Análise cinemática da mobilidade do complexo tornozelo/pé de mulheres com DFP durante testes funcionais de descarga de peso
DOI:
https://doi.org/10.5585/21.2022.23125Palavras-chave:
Joelho, Biomecânica, Step down test, Dor anterior no joelho, Reabilitação.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.
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Referências
Aliberti S, Costa MS, Passaro AC, Arnone AC, Sacco IC. Medial contact and smaller plantar loads characterize individuals with Patellofemoral Pain Syndrome during stair descent. Phys Ther Sport. 2010;11(1):30-34. doi: 10.1016/j.ptsp.2009.11.001
Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 2010;40(5):286-296. doi: 10.2519/jospt.2010.3227.
Barton CJ, Levinger P, Crossley KM, Webster KE, Menz HB. Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome. J Foot Ankle Res. 2011;4:10. doi: 10.1186/1757-1146-4-10
Barton CJ, Levinger P, Crossley KM, Webster KE, Menz HB. The relationship between rearfoot, tibial and hip kinematics in individuals with patellofemoral pain syndrome. Clin Biomech (Bristol, Avon). 2012;27(7):702-705. doi: 10.1016/j.clinbiomech.2012.02.007
Barton CJ, Levinger P, Menz HB, Webster KE. Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture. 2009;30(4):405-416. doi: 10.1016/j.gaitpost.2009.07.109
Barton CJ, Levinger P, Webster KE, Menz HB. Walking kinematics in individuals with patellofemoral pain syndrome: a case-control study. Gait Posture. 2011;33(2):286-291. doi: 10.1016/j.gaitpost.2010.11.022.
Blackburn JT, Padua DA. Sagittal-plane trunk position, landing forces, and quadriceps electromyographic activity. J Athl Train. 2009;44(2):174-179. doi: 10.4085/1062-6050-44.2.174
Bolgla LA, Malone TR, Umberger BR, Uhl TL. Hip strength and hip and knee kinematics during stair descent in females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(1):12-18. doi: 10.2519/jospt.2008.2462
Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med. 2009;37(11):2108-2116. doi: 10.1177/0363546509337934
Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010;20(5):725-730. doi: 10.1111/j.1600-0838.2009.00996.x.
Brechter JH, Powers CM. Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait Posture. 2002;16(2):115-123.
Buldt AK, Murley GS, Butterworth P, Levinger P, Menz HB, Landorf KB. The relationship between foot posture and lower limb kinematics during walking: A systematic review. Gait Posture. 2013;38(3):363-372. doi: 10.1016/j.gaitpost.2013.01.010
Chinkulprasert C, Vachalathiti R, Powers CM. Patellofemoral joint forces and stress during forward step-up, lateral step-up, and forward step-down exercises. J Orthop Sports Phys Ther. 2011;41(4):241-248. doi: 10.2519/jospt.2011.3408.
Cornwall MW, McPoil TG. Effect of ankle dorsiflexion range of motion on rearfoot motion during walking. J Am Podiatr Med Assoc. 1999;89(6):272-277.
da Cunha RA, Costa LO, Hespanhol Junior LC, Pires RS, Kujala UM, Lopes AD. Translation, cross-cultural adaptation, and clinimetric testing of instruments used to assess patients with patellofemoral pain syndrome in the Brazilian population. J Orthop Sports Phys Ther. 2013;43(5):332-339. doi: 10.2519/jospt.2013.4228
Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc. 1998;30(4):556-569.
Evans AM, Copper AW, Scharfbillig RW, Scutter SD, Williams MT. Reliability of the foot posture index and traditional measures of foot position. J Am Podiatr Med Assoc. 2003;93(3):203-213.
Hains G, Hains F. Patellofemoral pain syndrome managed by ischemic compression to the trigger points located in the peri-patellar and retropatellar areas: A randomized clinical Trial. Vol 13. Clinical Chiropractic2010:201-209.
Leardini A, Benedetti MG, Berti L, Bettinelli D, Nativo R, Giannini S. Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. Gait Posture. 2007;25(3):453-462. Doi:10.1016/j.gaitpost.2006.05.017
Lucareli PR, Contani LB, Lima B, et al. Repeatability of a 3D multi-segment foot model during anterior and lateral step down tests. Gait Posture. 2016;43:9-16. doi: 10.1016/j.gaitpost.2015.10.008
Magalhães E, Silva AP, Sacramento SN, Martin RL, Fukuda TY. Isometric strength ratios of the hip musculature in females with patellofemoral pain: a comparison to pain-free controls. J Strength Cond Res. 2013(8);27:2165-2170. doi: 10.1519/JSC.0b013e318279793d.
