Efeito do método Pilates nos parâmetros de desempenho neuromuscular em idosos com dor lombar
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Data
2018-03-16
Autores
Tozim, Beatriz Mendes [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A dor lombar (DL) crônica no idoso ocasiona diminuição da resistência e força dos músculos extensores de tronco, flexibilidade, modificações neuromusculares. O exercício terapêutico tem o intuito de manter e ou melhorar as condições físicas ocasionadas pela dor lombar, entre as terapêuticas existe a Protocolo cinesioterapêutico (CIN), que usa exercícios combinados e o método Pilates (MP). OBJETIVO:Analisar o MP e FC na dor, resistência muscular, flexibilidade, força, recrutamento e co-contração dos músculos do tronco de idosas com DL, e comparar com um grupo de ações educativas. MÉTODOS:Participaram do estudo 41 idosas, com DL crônica, divididas em: Grupo Pilates (GP, n=14; 66,71±3,56anos), Grupo CIN (GCIN, n=13; 68,46±4,89anos) e Grupo ações educativas (GAE, n=14; 68,00±4,66anos). A avaliação foi composta pelos testes para: dor (Escala visual analógica), resistência muscular (Teste Biering-Sorensen-TBS), flexibilidade (Sentar e Alcançar, Ângulo Poplíteo), força muscular (FM) e eletromiografia dos músculos tronco (Iliocostal-IL, Multífido- MU, Oblíquo interno- OI). Ao fim da avaliação GP e GCIN realizaram 16 sessões em 8 semanas, e GAE quatro palestras em 8 semanas. A análise estatística usou os testes Shapiro-Wilk, Análise multivariada, analise de Variância Mista e correlação de Pearson (p≤0,05). RESULTADOS: No GP diminuiu a dor (p=0,003), maior resistência muscular (p<0,001) e FM(p=0,003), redução do recrutamento de IL direito durante TBS (p=0,05), co-contração de OI/MU esquerdo (p=0,004), aumento do recrutamento da FM de IL (p<0,001) e MU (p<0,001) direito. O GCIN obteve redução da dor (p=0,014), aumento do tempo de resistência (p=0,003) e FM (p=0,002), e diminuição do recrutamento de IL direito (p=0,008) no TBS e para IL esquerdo na FM (p=0,005). O GAE aumentou co-contração de OI/MU (p=0,02) no TBS e na FM dos músculos IL direito (p=0,007) e esquerdo (p=0,002) e MU direito (p<0,001). CONCLUSÃO: O MP e a FC são importantes na diminuição da dor, aumento do tempo de resistência muscular, FM e redução do recrutamento do IL no TBS de idosos com DL, no teste de FM o IL aumentou o recrutamento. A co-contração diminuiu com o Pilates e aumentou no GAE.
Chronic low back pain (LBP) in the length of the endurance and the strength of the extensor muscles of the trunk, flexibility, neuromuscular modifications. Therapeutic exercise is intended to maintain and improve as the possibilities are caused by LBP, among which there is a kinesiotherapeutic exercise (KT), which uses combined exercise, and Pilates Method (PM). OBJECTIVE: To analyze PM and KT in pain, muscular endurance, flexibility, strength, recruitment and co-contraction of the trunk muscles of elderly women with LBP, and compare with a group educational actions. METHODS:41 elderly women with chronic LBP were divided into: Pilates Group (PG, n = 14, 66.71 ± 3.56 years), KT Group (KTG, n = 13, 68.46 ± 4.89 years) and Group educational actions (EAG, n = 14; 68,00 ± 4,66 years). The tests was evaluated for: pain (Visual Scale Analogy), muscle endurance (Biering-Sorensen test-BST), flexibility (sitting and reaching, popliteal angle), muscle strength (MS) and electromyography of the trunk muscles ( Iliocostal-IL,Multifido- MU, Internal Oblique - OI). The PG and KTG evaluation were performed 8 weeks with16 session, and EAG 8 weeks with 4 lesion. A statistical analysis used the Shapiro-Wilk tests, Multivariate Analysis, Analysis of Variance and Pearson's Key (p≤0.05). RESULTS:PG decreased pain (p = 0.003), higher muscle endurance (p <0.001) and MS (p = 0.003), reduction of right IL recruitment during BST (p = 0.05), IO/MU co-contraction (p = 0.004), increased recruitment of IL FM (p <0.001) and right MU (p <0.001). KTG achieved a reduction in pain (p = 0.014), increased endurance (p = 0.003) and MS (p = 0.002), and decreased recruitment of right IL (p = 0.008) in BST and IL (p = 0.005). EAG increased the co-contraction of OI/MU (p = 0.02) in BST, right (p = 0.007) and left (p = 0.002) IL and right MU (p <0.001) in MS. CONCLUSION: PM and KT are important in reduction pain, increasing muscle strength and endurance, and reduction IL activation in BST, increase MU and IL activation in MS. Cocontraction decreased with PM and increased in EA.
Chronic low back pain (LBP) in the length of the endurance and the strength of the extensor muscles of the trunk, flexibility, neuromuscular modifications. Therapeutic exercise is intended to maintain and improve as the possibilities are caused by LBP, among which there is a kinesiotherapeutic exercise (KT), which uses combined exercise, and Pilates Method (PM). OBJECTIVE: To analyze PM and KT in pain, muscular endurance, flexibility, strength, recruitment and co-contraction of the trunk muscles of elderly women with LBP, and compare with a group educational actions. METHODS:41 elderly women with chronic LBP were divided into: Pilates Group (PG, n = 14, 66.71 ± 3.56 years), KT Group (KTG, n = 13, 68.46 ± 4.89 years) and Group educational actions (EAG, n = 14; 68,00 ± 4,66 years). The tests was evaluated for: pain (Visual Scale Analogy), muscle endurance (Biering-Sorensen test-BST), flexibility (sitting and reaching, popliteal angle), muscle strength (MS) and electromyography of the trunk muscles ( Iliocostal-IL,Multifido- MU, Internal Oblique - OI). The PG and KTG evaluation were performed 8 weeks with16 session, and EAG 8 weeks with 4 lesion. A statistical analysis used the Shapiro-Wilk tests, Multivariate Analysis, Analysis of Variance and Pearson's Key (p≤0.05). RESULTS:PG decreased pain (p = 0.003), higher muscle endurance (p <0.001) and MS (p = 0.003), reduction of right IL recruitment during BST (p = 0.05), IO/MU co-contraction (p = 0.004), increased recruitment of IL FM (p <0.001) and right MU (p <0.001). KTG achieved a reduction in pain (p = 0.014), increased endurance (p = 0.003) and MS (p = 0.002), and decreased recruitment of right IL (p = 0.008) in BST and IL (p = 0.005). EAG increased the co-contraction of OI/MU (p = 0.02) in BST, right (p = 0.007) and left (p = 0.002) IL and right MU (p <0.001) in MS. CONCLUSION: PM and KT are important in reduction pain, increasing muscle strength and endurance, and reduction IL activation in BST, increase MU and IL activation in MS. Cocontraction decreased with PM and increased in EA.
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Palavras-chave
Fisioterapia, Técnicas de exercício e de movimento, Envelhecimento, Amplitude de movimento articular, Physiotherapy, Exercise and movement techniques, Aging, Range of joint motion