Anderson Aurélio da Silva

Análise do perfil, funções e habilidades do fisioterapeuta com atuação na área esportiva nas modalidades de futebol e voleibol no Brasil

OBJECTIVE: To analyze the profile of Brazilian physical therapists working with soccer and volleyball professional teams, by verifying their level of education (graduate or undergraduate), as well as their role and insertion within the interdisciplinary team. METHODS: Structured questionnaires were administered to forty-nine physical therapists working at soccer, volleyball clubs and Brazilian national teams. These questionnaires provided data on social demographic, characteristics of the work environment and organization of clinical practice and its domains. RESULTS: From the 49 participants in this study only five were female. Mean age of all participants was 32.2 years. The majority of the sports physical therapists had specialization degrees in different areas (78.2%), were hired through referral (78.2%), worked more than 8 hours a day or were exclusively dedicated to their clubs (80.0%) and earned seven to ten Brazilian minimal wages (58.2%). They reported to have participation in the domains of emergency care (87.3%), prevention (92.7%), functional rehabilitation (98.2%) and return to competition (100%). They had interdisciplinary relationships with physical educators during functional rehabilitation programs (70.9%) and with physicians in the decision process of return to activity after rehabilitation (74.5%) and on the veto of an athlete to take part in practices or matches (63.6%). Therapists also complained of threats to their professional autonomy, specially directed by the teams physician. CONCLUSION: There is still a need to invest in continuing education of sports physical therapists with the objective to improve their educational level and to strengthen their professional autonomy.

Avaliação muscular isocinética da articulação do joelho em atletas das seleções brasileiras infanto e juvenil de voleibol masculino

The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.

Avaliação muscular isocinética da articulação do ombro em atletas da Seleção Brasileira de voleibol sub-19 e sub-21 masculino

INTRODUCTION AND PURPOSE: The shoulder complex muscles play an important role in force, power and endurance production in volleyball, allowing the accomplishment of movement in a coordinated manner. The objective written account produced by isokinetic evaluations assists in the diagnosis and prevention of shoulder complex injuries. In addition, it is a useful tool in promoting safe and fast return of the injured athlete to sports practice. The purpose of this study was to analyze the isokinetic muscle performance of the lateral and medial rotators of the glenohumeral joint in Brazilian male volleyball teams (under-19 and under-21). METHODS: The protocol used during the test included five maximum repetitions of shoulder lateral and medial rotation in concentric-concentric mode at 60o/s and 30 repetitions at 360o/s. Analysis of variance was used to evaluate the dependent variables: maximum work and maximum torque of shoulder lateral and medial rotators normalized by body mass, antagonist/agonist ratio at the two speeds and muscular fatigue index. RESULTS: Data analysis demonstrated an imbalance between the shoulder lateral and medial rotators (antagonist/agonist ratio) in the under-21 category of the Brazilian volleyball athletes, demonstrating relative weakness of the lateral rotators. CONCLUSION: It was possible to identify changes in volleyball players, which added to specific demands of the sport, can lead to symptoms in the shoulder complex and / or decrease of performance.

Análise da associação entre a dinamometria isocinética da articulação do joelho e o salto horizontal unipodal, hop test, em atletas de voleibol

ABSTRACTAnalysis on the association between isokinetic dynamometryof the knee’s articulation and one-leg horizontal jump, hoptest, in volleyball athletes The isokinetic dynamometer has been widely used to assessthe muscle performance. Due to its high cost, the use of suchdevice in clinical practice becomes unfeasible. The one-leg hop isa test to evaluate the strength and reliance on lower limbs thatmay be used in routine clinical trials at low cost, being no time-consuming. The present study aimed to assess whether there isany association between the hop test and the muscular functiondata provided by the knee evaluations at the isokinetic dynamom-eter in professional athletes. Materials and methods: Thirty vol-leyball players (8 women and 22 men) were evaluated by means ofisokinetic dynamometer at speeds of 60 o /s and 300 o /s, and throughthe hop test at distance. Results: It was observed a low correla-tion between the deficit of the peak torque (r = 0,441) and thework (r = 0,610) at 60The isokinetic dynamometer has been widely used to assess the muscle performance. Due to its high cost, the use of such device in clinical practice becomes unfeasible. The one-leg hop is a test to evaluate the strength and reliance on lower limbs that may be used in routine clinical trials at low cost, being no timeconsuming. The present study aimed to assess whether there is any association between the hop test and the muscular function data provided by the knee evaluations at the isokinetic dynamometer in professional athletes. Materials and methods: Thirty volleyball players (8 women and 22 men) were evaluated by means of isokinetic dynamometer at speeds of 60 o /s and 300 o /s, and through the hop test at distance. Results: It was observed a low correlation between the deficit of the peak torque (r = 0,441) and the work (r = 0,610) at 60 o /s, with a deficit for hopped distance between lower limbs. Moreover, it was found a low correlation between the muscle performance and the distance reached during the hop test, except for women in the right lower limb. Conclusion: The current study has shown that the hop test cannot be used to replace isokinetic dynamometric tests for functional tests.

