ABSTRACT
Introdução: Alterações em estrutura e função decorrentes de espondilólise/espondilolistese podem incluir dor lombar e/ou irradiada para membros inferiores com limitações de atividade. Objetivo: avaliar a eficácia de programas de reabilitação baseados em movimento para redução da dor e melhora de atividade em indivíduos com diagnóstico de espondilólise/espondilolistese. Método: Revisão sistemática de ensaios clínicos aleatorizados, cuja intervenção foi programa de reabilitação baseado em exercício. As medidas de desfecho foram dor e atividade. Resultados: Cinco estudos foram incluídos. Dois estudos investigaram a eficácia da intervenção experimental comparada a placebo/não-intervenção, encontrando resultados inconclusivos. Três estudos investigaram a eficácia da intervenção experimental em comparação ao tratamento cirúrgico, reportando superioridade do tratamento cirúrgico. Conclusão: Os resultados são inconclusivos em relação à eficácia da reabilitação baseada em movimento, e sugerem que é menos eficaz do que tratamentos cirúrgicos na redução da intensidade de dor e melhora de atividade de indivíduos com diagnóstico de espondilólise/espondilolistese.
Introduction: Body structure and function impairments due to spondylolysis/spondylolisthesis may include low back pain and/or radiating pain, leading to activity limitations. Objective: To investigate the efficacy of movement-based rehabilitation programs to reduce pain and improve activity in people with spondylolysis/spondylolisthesis. Method: Systematic review of randomised clinical trials. Experimental intervention was movement-based rehabilitation program and outcome measures were pain and activity. Result: Five trials were included. Two trials examined the efficacy of the experimental intervention compared with placebo/no-intervention, and found inconclusive results. Three trials examined the efficacy of the experimental intervention compared with a surgical treatment, and reported superiority in favour of the surgical treatments. Conclusion: The results are inconclusive regarding the efficacy of movement-based rehabilitation, and suggested that it is less effective than surgical treatments.
Subject(s)
Humans , Spondylolysis/rehabilitation , Pain Management , Spondylolysis/surgery , Randomized Controlled Trials as Topic , Outcome Assessment, Health Care , Low Back Pain , Exercise TherapyABSTRACT
BACKGROUND: The dysfunction of gluteus medius (GMed) has been implicated in other musculoskeletal disorders including low back pain and lower limb injuries. The purpose of this study was to use a protocol involving low-load eccentric exercises to observe the effects on the three subdivisions of GMed activation through surface electromyography (sEMG) and digital dynamometry. METHODS: Eleven female subjects having femoral instability participated in a 4-week protocol (three sessions per week/non-consecutive days). At each session, two low-load eccentric exercises (12% of maximal isometric voluntary contraction [MVIC]) in abduction, extension and external rotation were applied to the hip joint. The sEMG of the GMed subdivisions (anterior, mid and posterior) during a squat and MVIC were assessed. The digital dynamometry was also assessed during MVIC. Parametric paired t-test was used to compare the results before and after treatment with α = 0.05. RESULTS: The results showed an increased sEMG activity of GMed (middle and posterior portions) during isometric voluntary contraction and squat after the protocol. No difference was noted to the anterior subdivision of GMed. Another finding was the significant difference to the dynamometry results, showing improvements to generate strength to the GMed as a whole muscle in abduction. CONCLUSION: The 4-week exercise protocol was effective to increase the activation of the GMed middle and posterior subdivisions, improving also the capacity to generate strength as a whole muscle during the proposed tasks. Copyright © 2015 John Wiley & Sons, Ltd.
Subject(s)
Exercise Therapy/methods , Isometric Contraction/physiology , Joint Instability/rehabilitation , Muscle Strength/physiology , Muscle Weakness/diagnosis , Muscle Weakness/rehabilitation , Adult , Buttocks , Electromyography/methods , Female , Follow-Up Studies , Hip Joint/physiopathology , Humans , Muscle, Skeletal/physiopathology , Risk Assessment , Sampling Studies , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: To evaluate the behaviour of the upper rectus abdominis, lower rectus abdominis and transverse abdominis/internal oblique (TrA/IO) by using surface electromyography during trunk flexion with and without the Pilates breathing technique. METHODS: Nineteen female subjects (without experience of the Pilates method) were recruited. The muscles were evaluated while trunk flexion was performed by using the Pilates breathing technique (POW) and Step Barrel device, followed by another contraction without the technique (NORM). Normality was accepted, and the paired t-test was used to determine data differences (p < 0.05). RESULTS: Significant differences were noted in the amplitude level of activation between TrA/IO-POW and TrA/IO-NORM. The activation amplitude level of TrA/IO-POW significantly increased compared with all the other muscles under the NORM condition. CONCLUSION: The breathing technique of the Pilates method associated with trunk flexion increases TrA/IO electrical activity.
