Efeito da rotação do quadril na sindrome da dor femoropatelar / Effect of hip rotation on patellofemoral pain syndrome

A proposta deste trabalho foi investigar o efeito da rotacao do quadril na atividade eletrica dos musculos Vasto Medial Obliquo (VMO). Vasto Lateral Obliquo (VLO) e Vasto Lateral Longo (VLL) no agachamento a 45o. de flexao do joelho associado a posicao neutra, rotacao laterala 45o. e rotacao medial a 15 e 30o. de quaril. Materiais e metodos: foram avaliadas 27 mulheres, sendo 15 mulheres normais do grupo controle (21,1+-2,1 anos) e 12 portadoras de sindrome da Dor Femoropatelar (SDFP) (21,0+-2,3 anos). A atividade eletrica do musculo quadriceps foi captada opr eletrodos ativos diferenciais simples de superficie, eletromiografo de 8 canais e programa Aqdados 7.2.6. Os dados foram normalizados pela porcentagem da media do agachamento a 75o. com o quadril em posicao neutra - RMS (uV). A analise estatistica utilizada foi ANOVA two way com medidas repetidas e Turkey pos hoc (p<-0,05). Resultados: os resultados evidenciaram interacao entre grupos e musculos (p=0,00), independente da posicao do quadril (p=0,39) e nao houve interacao entre grupos e posicoes do quadril (p=0,96). Os musculos VMO e VLL do grupo SDFP apresentaram atividade eletrica significativamente maior que o VMO (p=0,00) e VLL (p=0,04) do grupo controle. Por outro lado, a atividade eletrica do musculo VLO nao apresentou diferenca significativa entre os grupos (p=0,99). Conclusao: os resultados dessa pesquisa, nas condicoes experimentais utilizadas, sugerem que a rotacao do quadril nao influenciou a atividade eletrica das porcoes do quadriceps nos dois grupos no agachamento a 45o. de flexao do joelho

Avaliação propriocepção do joelho em individuos portadores de disfunção femoropatelar / Evaluation of proprioception on the knee among individuals with patellofemoral dysfunctuion

Avaliar a propriocepcao do joelho de individuos portadores de disfuncao femoropatelar (DFP) e de individuos-controle em dinamometro isocinetico. Metodo: forma selecionados 20 sujeitos do sexo feminino, sendo 10 (22,5 +- 2,3 anos) portadores de DFP unilateral sem sintomatologia dolorosa (grupo DFP) e 10 (21,3 +- 1,7 anos) clinicamente normais (grupo N). As voluntarias, sentadas na cadeira do dinamometro isocinetico e com os olhos vendados, realizaram tres reposicionamentos ativos para tres diferentes angulos-alvo (30, 45 e 60 graus) de flexao do joelho. As variaveis estudads foram o angulo de reposicionamento ativo do joelho e os erros absoluto e relativo em relacao a cada angulo-alvo avaliado. Resultados: o teste t evidenciou que nao houve diferenca significativa na media dos reposicionamentos ativos (P30º=0,33l; P45º=0,39; e P60º=0,96) entre os grupos DFP e controle. Alem disso, a analise de variancia (ANOVA) nao mostrou diferenca significativa, tanto na media do erro absoluto (p=0,66) quanto na media do erro relativo (p=0,81) entre os diferentes angulos-alvo de flexao do joelho. Conclusao: nas condicoes experimentais utilizadas, os dados do presente estudo nao evidenciam deficit proprioceptivo em realacao ao senso de posicao articular entre os grupos DFP e controle

Efeito do exercicio isometrico de extensao do joelho associado a aducao isometrica do quadril na atividade eletrica dos musculos vasto medial obliquo em individuos com disfuncao femoro-patelar / Knee extension exercise associated to the hip adduction in the emg activity of the vastus medialis oblique and vastus lateralis oblique muscles in subjects with patellofemoral dysfunction