Isokinetic muscle evaluation of the knee joint in athletes of the Under-19 and Under-21 Male Brazilian National Volleyball Team

The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.

Normative values of dynamic knee valgus during single leg squat in basketball and volleyball athletes

Background Volleyball and basketball are among the sports with a higher incidence of knee injuries. The inability to maintain a proper alignment of the lower limbs during functional activities could create a knee valgus which predisposes to injury. Thus, the quantification of knee valgus is necessary to guide prevention and clinical interventions. Objective To establish normative values for dynamic knee valgus during the single leg squat (SLS) in volleyball and basketball athletes. Design Observational cross-sectional. Setting Minas Tênis Club, Brazil, youth sports. Participants 151 athletes (108 male and 43 female) were assessed during national championship preseason. All participants were healthy, with no current pain of lower limb injury and no history of previous lower extremity surgery. The mean age, weight and height were 14.21+2.09; 62.75+14.20 and 173.89+13.42, respectively. Assessment of risk factors Gender, age and sport. Main outcome measurements Knee valgus was measured as frontal plane projection angle of the knee (FPPAK) during SLS up to 60° of knee flexion. The mean of three repetitions of SLS from each limb was used for analysis, using SIMI Motion Twinner software. The FPPAK was defined as the connections between ASIS, midpoint of femoral epicondyles and anterior midpoint of the malleolis. Results The mean FPPAK during SLS for right leg was 7.08+4.0 and 8.68+4.2 for left leg. There were no differences between ages and genders. There were significant differences between sides in both modalities (p<0.000).The basketball athletes had lower FPPAK on the left leg when compared with athletes from volleyball (p<0.000). Conclusion All athletes showed an inability to maintain proper alignment during dynamic squat. The differences found between modalities may be linked to the specific technique of each sport and are important to guide an intervention focused on injury prevention.

Assessment of intensity effort of middle-aged adults practicing regular walking

Background: Walking is one of the most commonly recommended activities for sedentary individuals. When performed at the correct intensity, it can provide cardiovascular, respiratory, metabolic, and other benefits by providing a training effect in addition to reducing the risk of death from cardiovascular diseases and other chronic health conditions. Objectives: The primary aim of this study was to assess whether individuals who practiced regular unsupervised walking carry out the activity safely and with sufficient effort intensity parameters to have a positive physiological (training) effect. The secondary objective was to compare the training heart rate (HR) and the stability of the HR within the ideal range of training between the sexes. Method: Individuals were selected from walking tracks within the city of Belo Horizonte, Brazil. The study included subjects from 40 to 60 years of age who had practiced walking for at least two months prior to the study, walking at least three times a week. Individuals who agreed to participate in the survey were asked to walk 15 minutes at their usual pace with their HR measured every 5 minutes using a heart rate monitor. Their average walking HR was compared to the average training HR based on the formula: (220 - age) × 70 to 80% that would result in a positive physiological training effect. Results: Of the 142 individuals evaluated, 25.4% achieved the average training HR. This result was significantly lower than those who did not achieve the average training HR while walking (p=0.002). There were significant differences between men and women who had reached the training HR (p=0.0001). Conclusion: The authors found that individuals who walk regularly performed outside the range of the ideal HR intensity that would cause a positive physiological effect and therefore would probably not achieve a beneficial training effect while walking.

