O papel de fatores estruturais e neurofisiológicos na produção do momento extensor do joelho em mulheres com dor femoropatelar
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Data
2020-02-10
Autores
Waiteman, Marina Cabral [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A dor femoropatelar (DFP) é uma das desordens de joelho mais comumente reportada na população geral e populações específicas (atletas, adolescentes e militares), sendo a população feminina mais afetada. Por anos, pesquisadores têm investigado mecanismos que possam explicar o desenvolvimento e a persistência da DFP, como a função muscular do quadríceps femoral. Especificamente, alterações na produção do momento extensor do joelho (MEJ) têm sido reportadas, embora ainda com limitada investigação, e definidas como importantes alterações que necessitam de análises mais aprofundadas no contexto da DFP. Sugere-se que uma melhor compreensão dos mecanismos envolvidos com essas alterações possa fornecer novas informações a respeito do desenvolvimento da DFP e também novas abordagens clínicas a serem investigadas para auxiliar no prognóstico desses pacientes. É proposto que as alterações no MEJ possam estar inter-relacionadas com alterações estruturais e neurofisiológicas recentemente investigadas. Assim, o principal objetivo desse trabalho foi investigar o papel da presença da crepitação do joelho e de alterações no reflexo H na produção do MEJ em mulheres com DFP baseado em dois importantes estudos que fundamentaram essa dissertação. Resultados controversos ao que tem sido teorizado pela literatura foram encontrados, entretanto, estas ainda são investigações primárias e cautelas a respeito de quaisquer conclusões devem ser tomadas. Investigações futuras são importantes para maior compreensão das alterações do MEJ na DFP.
Patellofemoral pain (PFP) is one of the most commonly reported knee disorder in general population and also in specific populations (athletes, adolescents and military), being women the most affected population. For years, researchers have been investigated several mechanisms in an attempt to understand the development and persistence of PFP, such quadriceps muscular function. More specifically, alterations on knee extensor moment (KEM) production have been reported, although poor explored so far, and defined as important to be more deeply explored in PFP context. It is suggested that a better comprehension about mechanisms involved with KEM alterations can provide novel information about PFP development and also novel insights for clinical approaches to be investigated in order to help in PFP prognosis. Interestingly, it has been proposed that KEM alterations can be inter-related to structural and neurophysiological factors, which were recently explored in PFP. However, these inter-relationships have not been investigated. The mainly aim of this work was to investigate the role of knee crepitus presence and H reflex alterations in KEM in women with PFP based in two important studies that substantiated this mainly work. Controversial findings related to what have been proposed in theory by the literature were found. However these are only primary investigations and caution with any conclusion should be taken. Future investigations are important for more comprehension about KEM alterations in PFP.
Patellofemoral pain (PFP) is one of the most commonly reported knee disorder in general population and also in specific populations (athletes, adolescents and military), being women the most affected population. For years, researchers have been investigated several mechanisms in an attempt to understand the development and persistence of PFP, such quadriceps muscular function. More specifically, alterations on knee extensor moment (KEM) production have been reported, although poor explored so far, and defined as important to be more deeply explored in PFP context. It is suggested that a better comprehension about mechanisms involved with KEM alterations can provide novel information about PFP development and also novel insights for clinical approaches to be investigated in order to help in PFP prognosis. Interestingly, it has been proposed that KEM alterations can be inter-related to structural and neurophysiological factors, which were recently explored in PFP. However, these inter-relationships have not been investigated. The mainly aim of this work was to investigate the role of knee crepitus presence and H reflex alterations in KEM in women with PFP based in two important studies that substantiated this mainly work. Controversial findings related to what have been proposed in theory by the literature were found. However these are only primary investigations and caution with any conclusion should be taken. Future investigations are important for more comprehension about KEM alterations in PFP.
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Palavras-chave
Dor femoropatelar, Momento extensor do joelho, Reflexo H, Crepitação de joelho, Patellofemoral pain, Knee extensor moment, H-reflex, Knee crepitus