A articulacao do joelho esta envolvida em cerca de 50 (por cento) das lesoes musculo-esqueleticas, sendo que a alteracao mais encontrada e a disuncao femoro-patelar (DFP). Diante disso, a proposta deste trabalho foi avaliar a atividade eletrica dos musculos vasto medial obliquo e o vasto lateral obliquo no Leg Press Horizontal, no exercicio de contracao isometrica voluntaria maxima(CIVM) de extensao do joelho, com o mesmo fletido a 90 grau, associado a aducao isometrica do quadril. Para iss, a atividade eletrica dos msuculosfoi mensurada em 10 voluntarios do sexo feminino com sinais de DFP e idade variando de 20 a 29 anos(22,2+-2,65 anos), utilizando um conversor analogico-digital e eletrodos ativos diferenciais simples. O sinal eletromiografico foi quantificado pela raiz quadrada da media (RMS) e normalizado pela CIVM de extensao do joelho fletido a 90o. Os dados foram estatisticamente analisados por meio da analise de variancia para medidas repetidas e do teste de analise de variancia de contrastes variaveis, com 5 (por cento) de significancia. Os resultados evidenciaram que a tividade eletrica do musculo vasto medial obliquo foi significativamente maior que a do vasto lateral obliquo no exercicio proposto. os resultados desta pesquisa, nas condicoes experimentais utilizadas, sugerem que o exercicio isometrico de extensao do joelho, associado a aducao isometrica do quadril, e recomendado para tratamento de pacientes com disfuncao femoro-patelar, ja que potencializou a atividade do musculo vasto medial obliquo em relacao ao vasto lateral obliquo

Functional changes of human quadriceps muscle injured by eccentric exercise.

The present study evaluated functional changes of quadriceps muscle after injury induced by eccentric exercise. Maximal isometric torque of quadriceps and the surface electromyography (root mean square, RMS, and median frequency, MDF) of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles were examined before, immediately after and during the first 7 days after injury. Serum creatine kinase (CK) levels and magnetic resonance imaging (MRI) were used to identify muscle injury. The subject was used as her own control and percent refers to pre-injury data. Experiments were carried out with a sedentary 23-year-old female. Injury was induced by 4 bouts of 15 maximal isokinetic eccentric contractions (angular velocity of 5 /s; range of motion from 40 to 110 of knee flexion). The isometric torque of the quadriceps (knee at 90 flexion) decreased 52% immediately after eccentric exercise and recovered on the 5th day. The highest reduction of RMS occurred on the 2nd day after injury in both VL (63%) and VMO (66%) and only VL recovered to the pre-injury level on the 7th day. Immediately after injury, the MDF decreased by 5 and 3% (VMO and VL, respectively) and recovered one day later. Serum CK levels increased by 109% on the 2nd day and were still increased by 32% on the 7th day. MRI showed large areas of injury especially in the deep region of quadriceps. In conclusion, eccentric exercise decreased the isometric torque and electromyographic signals of quadriceps muscle, which were recovered in one week, despite the muscle regeneration signals.

Functional changes of human quadriceps muscle injured by eccentric exercise

The present study evaluated functional changes of quadriceps muscle after injury induced by eccentric exercise. Maximal isometric torque of quadriceps and the surface electromyography (root mean square, RMS, and median frequency, MDF) of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles were examined before, immediately after and during the first 7 days after injury. Serum creatine kinase (CK) levels and magnetic resonance imaging (MRI) were used to identify muscle injury. The subject was used as her own control and percent refers to pre-injury data. Experiments were carried out with a sedentary 23-year-old female. Injury was induced by 4 bouts of 15 maximal isokinetic eccentric contractions (angular velocity of 5º/s; range of motion from 40º to 110º of knee flexion). The isometric torque of the quadriceps (knee at 90º flexion) decreased 52 percent immediately after eccentric exercise and recovered on the 5th day. The highest reduction of RMS occurred on the 2nd day after injury in both VL (63 percent) and VMO (66 percent) and only VL recovered to the pre-injury level on the 7th day. Immediately after injury, the MDF decreased by 5 and 3 percent (VMO and VL, respectively) and recovered one day later. Serum CK levels increased by 109 percent on the 2nd day and were still increased by 32 percent on the 7th day. MRI showed large areas of injury especially in the deep region of quadriceps. In conclusion, eccentric exercise decreased the isometric torque and electromyographic signals of quadriceps muscle, which were recovered in one week, despite the muscle regeneration signals

