Relação dos aspectos clínicos e termográficos dos pontos gatilhos miofasciais do membro inferior
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Data
2023-06-19
Autores
Guimarães, Nathalie Zambaldi
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A baixa amplitude de movimento do tornozelo (ADM), especialmente da dorsiflexão, podem gerar padrões lesivos aos membros inferiores. Uma das causas da baixa mobilidade desta articulação pode estar relacionada a falta de flexibilidade do músculo gastrocnêmio, que acometido por pontos gatilhos miofasciais, pode produzir dor local e referida, bem como amplitude de movimento (ADM) restrita e diminuição da função e estabilidade da articulação do tornozelo. A termografia infravermelha (TRI) tem sido utilizada para a detecção precoce de lesões, possibilitando medidas de prevenção para a prática clínica. Objetivo: Investigar a relação da temperatura da região do músculo gastrocnênio com a mobilidade do tornozelo, os achados da palpação manual e limiar de dor (LDP) por pressão em atletas recreativos. Método: Participaram 58 indivíduos saudáveis ativos praticantes de futebol e musculação, com a presença de Ponto Gatilho (PG) latente na musculatura da região do gastrocnênio, com idades entre 18 a 37± 7,95 (anos) anos, de ambos os sexos. A avaliação inicial consistiu da captura de imagens na região do gastrocnêmio por meio de termografia infravermelha, seguida de uma avaliação por meio de palpação para identificação de pontos gatilhos. Para obter o limiar de dor por pressão (LDP) foi utilizado um dinamômetro de pressão e para avaliação da amplitude de movimento de dorsiflexão em cadeia fechada foi realizado o Lunge Test. Para a análise dos dados, com o objetivo de quantificar a associação entre as temperaturas obtidas e os valores de mobilidade e de algometria, foram utilizados o teste de correlação de Person, enquanto que, para verificar se existia diferença de temperatura entre o ponto gatilho e a temperatura geral do gastrocnêmio foi utilizado o ANOVA para medidas repetidas. Resultados: Os resultados demonstraram haver uma correlação significativa (p<0.05) entre os valores de temperatura e o desempenho no Lunge Test relacionado a distância (cm), porém essa correlação foi fraca, tanto quando se observa a temperatura geral do músculo quanto a temperatura do PG avaliado. Ainda foi possível observar que, após a palpação do ponto-gatilho, tanto para localização quanto para registro do LDP sob o ponto, houve uma diminuição nos valores máximos de temperatura no ponto selecionado, sem modificação das médias térmicas quando comparada a temperatura geral do músculo. Conclusão: Foi possível observar que maiores temperaturas estavam relacionadas com menor mobilidade do tornozelo.
Introduction: Low ankle range of motion (ROM), especially dorsiflexion, can generate harmful patterns to the lower limbs. One of the causes of the low mobility of this joint may be related to the lack of flexibility of the gastrocnemius muscle, which, when affected by myofascial trigger points, can produce local and referred pain, as well as restricted range of motion (ROM) and decreased joint function and stability. from the ankle. Infrared thermography (IRT) has been used for the early detection of lesions, enabling preventive measures for clinical practice. Objective: To investigate the relationship between temperature in the gastrocnemius muscle region and ankle mobility, manual palpation findings and pressure pain threshold (PPT) in recreational athletes. Method: Participants were 58 active healthy individuals who practice soccer and bodybuilding, with the presence of a latent Trigger Point (TP) in the musculature of the gastrocnemius region, aged between 18 and 37 ± 7.95 (years) years, of both sexes. The initial assessment consisted of capturing images in the gastrocnemius region using infrared thermography, followed by an assessment using palpation to identify trigger points. To obtain the pressure pain threshold (PPT), a pressure dynamometer was used, and the Lunge Test was performed to assess the dorsiflexion range of motion in closed chain. For data analysis, with the objective of quantifying the association between the temperatures obtained and the mobility and algometry values, the Person correlation test was used, while, to verify whether there was a temperature difference between the trigger point and the general temperature of the gastrocnemius ANOVA was used for repeated measures. Results: The results demonstrated a significant correlation (p<0.05) between the temperature values and the performance in the Lunge Test related to the distance (cm), however this correlation was weak, both when observing the general temperature of the muscle and the temperature of the evaluated PG. It was also possible to observe that, after palpation of the trigger point, both for location and for recording the PPT under the point, there was a decrease in the maximum temperature values at the selected point, without modification of the thermal averages when compared to the general temperature of the muscle. Conclusion: It was possible to observe that higher temperatures were related to lower ankle mobility.
Introduction: Low ankle range of motion (ROM), especially dorsiflexion, can generate harmful patterns to the lower limbs. One of the causes of the low mobility of this joint may be related to the lack of flexibility of the gastrocnemius muscle, which, when affected by myofascial trigger points, can produce local and referred pain, as well as restricted range of motion (ROM) and decreased joint function and stability. from the ankle. Infrared thermography (IRT) has been used for the early detection of lesions, enabling preventive measures for clinical practice. Objective: To investigate the relationship between temperature in the gastrocnemius muscle region and ankle mobility, manual palpation findings and pressure pain threshold (PPT) in recreational athletes. Method: Participants were 58 active healthy individuals who practice soccer and bodybuilding, with the presence of a latent Trigger Point (TP) in the musculature of the gastrocnemius region, aged between 18 and 37 ± 7.95 (years) years, of both sexes. The initial assessment consisted of capturing images in the gastrocnemius region using infrared thermography, followed by an assessment using palpation to identify trigger points. To obtain the pressure pain threshold (PPT), a pressure dynamometer was used, and the Lunge Test was performed to assess the dorsiflexion range of motion in closed chain. For data analysis, with the objective of quantifying the association between the temperatures obtained and the mobility and algometry values, the Person correlation test was used, while, to verify whether there was a temperature difference between the trigger point and the general temperature of the gastrocnemius ANOVA was used for repeated measures. Results: The results demonstrated a significant correlation (p<0.05) between the temperature values and the performance in the Lunge Test related to the distance (cm), however this correlation was weak, both when observing the general temperature of the muscle and the temperature of the evaluated PG. It was also possible to observe that, after palpation of the trigger point, both for location and for recording the PPT under the point, there was a decrease in the maximum temperature values at the selected point, without modification of the thermal averages when compared to the general temperature of the muscle. Conclusion: It was possible to observe that higher temperatures were related to lower ankle mobility.
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Palavras-chave
Ponto gatilho, Síndrome da dor miofascial, Ponto gatilho latente, Amplitude de movimento, Tornozelo, Trigger point, Latent trigger point, Myofascial pain syndrome, Range of motion, Ankle, Gastrocnemius, Thermography, Athletes