Efeito da dor sobre a capacidade muscular e correlação de variáveis baropodométricas em mulheres com dor patelofemoral
Carregando...
Data
2023-03-03
Autores
Andriani, Mariana Siqueira
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Estudos mostraram que sujeitos com dor patelofemoral (DPF) apresentam fraqueza dos músculos do joelho e quadril e apontaram que o torque muscular pode ser influenciado pela intensidade da dor. Acreditamos que além do torque, o trabalho e a potência muscular também possam sofrer essa influência, no entanto, pouco se sabe sobre isso. Ademais, podem ser encontradas variáveis baropodométricas e estabilométricas alteradas nesses indivíduos. Estudos que correlacionam essas variáveis à intensidade da dor e ao torque apresentam limitações e são escassos. Nesse contexto, o presente estudo possui como objetivos verificar a influência da intensidade da dor sobre o desempenho muscular (torque, trabalho e potência) dos extensores de joelho, abdutores e extensores de quadril em mulheres com DPF e avaliar as variáveis baropodométricas e estabilométricas durante o agachamento unipodal e correlacioná-las ao nível de dor, capacidade funcional e torques musculares, bem como, correlacionar os torques a dor e função. Foram avaliadas 22 mulheres com DPF e 21 assintomáticas. A coleta de dados foi realizada em dois encontros. No primeiro dia foram registrados os dados antropométricos e mensurada a intensidade de dor. Posteriormente, o torque, trabalho e potência muscular concêntricos do joelho e quadril foram mensurados através do dinamômetro isocinético. No segundo dia de coleta, foi realizado o protocolo de sobrecarga para exacerbação da dor (agachamento unipodal) executado com a voluntária sobre o baropodômetro e registro da Escala Visual Analógica (EVA) durante o teste, seguido da avaliação do torque, trabalho e potência muscular novamente. As voluntárias com DPF apresentaram aumento da EVA após protocolo de sobrecarga (p=,000; np2=,367); menor torque (p=,000; np2= ,292), trabalho (p= ,020; np2= ,125) e potência (p=,033; np2=,106) dos extensores de joelho com relação ao grupo controle; menor torque (p= ,029; np2= ,110) dos extensores de quadril. Houve efeito significativo da interação entre grupo e momento sobre o trabalho (p= ,032, ηp2= ,108) e a potência (p= ,02, ηp2= ,125) para as medidas dos extensores de quadril. A análise de correlação mostrou que o aumento da EVA durante o agachamento unipodal está correlacionado a diminuição do torque dos extensores de joelho (p=,005; r= -,572) e quadril (p=, 031; r= -,461), ao aumento da pressão anteromedial (p=,022; r=,486), da velocidade de oscilação anteroposterior (p=,022; r=,487) e deslocamento total do centro de pressão (p=,033; r=,456) e a diminuição da pressão póstero medial (p=,024; r=-,479). Houve também correlação entre a redução do torque extensor de joelho com o aumento da velocidade de oscilação anteroposterior (p=,002; r=-,621) e do deslocamento total do centro de pressão (p=,022; r=-,486), bem como a correlação da redução do torque extensor de quadril com o aumento das mesmas variáveis (p=,003; r=-,597 e p=,030; r=-,463 respectivamente). No GC, o aumento do torque dos extensores de joelho teve correlação com a redução da pressão anterior (p=,029; r=-,475) e aumento da pressão posterior (p=,029; r=,475). Conclui-se que mulheres com DPF, após um protocolo de sobrecarga para exacerbação da dor, não apresentaram uma redução do desempenho muscular do joelho e quadril quando comparadas a mulheres assintomáticas, no entanto, na análise de correlação, a intensidade de dor teve relação com o torque muscular extensor do joelho e quadril. Os resultados também indicam que quanto maior o torque muscular, menor será a instabilidade postural anteroposterior, maior será a pressão plantar posterior e menor será a intensidade da dor.
