RESUMO
Abstract: Patellofemoral pain (PFP) has been frequently associated with abnormalities in the alignment of the lower limbs and trunk, particularly during weight-bearing activities. In this context, proximal and local factors have been widely discussed. Distal factors could also be involved and need to be investigated in more detail. Our objective was to compare the foot kinematics of the ankle/foot complex in women with pronated feet and patellofemoral pain with the kinematics of asymptomatic women during the execution of anterior and lateral step down tests. Methods: Fifty women were divided into two groups: control (n=16); and patellofemoral pain (n=34). All volunteers were evaluated using three-dimensional motion capture during the forward and lateral step-down tests. For each session, nine repetitions of each clinical test were performed on the most painful limb of the women with PFP and the dominant limb of the women in the control group. The mobility of the ankle/foot complex was measured and the range of motion was calculated for all segments. The two groups were compared using multivariate analysis of variance. Results: Women in the PFP group exhibited less knee flexion and significantly greater mobility of: the hindfoot in relation to the tibia and the laboratory; the forefoot in relation to the tibia; and the forefoot in relation to the hindfoot. Conclusion: Women with PFP exhibited greater mobility of the ankle/foot complex during the anterior and lateral step down tests, when compared with asymptomatic women.
Resumo: Introdução: A dor femoropatelar (DFP) tem sido frequentemente associada a anormalidades no alinhamento dos membros inferiores e tronco, principalmente durante atividades de descarga de peso. Nesse contexto, fatores proximais e locais têm sido amplamente discutidos. Fatores distais também podem estar envolvidos e precisam ser investigados com mais detalhes. Nosso objetivo foi comparar a cinemática do complexo tornozelo/pé em mulheres com pés pronados e dor femoropatelar pormeio de cinemática tridimensional de mulheres assintomáticas durante a execução dos testes step down anterior e lateral. Métodos: Cinquenta mulheres foram divididas em dois grupos: controle (n=16); e dor patelofemoral (n=34). Todos os voluntários foram avaliados usando captura de movimento tridimensional durante os testes step down anterior e lateral. Para cada sessão, foram realizadas nove repetições de cada teste clínico no membro mais doloroso das mulheres com DFP e no membro dominante das mulheres do grupo controle. A mobilidade do complexo tornozelo/pé foi medida e a amplitude de movimento foi calculada para todos os segmentos. Os dois grupos foram comparados por meio de análise multivariada (MANOVA). Resultados: As mulheres do grupo DFP apresentaram menor flexão do joelho e mobilidade significativamente maior de: retropé em relação à tíbia e ao laboratório; do antepé em relação à tíbia; e do antepé em relação ao retropé. Conclusão: Mulheres com DFP apresentaram maior mobilidade do complexo tornozelo/pé durante os testes de step down anterior e lateral, quando comparadas com mulheres assintomáticas.
RESUMO
BACKGROUND: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition, particularly among women. Patients with PFPS usually experience weakness in the gluteal muscles, as well as pain and impaired motor control during activities of daily living. Strengthening the hip muscles is an effective way of treating this disorder. Neuromuscular training has also been identified as a therapeutic tool, although the benefits of this intervention in patients with PFPS patients remain inconclusive. DESIGN: This is a protocol of randomized controlled trial with a blind assessor. Thirty-four women with a clinical diagnosis of PFPS participated. These participants were allocated into two groups (experimental and control). The experimental group performed twelve sessions to strengthen the knee extensors, hip abductor and lateral rotator muscles in association with neuromuscular training of the trunk and lower extremities. The control group performed the same number of sessions to strengthen the muscles of the hip and knee. The primary outcome was functional capacity (Anterior Knee Pain Scale - AKPS) at 4 weeks. Pain intensity, muscle strength and kinematic changes were also measured during the step down test after four weeks of intervention. Follow up assessments were conducted after three and six months to assess functional capacity and pain. The effects of the treatment (i.e. between-group differences) were calculated using mixed linear models. DISCUSSION: The present study was initiated on the 1st of April 2013 and is currently in progress. The results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS. TRIAL REGISTRATION: Current Controlled Trials NCT01804608.
Assuntos
Força Muscular/fisiologia , Síndrome da Dor Patelofemoral/diagnóstico , Síndrome da Dor Patelofemoral/terapia , Treinamento Resistido/métodos , Adolescente , Adulto , Feminino , Humanos , Síndrome da Dor Patelofemoral/fisiopatologia , Método Simples-Cego , Adulto JovemRESUMO
INTRODUÇÃO: As lombalgias são causas de morbidade e incapacidade na realização de atividades de vida diária. Motoristas de caminhão apresentam risco aumentado de desenvolvimento da lombalgia em razão das demandas mecânico-posturais características da profissão. OBJETIVO: Investigar o nível de interferência das lombalgias nas atividades de vida diária de motoristas de caminhão. MÉTODOS: Foi realizado um estudo transversal, no qual foram entrevistados 30 motoristas de caminhão, do sexo masculino, com idade entre 25 e 35 anos e com mais de cinco anos de experiência na profissão. Apenas os indivíduos que referiram dor lombar crônica, persistente há mais de três meses, foram instruídos a responder o questionário sobre o índice de incapacitação de Oswestry para dor lombar, com intuito de classificar os níveis de interferência das lombalgias nas atividades de vida diária. RESULTADOS: Vinte e nove motoristas de caminhão atenderam aos critérios de inclusão do estudo (média de idade 31,83±3,63 anos, tempo de experiência 8,93±2,4 anos e média de 13,66±2,47 horas diárias de trabalho). Vinte e dois motoristas (75,86%) apresentavam incapacidade mínima (score 8,45±6,58) e sete (24,14%), incapacidade moderada (score 27,14±6,3). CONCLUSÃO: Apenas 24,14% da amostra estudada apresentou incapacidade moderada, interferindo assim na realização de atividades de vida diária, tais como: problemas ao sentar, levantar peso e ficar de pé.
INTRODUCTION: Low back pain leads the morbidity and disability in performing daily living activities. Truck drivers have high risks to developing low back pain due to postural and mechanical characteristics of the profession. OBJECTIVE: To investigate the low back pain interference level in daily living activities of the truck drivers. METHODS: This is a cross-sectional studythat recruited 30 truck drivers, male, aged between 25 and 35 years old and more than five years of experience in this profession. Only individuals with chronic low back pain (at least three months), were instructed to answer the Oswestry disability index questionnaire, to classify the low back pain interference levels in daily activities. RESULTS: Twenty-ninetruck drivers were included (mean age 31.83±3.63 years, meanexperience 8.93±2.4 years and a mean daily work 13.66±2.47 hours). Twenty-two truck drivers (75.86%) showed minimal disability (score 8.45±6.58) and seven (24.14%), moderate disability (score 27.14±6.3). CONCLUSION: Only 24.14% of the sample showed moderate disability, that can be interfering in the daily living activities performance of the truck drivers, such as; problems when sitting, lifting and standing up.
