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Universidade Estadual Paulista (Unesp)
Resumo
A análise do senso de posição articular (SPA), apresenta na literatura diversos métodos e testes. No entanto, há divergências nos protocolos e metodologias, e nos dados sobre o teste em diversas populações, além da escassez de estudos de confiabilidade do teste de reprodução do movimento assistido por ponteira-laser (TRMPL). Por isso, a avaliação confiável deste teste representa uma lacuna científica. Portanto, determinar essas medidas contribuem para a aplicabilidade deste teste. Objetivos: i) Apresentar e analisar a confiabilidade intra-avaliador e inter-avaliadores do TRMPL do ombro em atletas de natação; ii) Descrever o perfil das medidas do TRMPL segundo as características da amostra em subgrupos (sexo, categoria por faixa etária, tempo de treinamento e especialidade de nado); iii) Apresentar os valores esperados para o TRMPL do ombro para atletas jovens de natação; iv) Correlacionar a dor relatada no ombro dominante pela Escala Visual Numérica com o desempenho em todas as angulações (55°, 90° e 125°) TRMPL. Métodos: Quarenta e oito atletas jovens de natação de ambos os sexos, foram submetidos à 3 etapas para confiabilidade o TRMPL, teste em que é realizado a reprodução de movimentos do ombro no plano de flexão, com medidas angulares pré-determinados (55º, 90º e 125º). Na etapa (1) de Familiarização o participante realizou o TRMPL, para garantir o entendimento do teste. Após cinco minutos iniciou-se a etapa (2) teste, na qual o TRMPL foi aplicado duas vezes, por avaliadores distintos, com um intervalo de cinco minutos entre as aplicações (confiabilidade inter-avaliador). Dez minutos após o término dos testes foi iniciada a etapa (3) reteste (confiabilidade intra-avaliador), seguindo os mesmos procedimentos da etapa 2, nestas duas etapas o estímulo visual foi retirado. Resultado: Os melhores resultados de confiabilidade foram apresentados na medida angular de 55º, para análise intra e inter-avaliadores. Os resultados inter-avaliadores para 55º variaram de moderada a boa (CCI = 0,74 – 0,86 [IC95% 0,55; 0,92]). Já 90° (CCI = 0,58 – 0,67 [IC95% 0,25; 0,76]) e 125° (CCI = 0,48 – 0,69 [IC95% 0,08; 0,83). Para análise intra-avaliador, os valores foram no mínimo de moderada confiabilidade, 55° (CCI = 0, 79 – 81; [IC95% 0,63; 0,89]), 90° (CCI = 0,39- 0,52; [IC95% (-0,02; 0,73)] e 125° (CCI = 0,32 – 0,50 [IC95% -0,15; 0,72]). Não foram encontradas diferenças estatisticamente significativas entre os subgrupos da amostra. Não houve correlação estatisticamente significativa entre a dor no ombro relatada e o desempenho no TRMPL. Conclusão: O TRMPL apresentou boa confiabilidade para a angulação de 55° e moderada confiabilidade para angulação de 90° e 125°, sendo uma ferramenta alternativa ao uso na prática clínica, preferencialmente a 55°. Obtivemos valores esperados para a análise do senso se posição do ombro para a utilização na prática clínica com jovens atletas nadadores.