Recuperacao funcional de individuos com disfuncao femoro-patelar por meio de exercicios em cadeia cinetica fechada: revisao da literatura / Functional recovery of patients suffering from patellofemoral dysfunction through closed kinetic chain exercices

A disfuncao femoro-patelar constitui importante lesao musculo-esqueletica, acometendo adultos jovens e uma grande porcentagem de atletas. Varios fatores etiologicos estao envolvidos nessa patologia da articulacao femoro-patelar, a qual e estabilizada principalmentepor estruturas dinamicas - musculos. Somente apos o correto conhecimento dos estabilizadores dinamicos da articulacao femoro-patelar e dos principais fatores envolvidos em sua etiologia pode-se prescrever um correto protocolo de exercicios na reabilitacao funcional. Dentre os mais utilizados estao os exercicios em cadeia cinetica fechada, realizados com o segmento distal do membro inferior fixo. Exemplos desses exercicios sao o agachamento e os exercicios realizados no leg-press e no step. Apesar de varios estudos terem analisado os estabilizadores dinamicos da articulacao femoro-patelar nesses exercicios em cadeia cinetica fechada, faltam evidencias cientificas que comprovem o aumento da hipertrofia ou do desempenho muscular. Dessa forma, mais estudos biomecanicos, anatomicos e eletromiograficos tornam-se necessarios para embasar em cadeia cinetica fechada na reabilitacao de pacientes com disfuncao femoro-patelar

A physiotherapeutic approach to craniomandibular disorders: a case report.

This is a case report of a 19-year-old female who presented with a unilateral weakness of the right masseter muscle evidenced by electromyographic examination. The presence of a mandibular deviation to the right during opening because of this weakness was treated with neuromuscular electrical stimulation (NMES). After the physiotherapeutic treatment, the electrical activity of the right masseter muscle increased during function and the mandibular deviation disappeared. Electromyography (EMG) can have a useful role in the determination of the muscular profile, and for evaluating therapeutics.

The effect of free isotonic and maximal isometric contraction exercises of the hip adduction on vastus medialis oblique muscle: an electromyographic study.

The purpose of this study was to analyse the activity of the vastus medialis oblique (VMO) muscle electromyographically during free isotonic and maximal isometric contraction of the hip adduction with knee extension performing exercises at sitting and in decubitus lateralis positions. Using a 8 channels Nicolet Electromyograph and Beckman surface mini electrodes, the activity of the vastus medialis oblique muscle was recorded among 15 healthy subjects, aged 19 to 33 years, (mean = 24.4, SD = 4.1) without prior knee and hip joints pathology. The sign was recorded in root mean square (RMS), expressed in microvolts. The data were statistically calculated employing an analysis of variance (ANOVA) and the Tukey test, at 5% of significance. The results showed that the electromyographic (EMG) activity of the vastus medialis oblique muscle was significantly greater in both exercises of maximal contraction when compared with free isotonic at decubitus lateralis. On the other hand, there was no significant difference of the electromyographic activity of the vastus medialis oblique muscle between the two exercises of maximal isometric contraction. These findings, within the experimental conditions used, suggest that prior stages of patellofemoral dysfunction, the exercises of hip adduction with knee extension could be performed isometrically or isotonically, at sitting and in decubitus lateralis positions, depending on the biological conditions of each patient.