Comparative analysis of knee valgus in athletes during takeoff and landing

Background The knee malalignment is a risk factor of injuries such as anterior cruciate ligament tear. Most studies that analyses the knee valgus in jump tasks, investigates only this pattern at landing. It would be interesting to study the knee valgus at takeoff, because at this specific moment the active components of the movement are the primary injury contributors. Objective to compare the frontal plane knee angle (FPKA) during takeoff and landing at countermovement jump in athletes. Design Observational cross sectional. Setting Volleyball and basketball players were evaluated at Minas Tennis Club and at Sports Prevention and Rehabilitation Laboratory (CENESP-UFMG). Participants 101 athletes, mean age 15.88 (0.35) years were included in this study. All participants were healthy, with no current complaints of lower limb injury or pain and no history of lower limbs previous surgery. Assessment of risk factors High-FPKA. Reflexive markers were located in ASIS, femoral condyles and in a middle point of the medial and lateral maleolus. Main outcome measurements The FPKA was determined in SIMI motion 2D software. Results The mean angle during takeoff was 3.020 and 3.13 0 for dominant and non-dominant leg. For landing, it was 2840 and 2210 respectively. There was no significant statistical differences between the two means on both legs (p=0.73 dominant leg and p=0.13 non-dominant leg). Meanwhile, the variance was greater in the impulsion analysis (37.2 right leg and 48.3 left leg) compared to landing (24.4 and 29.8 respectively). Conclusion The analysis of FPKA during takeoff provides data about the active contribution of certain variables in knee injuries and must be better understood. Differences between the FPKA during takeoff and landing were not found in this study, although in the first movement there was a major variance. This inconsistency may demand a more thorough investigation.

Correlation between isokinetic profile and knee injuries in male volleyball athletes

Background Knee injuries are prevalent in elite volleyball and their preventive management is still discussed. Isokinetic assessment is largely use in sports injury prevention; however few studies investigate the differences in the isokinetic profile of injured knees. These studies analyses the agonist/antagonist ratio and do not consider other parameters as fatigue index. Objective to investigate the differences between injured and non injured knee in the hamstring/quadriceps ratio and fatigue index in volleyball male athletes. Setting all testing took place in the Sports Injury Prevention and Rehabilitation Laboratory- LAPREV in elite volleyball. Participants 49 male (mean+SD age, 21.96+4.1; height, 196.5+0.06; body mass, 89.1+9.03) athletes were evaluated in this study, being 20 at injured group. Participants with lower-extremity surgery in the previous 6 months and pain during the isokinetic test were excluded. Assessment of risk factor: hamstring/quadriceps ratio at 60°/s and 300°/s and fatigue at 300°/s at the dominant knee with 90° of hip flexion. Main outcome measurements trauma and overuse knee injuries provided by questionnaire. Results Differences between groups were found just in hamstring fatigue (p=0.002). The means of this parameter were 63.1 and 55.6 for injured and non-injured group respectively. For quadriceps fatigue the means were 48.4 and 47.3 respectively. No differences were found in the ratio analysis between groups (p=0.403 for 60°/s and p=0.289 for 360°/s). The means were 199.4 and 203.5 for injured and non-injured groups at 60°/s and 157.4 and 168.6 respectively at 300°/s. Conclusion The results showed that the injured group has more hamstring fatigue compared to non-injured group. The ratio analysis does not reveal differences between groups. The fatigue analysis must be incorporated in the athletes assessment, because seems to be more informative about injury risk.

Evaluación muscular isocinetica de la articulación de la rodilla en atletas de las selecciones brasileras infanto y juveniles de voleibol masculino

The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.The vertical jump is a basic volleyball practice that demands a high ability to generate strength and work in the muscles involved, mainly in the quadriceps muscle. Due to such demand, muscle imbalances between extensor and flexor muscles may be present, causing an overloading on the muscle-tendinous structures of the knee joint. Thus, the establishment of normal parameters for the muscle function related to that joint in volleyball athletes is necessary. Therefore, the purpose of this study was to assess through isokinetic dynamometry the peak torque, work peak, agonist/antagonist ratio, and fatigue index of the flexor and extensor of the knee among both volleyball athlete population. The isokinetic flexion and extension tests of the knees were performed in the concentric-concentric seat mode at 60 and 300o/sec. velocity in thirty-six athletes (20 under 19-under 21, and 16 under 21). The data allowed to set the parameters for the muscle function of the knee joint among athletes of the 2003 Under 19-Under 21 and Under 21 Brazilian National Team Selection of Male Volleyball. Athletes presented peak torque and work peak values normalized by the body mass to the upper quadriceps to the mean normal values for the athletes and non-athletes populations. Compared to other categories, the under 21 athletes presented significantly higher values for the agonist/antagonist ratio, and peak work ratio of the knee flexors at 60o/sec. velocity. Furthermore, the agonist/antagonist ratio was lower than the reference value expected for both categories, thus characterizing predominance in the extensor musculature over the flexor musculature. The fatigue index was close to what would be expected for the majority of athletes. The present study may be useful as comparison basis for future studies aiming evaluate the isokinetic muscle function in volleyball players.