Studies have shown that subjects with patellofemoral pain (PFP) have weakness in the knee and hip muscles and have indicated that muscle torque can be influenced by pain intensity. We believe that in addition to torque, work and muscle power can also be influenced by this, however, little is known about this. Furthermore, altered baropodometric and stabilometric variables can be found in these individuals. Studies that correlate these variables with pain intensity and torque have limitations and are scarce. In this context, the present study aims to verify the influence of pain intensity on muscle performance (torque, work and power) of knee extensors, hip abductors and extensors in women with PFP and to evaluate baropodometric and stabilometric variables during exercise. single leg squat and correlate them to the level of pain, functional capacity and muscle torques, as well as correlate the torques to pain and function. Twenty-two women with PFP and 21 asymptomatic women were evaluated. Data collection was carried out in two meetings. On the first day, anthropometric data were recorded and pain intensity was measured. Subsequently, the torque, work and concentric muscle power of the knee and hip were measured using an isokinetic dynamometer. On the second day of collection, the overload protocol for pain exacerbation (single-legged squat) was carried out with the volunteer on the baropodometer and the Visual Analog Scale (VAS) was recorded during the test, followed by the evaluation of torque, work and muscle power again. Volunteers with PFP showed an increase in the VAS after the overload protocol (p=.000; np2=.367); lower torque (p=.000; np2=.292), work (p=.020; np2=.125) and power (p=.033; np2=.106) of the knee extensors in relation to the control group; lower torque (p= .029; np2= .110) of the hip extensors. There was a significant effect of the interaction between group and moment on work (p= .032, ηp2= .108) and power (p= .02, ηp2= .125) for hip extensor measurements. The correlation analysis showed that the increase in the VAS during the single leg squat is correlated with the decrease in the torque of the knee extensors (p=.005; r= -.572) and hip (p=.031; r= -.461) , increased anteromedial pressure (p=.022; r=.486), anteroposterior oscillation velocity (p=.022; r=.487) and total displacement of the center of pressure (p=.033; r=. 456) and decreased posteromedial pressure (p=.024; r=-.479). There was also a correlation between the reduction of the knee extensor torque with the increase in the anteroposterior oscillation velocity (p=.002; r=-.621) and the total displacement of the center of pressure (p=.022; r=-.486 ), as well as the correlation between the reduction in hip extensor torque and the increase in the same variables (p=.003; r=-.597 and p=.030; r=-.463, respectively). In the CG, the increase in knee extensor torque was correlated with a reduction in anterior pressure (p=.029; r=-.475) and an increase in posterior pressure (p=.029; r=.475). It is concluded that women with PFP, after an overload protocol for pain exacerbation, did not present a reduction in knee and hip muscle performance when compared to asymptomatic women, however, in the correlation analysis, pain intensity was related to knee and hip extensor muscle torque. The results also indicate that the greater the muscle torque, the lower the anteroposterior postural instability, the greater the posterior plantar pressure and the lower the pain intensity.
Studies have shown that subjects with patellofemoral pain (PFP) have weakness in the knee and hip muscles and have indicated that muscle torque can be influenced by pain intensity. We believe that in addition to torque, work and muscle power can also be influenced by this, however, little is known about this. Furthermore, altered baropodometric and stabilometric variables can be found in these individuals. Studies that correlate these variables with pain intensity and torque have limitations and are scarce. In this context, the present study aims to verify the influence of pain intensity on muscle performance (torque, work and power) of knee extensors, hip abductors and extensors in women with PFP and to evaluate baropodometric and stabilometric variables during exercise. single leg squat and correlate them to the level of pain, functional capacity and muscle torques, as well as correlate the torques to pain and function. Twenty-two women with PFP and 21 asymptomatic women were evaluated. Data collection was carried out in two meetings. On the first day, anthropometric data were recorded and pain intensity was measured. Subsequently, the torque, work and concentric muscle power of the knee and hip were measured using an isokinetic dynamometer. On the second day of collection, the overload protocol for pain exacerbation (single-legged squat) was carried out with the volunteer on the baropodometer and the Visual Analog Scale (VAS) was recorded during the test, followed by the evaluation of torque, work and muscle power again. Volunteers with PFP showed an increase in the VAS after the overload protocol (p=.000; np2=.367); lower torque (p=.000; np2=.292), work (p=.020; np2=.125) and power (p=.033; np2=.106) of the knee extensors in relation to the control group; lower torque (p= .029; np2= .110) of the hip extensors. There was a significant effect of the interaction between group and moment on work (p= .032, ηp2= .108) and power (p= .02, ηp2= .125) for hip extensor measurements. The correlation analysis showed that the increase in the VAS during the single leg squat is correlated with the decrease in the torque of the knee extensors (p=.005; r= -.572) and hip (p=.031; r= -.461) , increased anteromedial pressure (p=.022; r=.486), anteroposterior oscillation velocity (p=.022; r=.487) and total displacement of the center of pressure (p=.033; r=. 456) and decreased posteromedial pressure (p=.024; r=-.479). There was also a correlation between the reduction of the knee extensor torque with the increase in the anteroposterior oscillation velocity (p=.002; r=-.621) and the total displacement of the center of pressure (p=.022; r=-.486 ), as well as the correlation between the reduction in hip extensor torque and the increase in the same variables (p=.003; r=-.597 and p=.030; r=-.463, respectively). In the CG, the increase in knee extensor torque was correlated with a reduction in anterior pressure (p=.029; r=-.475) and an increase in posterior pressure (p=.029; r=.475). It is concluded that women with PFP, after an overload protocol for pain exacerbation, did not present a reduction in knee and hip muscle performance when compared to asymptomatic women, however, in the correlation analysis, pain intensity was related to knee and hip extensor muscle torque. The results also indicate that the greater the muscle torque, the lower the anteroposterior postural instability, the greater the posterior plantar pressure and the lower the pain intensity.
Descrição
Palavras-chave
Dor patelofemoral, Força, Pressão, Pé, Patellofemoral pain, Force, Pressure, Foot