The analysis of the sense of articular position (SPA) presents in the literature several methods and tests. However, there are divergences in the protocols and methodologies, and in the data on the test in several populations, in addition to the scarcity of reliable studies of the test of reproduction of the movement assisted by laser pointer (TRMLP).So a reliable assessment of this test represents a scientific gap. Therefore, determining these measures contribute to the applicability of this test. Objectives: i) to present and analyze the intra-rater and inter-rater reliability of the shoulder TRMLP in swimming athletes; ii) describe the profile of the TRMLP measurements according to the characteristics of the sample in subgroups (sex, category by age group, training time and swimming specialty); iii) present the expected values the TRMLP for the shoulder for young swimming athletes; iv) correlate the pain reported in the dominant shoulder by the Visual Numerical Scale with the performance in all angles (55 °, 90 ° and 125 °) TRMLP. Methods: Forty-eight young swimming athletes of both sexes, were submitted to 3 stages for reliability of the TRMLP, a test in which the shoulder movement is reproduced in the flexion plane, with predetermined angular measures (55º, 90º and 125º). In step (1) of Familiarization, the participant performed the TRMLP, to ensure the understanding of the test. After five minutes, a step (2) test was initiated, in which the TRMLP was applied twice, by different evaluators, with an interval of five minutes between applications (inter-rater reliability). Ten minutes after the end of the tests, a step (3) retest (inter-rater reliability) were initiated, following the same procedures as step 2, in this two steps the visual stimulus was removed. Results: The best results was obtained in the angular measure of 55º, for intra and inter-rater analysis. The inter-rater reliability results for 55º ranged from moderate to good (ICC = 0.74 - 0.86 [95% CI 0.55; 0.92]). 90 ° (ICC = 0.58 - 0.67 [95% CI 0.25; 0.76]) and 125 ° (ICC = 0.48 - 0.69 [95% CI 0.08; 0.83). For intrarater analysis, the values were at least moderate reliability, 55 ° (ICC = 0.79 - 81; [95% CI 0.63; 0.89]), 90 ° (ICC = 0.39-0, 52; [95% CI (-0.02; 0.73)] and 125 ° (ICC = 0.32 - 0.50 [95% CI -0.15; 0.72]). No were found statistically significant differences between the sample's subgroups. There was no statistically significant correlation between reported shoulder pain and TRMLP performance. Conclusions: The TRMLP showed good reliability for the angle of 55° and moderate reliability for angles of 90° and 125 °, being an alternative tool to use in clinical practice, preferably at 55°. We obtained expected values for the analysis of the sense of position of the shoulder for use in clinical practice with young swimming athletes.
The analysis of the sense of articular position (SPA) presents in the literature several methods and tests. However, there are divergences in the protocols and methodologies, and in the data on the test in several populations, in addition to the scarcity of reliable studies of the test of reproduction of the movement assisted by laser pointer (TRMLP).So a reliable assessment of this test represents a scientific gap. Therefore, determining these measures contribute to the applicability of this test. Objectives: i) to present and analyze the intra-rater and inter-rater reliability of the shoulder TRMLP in swimming athletes; ii) describe the profile of the TRMLP measurements according to the characteristics of the sample in subgroups (sex, category by age group, training time and swimming specialty); iii) present the expected values the TRMLP for the shoulder for young swimming athletes; iv) correlate the pain reported in the dominant shoulder by the Visual Numerical Scale with the performance in all angles (55 °, 90 ° and 125 °) TRMLP. Methods: Forty-eight young swimming athletes of both sexes, were submitted to 3 stages for reliability of the TRMLP, a test in which the shoulder movement is reproduced in the flexion plane, with predetermined angular measures (55º, 90º and 125º). In step (1) of Familiarization, the participant performed the TRMLP, to ensure the understanding of the test. After five minutes, a step (2) test was initiated, in which the TRMLP was applied twice, by different evaluators, with an interval of five minutes between applications (inter-rater reliability). Ten minutes after the end of the tests, a step (3) retest (inter-rater reliability) were initiated, following the same procedures as step 2, in this two steps the visual stimulus was removed. Results: The best results was obtained in the angular measure of 55º, for intra and inter-rater analysis. The inter-rater reliability results for 55º ranged from moderate to good (ICC = 0.74 - 0.86 [95% CI 0.55; 0.92]). 90 ° (ICC = 0.58 - 0.67 [95% CI 0.25; 0.76]) and 125 ° (ICC = 0.48 - 0.69 [95% CI 0.08; 0.83). For intrarater analysis, the values were at least moderate reliability, 55 ° (ICC = 0.79 - 81; [95% CI 0.63; 0.89]), 90 ° (ICC = 0.39-0, 52; [95% CI (-0.02; 0.73)] and 125 ° (ICC = 0.32 - 0.50 [95% CI -0.15; 0.72]). No were found statistically significant differences between the sample's subgroups. There was no statistically significant correlation between reported shoulder pain and TRMLP performance. Conclusions: The TRMLP showed good reliability for the angle of 55° and moderate reliability for angles of 90° and 125 °, being an alternative tool to use in clinical practice, preferably at 55°. We obtained expected values for the analysis of the sense of position of the shoulder for use in clinical practice with young swimming athletes.
Descrição
Palavras-chave
Confiabilidade dos resultados, Senso de posição articular, Natação, Reprodutibilidade dos testes, Propriocepção, Reliability of results, Joint of position sense, Swimming, Proprioception, Swimmers