Alongamento muscular segmentar melhora função e alinhamento do joelho de indivíduos com síndrome femoropatelar: estudo preliminar

Abstract

RESUMOIntrodução: A síndrome femoropatelar (SFP) é uma desordem dolorosa comum do joelho e para seu tratamento normalmente são utilizados exercícios de fortalecimento do músculo quadríceps femoral, sendo que poucos trabalhos encontrados na literatura investigaram os efeitos diretos do alongamento muscular. Objetivo: O objetivo deste estudo foi avaliar os efeitos do alongamento muscular segmentar no tratamento de pacientes com SFP. Métodos: Participaram do estudo 12 voluntários com SFP, dominância de membro inferior direito e idade média de 20 anos. As variáveis funcionais avaliadas antes e depois do tratamento foram: ângulo Q, intensidade da dor, capacidade funcional pela escala de contagem de Lysholm, sensação de posição articular (SPA) a 40 e 50 graus de flexão do joelho, trabalho total e momento de força concên-trico dos músculos quadríceps femoral e isquiotibiais a 60 e 180º/s. Após a avaliação inicial, foi realizado o tratamento que consistiu em alongamento muscular segmentar bilateral dos músculos isquiotibiais, tríceps sural e quadríceps femoral, com duração de 30 segundos e 10 repetições para cada músculo. As variáveis avaliadas antes e após o tratamento foram analisadas pelo teste t para amostras dependentes (α < 0,05). Resultados: Todas as variáveis apresentaram diferença significante após o tratamento (p < 0,05), exceto o momento de força e trabalho total dos músculos extensores a 60°/s, trabalho total dos extensores e flexores a 180º/s e a SPA a 50 e 40 graus de flexão do joelho. Conclusão: Os resultados desta pesquisa permitem inferir que o tratamento com alongamento muscular segmentar possibilita melhoras de vários sinais e sintomas apresentados pelos pacientes com SFP, como alinhamento, dor e função do joelho.Palavras-chave: exercícios de alongamento muscular/métodos, síndrome da dor patelofemoral, terapia por exercício. ABSTRACTIntroduction: Patellofemoral syndrome (PFS) is a common painful knee disorder and for its treatment, quadriceps femoris strengthening exercises are normally used; however, few studies in the literature investigate the direct effects of stretching exercises. Objective: In order to fill this gap, the objective of this study was to evaluate the effects of segmental stretching exercises on the treatment of patients with PFS. Methods: Twelve PFS patients with right foot dominance and mean age of 20 years were evaluated. The following functional variables were assessed, before and after treatment: Q angle, pain intensity, knee functional injury level (Lysholm scale), joint position sense (JPS) at 40 and 50 degrees of knee flexion and total work and concentric torque of quadriceps femoris and hamstring muscles at 60 and 180 degrees/sec. After initial evaluation, bilateral segmental stretching exercises for hamstring, triceps surae and quadriceps femoris muscles were performed, with 30-second duration and 10 repetitions on each muscle. Data obtained before and after treatment were analyzed by t test for dependent samples (α < 0.05). Results: All variables showed significant differ...

Correlation between anterior knee pain with flexibility muscles hip

“…In the present study, no statistically significant difference was found in ROM of flexion, which would represent the retraction of the hamstrings. Such difference in results could be due to the fact that the present study did not perform effective treatment to verify the efficacy of this in the pain, it only verified the presence or not of ROM alteration, whereas in the work of Miyamoto, Soriano and Cabral (16) , was verified the efficacy of the hamstring elongation in the treatment of PFPS.…”

“…In addition it also participates in the lateralization of the patella. (17) The influence of the tensor fasciae latae muscle on the ROM was not verified, however, as pointed out in the studies of Miyamoto, Soriano and Cabral (16) , this is a muscle that, when retracted, pulls the patella laterally and causes the appearance of femur-patellar pain, and since this muscle also has flexor function, its retraction was demonstrated in the present study when it was evaluated the flexibility of the hip flexors.…”

“…The study carried out by Miyamoto, Soriano and Cabral (16) evaluated the ROM and the shortening of the ischiotibial muscles of patients with PFPS, being verified retraction of this muscular group and significant improvement after the treatment. In the present study, no statistically significant difference was found in ROM of flexion, which would represent the retraction of the hamstrings.…”

“…Because it has an important extensor torque, such shrinkage verified in the current study may also interfere with flexion ROM as cited in the study of Miyamoto, Soriano and Cabral. (16) The study of Tyler et al (18) cited by Nakagawa et al (9) , with 35 patients with PFPS, undergoing a 6-week treatment program, composed of hip strengthening and flexibility exercises in open and closed kinetic chain, in which was reported the association of the gain of 35% of muscle strength of the hip flexors and increase in flexibility of the iliopsoas muscle and the iliotibial band with the success of the treatment.…”

Effects of three protocols of hamstring muscle stretching and paravertebral lumbar

“…Stretching is often used with the aim of promoting accruals in range of motion (ROM) in different population types (1,2,3,4,5,6,7), favoring the improvement of the daily life functions and injuries recovering (8,9), despite controversies with respect to physical performance and pain relief after its application (10,11,12,13,14,15). The increasing in ROM is possible because the stretching techniques influence muscle extensibility and joint flexibility (16,17).…”