Análise da função dos músculos do quadril em portadores de síndrome da dor patelofemural

The Patellofemoral pain syndrome is defined as a fore or retro patellar pain and it has multifactorial etiology, where the bad patellar alignment is the most acceptable hypothesis. However proximal factors to the knee, as the debility of the muscles of the hip, have been demonstrated as a contributing factor to the appearing of that syndrome. Purpose: To evaluate if exists a relation between the hip muscles performance and the development of the SDPF. Methods: Thirty women took part in this study. They were divided in two groups; a control group (fifteen asymptomatic subjects) and an experimental group (fifteen subjects with the diagnosis of SDPF). The muscle performance was evaluated in an isokinetic dynamometer, where it was verified the peak torque (PT), PT to body weight, PT time and the agonist/antagonist relation. It was also analyzed the electromyographic activity of the middle gluteus. The data was analyzed by the not paired t test at a significance level of 5%. Results:. Didn t have significant difference to the PT of the abductor muscles (p = 0,46) and lateral rotators of the hip (p = 0,17) between groups. Also didn t have significant difference to the PT values by the body weight, to these muscle groups either (p = 0,10 e p = 0,11, respectively). Didn t have significant difference between the amplitude of the signal (p = 0,05) and the onset of medium gluteus (p = 0,25) between the groups. Conclusion: In the experimental conditions realized, the study didn t demonstrate a relation between performance the hip muscles behavior and the development of the SDPF

Efeito imediato da estimulação elétrica neuromuscular seletiva do músculo VMO em pacientes com síndrome da dor femoropatelar

Patellofemoral pain syndrome (PFPS) is described as anterior or retropatellar pain knee in the absence of other pathologies and is frequently associated with dysfunction of the vastus medialis oblique (VMO). However, several studies have demonstrated the inability to selectively activate this muscle through exercise. To evaluate the effect of Neuromuscular Electrical Stimulation (NMES) selective VMO in women with syndrome. We evaluated thirty-eight women: twenty in the control group (24.15 ± 2.60 years) and eighteen diagnosed with PFPS (25.56 ± 3.55 years). Both groups were evaluated before and after a protocol of electro stimulation. To measure for comparing groups before and after treatment, we assessed the extensor torque concentric and eccentric knee through an isokinetic dynamometer, the intensity (Root Mean Square - RMS) and the onset of activation (onset) of VMO compared to the vastus lateralis (VL) in two types of exercise: open and closed kinetic chain. . Statistical analysis was performed using SPSS 15.0, with a significance level of 5%. Results: Our data showed an increase in the intensity of activation (RMS) of the VMO muscle after NMES in both study groups. During concentric contraction the RMS of the VMO before the NMES was 105.69 ± 32.26 μV and after a single intervention was 122.10 ± 39.62 μV (p = 0.048) for the control group. In the group with PPS, we found a similar behavior, with RMS of the VMO before NMES of 96.25 ± 18.83 μV and 139.80 ± 65.88 μV after the intervention (p = 0.0001). However, there was no evidence in the RMS value of VL muscle. The onset was calculated by subtracting the onset of VL by the onset of VMO. For the group with PFPS, the onset before the intervention was -0.007 ± 0.14 ms, indicating a delay of the VMO relative to VL, and after NMES was 0.074 ± 0.09 ms (p = 0.016), showing an activation previous VMO to VL. The same occurred for the control group. We also observed that NMES increased knee extensor power during the concentric contraction in both groups. Before the intervention the mean power was 28.97 ± 9.01 W for the PPS group and after NMES was 34.38 ± 7.61 W (p = 0.0001). Conclusion: We observed an increase in electromyographic activity of the VMO and also an anticipatory effect of this muscle

Influência da fadiga no comportamento neuromuscular do quadríceps femoral, após reconstrução do ligamento cruzado anterior

Muscle fatigue is a phenomenon that promotes physiological and biomechanical disorders and their changes in healthy subjects have been widely studied and have significant importance for care in preventing injuries, but we do not have many information about its effects in patients after ACL reconstruction. Thus, this study is to analyze the effects of fatigue on neuromuscular behavior of quadriceps after ACL reconstruction. To reach this objective, participants were forty men, twenty healthy (26,90 ± 6,29 years) and twenty after ACL reconstruction (29,75 ± 7,01 years) with a graft of semitendinosus and gracilis tendons, between four to six months after surgery. At first, there was an assessment of joint position sense (JPS) at the isokinetic dynamometer at a speed of 5°/s and target angle of 45° to analyze the absolute error of JPS. Next, we applied the a muscle fatigue protocol, running 100 repetitions of isokinetic knee flexion-extension at 90°/s. Concurrently with this protocol, there was the assessment of muscle performance, as the peak torque (PT) and fatigue index, and electromyographic activity (RMS and median frequency). Finally, we repeated the assessment of JPS. The statistical analysis showed that patients after ACL reconstruction have, even under normal conditions, the amended JPS compared with healthy subjects and that after fatigue, both have disturbances in the JPS, but this alteration is significantly exacerbated in patients after ACL reconstruction. About muscle performance, we could notice that these patients have a lower PT, although there are no differences between the dynamometric and EMG fatigue index. These findings show the necessity about the cares of pacients with ACL reconstruction in respect of the risks of articulate instability and overload in ligamentar graft