Mascal CL, Landel R, Powers C. Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther. 2003;33(11):647-660. Doi:10.2519/jospt.2003.33.11.647
Nakagawa TH, Moriya ET, Maciel CD, Serrão FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2012;42(6):491-501. doi: 10.2519/jospt.2012.3987
Neal BS, Griffiths IB, Dowling GJ, et al. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. J Foot Ankle Res. 2014;7(1):55. doi: 10.1186/s13047-014-0055-4
Nester C. The relationship between transverse plane leg rotation and transverse plane motion at the knee and hip during normal walking. Gait Posture. 2000;12(3):251-256.
Nester C, Jones RK, Liu A, et al. Foot kinematics during walking measured using bone and surface mounted markers. J Biomech. 2007;40(15):3412-3423. Doi:10.1016/j.jbiomech.2007.05.019
Park KM, Cynn HS, Choung SD. Musculoskeletal predictors of movement quality for the forward step-down test in asymptomatic women. J Orthop Sports Phys Ther. 2013;43(7):504-510. doi: 10.2519/jospt.2013.4073
Portney L, Watkins M. Foundations of clinical research: applications to practice. 2 ed. Upper Saddle River, NJ2000.
Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003;33(11):639-646. Doi: 10.2519/jospt.2003.33.11.639
Powers CM, Bolgla LA, Callaghan MJ, Collins N, Sheehan FT. Patellofemoral pain: proximal, distal, and local factors, 2nd International Research Retreat. J Orthop Sports Phys Ther. 2012;42(6):A1-54. doi: 10.2519/jospt.2012.0301
Powers CM, Chen PY, Reischl SF, Perry J. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot Ankle Int. 2002;23(7):634-640. Doi: 10.1177/107110070202300709
Powers CM, Ho KY, Chen YJ, Souza RB, Farrokhi S. Patellofemoral joint stress during weight-bearing and non-weight-bearing quadriceps exercises. J Orthop Sports Phys Ther. 2014;44(5):320-327. doi: 10.2519/jospt.2014.4936
Rabin A, Kozol Z. Measures of range of motion and strength among healthy women with differing quality of lower extremity movement during the lateral step-down test. J Orthop Sports Phys Ther. 2010;40(12):792-800. doi: 10.2519/jospt.2010.3424
Rathleff MS, Richter C, Brushøj C, et al. Increased medial foot loading during drop jump in subjects with patellofemoral pain. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2301-2307. doi: 10.2519/jospt.2010.3424
Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol, Avon). 2006;21(1):89-98. Doi: 10.1016/j.clinbiomech.2005.08.002
Selfe J, Richards J, Thewlis D, Kilmurray S. The biomechanics of step descent under different treatment modalities used in patellofemoral pain. Gait Posture. 2008;27(2):258-263. Doi: 101016/j.gaitpost.2007.03.017
Silva DeO, Briani RV, Pazzinatto MF, et al. Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain. Clin Biomech (Bristol, Avon). 2015;30(2):144-148. doi: 10.1016/j.clinbiomech.2014.12.009
Simon J, Doederlein L, McIntosh AS, Metaxiotis D, Bock HG, Wolf SI. The Heidelberg foot measurement method: development, description and assessment. Gait Posture. 2006;23(4):411-424. Doi: 10.1016/j.gaitpost.2005.07.003
Stebbins J, Harrington M, Thompson N, Zavatsky A, Theologis T. Repeatability of a model for measuring multi-segment foot kinematics in children. Gait Posture. 2006;23(4):401-410. Doi: 10.1016/j.gaitpost.2005.03.002
Terada M, Wittwer AM, Gribble PA. Intra-rater and inter-rater reliability of the five image-based criteria of the foot posture index-6. Int J Sports Phys Ther. 2014;9(2):187-194.
Teyhen DS, Stoltenberg BE, Eckard TG, et al. Static foot posture associated with dynamic plantar pressure parameters. J Orthop Sports Phys Ther. 2011;41(2):100-107. doi: 10.2519/jospt.2011.3412
Thijs Y, De Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med. 2008;42(6):466-471. doi: 10.1136/bjsm.2008.046649
Thomeé R, Augustsson J, Karlsson J. Patellofemoral pain syndrome: a review of current issues. Sports Med. 1999;28(4):245-262.
Tulchin K, Orendurff M, Karol L. Willson JD, Davis IS. Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clin Biomech (Bristol, Avon). 2008;23(2):203-211.Gait Posture. Doi: 10.1016/j.clinbiomech.2007.08.025
Willson JD, Davis IS. Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clin Biomech (Bristol, Avon). 2008;23(2):203-211. Doi: 10.1016/j.clinbiomech.2007.08.025
Willson JD, Ellis ED, Kernozek TW. Plantar loading characteristics during walking in females with and without patellofemoral pain. J Am Podiatr Med Assoc. 2015;105(1):1-7. doi: 10.7547/8750-7315-105.1.1
Witvrouw E, Callaghan MJ, Stefanik JJ, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014;48(6):411-414. doi: 10.1136/bjsports-2014-093450
Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Am J Sports Med. 2000;28(6):480-489. Doi:1101177/03635465000280040701
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