Fisioterapia en la inhibición muscular artrogenica. Revisión de literatura

Abstract

El objetivo de este estudio fue investigar la efectividad de la Fisioterapia en la inhibición muscular artrogénica. Se realizaron búsquedas en las bases PEDro, Embase, Scielo y PubMed para identificar ensayos controlados aleatorios (ECA) de intervenciones de Fisioterapia en la inhibición muscular artrogénica. La literatura incluyo referencias en inglés, español y portugués, publicados entre Enero de 2000 y Junio de 2017. Se identificaron 7 ensayos clínicos que se incluyeron en esta revisión y 4 Revisión Sistemática/Meta-análisis. Se realizó una evaluación crítica de la literatura y se procesó una descripción narrativa debido al pequeño número de ECA. La evidencia muestra que la intervención fisioterapéutica puede ser beneficiosa para el manejo de la inhibición muscular artrogénica, sin embargo, el resultado de baja calidad de la evaluación crítica y el pequeño número de ensayos sugieren que se requieren ECA de alta calidad para examinar más a fondo los efectos de la intervención fisioterapéutica en el control de la inhibición muscular artrogénica.

Rehabilitation of Patients with Arthrogenic Muscular Inhibition in Pathologies of Knee Using Virtual Reality

“…Regarding the normalized force in knee flexion and extension with both legs MVIC in the CG, there was a statistically significant difference since the p value is 0.013, an initial median of 8.26, intermediate of 9.41, and final of 10.7 for a delta of 1.22 between the final and initial assessment; while for the IG the delta between the final assessment, with a median of 9.40, and the initial one with a median of 7.83, was 1.25, being slightly higher for the IG. This is in line with the study by Bartholdy in [1], in which he found a statistically significant difference in favor of American College of Sport Medicine interventions with respect to knee extensor strength (SMD difference: 0.448 (CI 95%: 0.091-0.805)). In the Bartholdy study [1], no non-American College of Sport Medicine interventions were observed and associations between increased knee extensor strength and changes in pain and/or disability were assessed using meta-regressions that indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively.…”

“…This is in line with the study by Bartholdy in [1], in which he found a statistically significant difference in favor of American College of Sport Medicine interventions with respect to knee extensor strength (SMD difference: 0.448 (CI 95%: 0.091-0.805)). In the Bartholdy study [1], no non-American College of Sport Medicine interventions were observed and associations between increased knee extensor strength and changes in pain and/or disability were assessed using meta-regressions that indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively.…”

“…Recovery speed is the weighting of the following variables: Pain level: the WOMAC questionnaire [19] was used, (See Supplementary Materials-WOMAC), which has 6 questions to assess the level of pain. Each question has a range of [0][1][2][3][4]. The responses of each patient were added, with which there was a possible range per patient from 0 to 24.…”

“…According to [1], in many cases AMI hinders rehabilitation after knee joint injury by preventing functional activation of the quadriceps. This has been attributed to neural reflex activity originating in the injured joint and producing decreased efferent drive to muscles, such as the quadriceps, therefore rehabilitation protocols after knee injury should focus in neuromuscular and mechanical alterations, improving therapeutic adherence more than in the pathology itself, since in most cases AMI is chronic.…”

“…Currently, injuries involving the skeletal and muscular systems are considered a public health problem, since they represent up to 80% of physiotherapy consultations [1]. Worldwide, a substantial portion of the population experiences these musculoskeletal issues, which can be attributed to several factors, including poor postural habits, occupational activities [2], age, gender [3], participation in sports activities, insufficient musculoskeletal strength, and others.…”