Christiane de Souza Guerino Macedo

Efeito do isostretching na resistência muscular de abdominais, glúteo máximo e extensores de tronco, incapacidade e dor em pacientes com lombalgia

Objetivou-se determinar a influencia do metodo Isostretching na resistencia muscular do gluteo maximo, abdominais e extensores de tronco, incapacidade e dor de pacientes com lombalgia. MATERIAL E METODOS: Este estudo caracterizou-se como um ensaio clinico aleatorio, constituido de 18 mulheres, entre 18 e 25 anos, com dor cinco ou mais na escala visual analoga (EVA) na regiao lombar, no minimo tres vezes por semana, randomizadas em grupo ativo e controle. Foram excluidas as submetidas a tratamentos fisioterapicos ou que tenham passado por cirurgia recente e com outras patologias. As pacientes foram avaliadas (avaliadores cegos) no inicio, apos 10 e 20 sessoes, pelo questionario Roland-Morris, EVA e Teste de Repeticao Maxima em um minuto para abdominais, extensores de tronco e gluteo maximo. Para a analise estatistica, foi aplicado o teste de Shapiro Wilk, Teste t de Student e ANOVA. RESULTADOS: A comparacao entre os valores iniciais e finais no grupo ativo para a analise da resistencia dos musculos abdominais, gluteo maximo, extensores de tronco, incapacidade e dor apresentou p = 0,00 e no grupo controle p = 0,02 para o gluteo maximo. A analise dos tres momentos de avaliacao no grupo ativo evidenciou para a resistencia dos musculos abdominais, gluteo maximo e dor p = 0,00, incapacidade p = 0,01 e para os extensores de tronco p = 0,80 e o grupo controle nao evidenciou alteracao. CONCLUSAO: O Isostretching mostrou-se eficiente para diminuir a incapacidade e dor, bem como para o aumento da resistencia muscular de abdominais, gluteo maximo e extensores de tronco de pacientes com lombalgia.

Análise comparativa do equilíbrio unipodal de atletas de ginástica rítmica

ABSTRACT Introduction: Rhythmic gymnastics requires a high level of physical quality; therefore, good performance depends on muscular strength and endurance, motor coordination and postural balance. Objective: To develop a comparative analysis of postural balance in rhythmic gymnasts. Methods: 10 female rhythmic gymnasts were evaluated by a force platform on one foot and balance functional tests (Side Hop Test and Figure of Eight Hop Test). The following data of the force platform were analyzed: anteroposterior and mediolateral of the center of pressure parameters, while for the functional tests, the time in seconds was analyzed. Results: Significant difference (p = 0.01) was found between lower limbs in the median frequency parameter in the mediolateral direction, in which non dominant lower limb showed higher postural stability than the dominant one. For functional tests, there was no significant difference between limbs. Conclusion: The difference found in the balance control of mediolateral direction may be related to different muscular actions of the hip region, which is present during the sport practice for stabilization, trunk maintenance, and movement performance with lower limbs. These results indicate the need of a balance program and pelvic sta-bilization for the analyzed athletes in order to maintain muscular symmetry of the limbs for high sports performance.Keywords: postural balance, athletes, sports.

Relação entre testes funcionais e plataforma de força nas medidas de equilíbrio em atletas

INTRODUCTION: Few studies have correlated the balance measurements based in functional tests and force platform in athletes.OBJECTIVE: to determine the relationship between three functional balance tests with the main measurements of the force platform in athletes.METHODOLOGY: Fifteen female athletes, indoor soccer and handball players, aged between 13 and 17 years, participated of this study. The athletes performed tree functional tests: 1) the star excursion balance test, 2) the lateral jump, and 3) the figure eight test; as well as the one leg-stance test on a force platform with the eyes open for 30 seconds. The parameters of center of pressure (COP) of the foot were calculated by stabilographic analysis. For all the tests (functional and platform), tree trials attempts were made, and the mean value retained for the analyses.RESULTS: The correlations between the functional tests and the force platform were from r = 0.01 to -0.69 (weak to moderate), depending on the COP variable. The best correlations (r = -0.69) were found between the star excursion balance test and the COP area, indicating that when a greater distance was reached, the better the postural balance. Secondly, a weak to moderate correlation was found between the figure eight test and COP area (e.g. r = 0.43). The side hop test did not present good correlation with the values obtained on the force platform.CONCLUSION: This study shows that to evaluate balance in athletes practicing indoor soccer and handball, the Star excursion balance test may be used in the absence of a force platform, to identify possible balance deficits.INTRODUCCION: Pocos estudios han correlacionado las medidas de equilibrio entre las principales pruebas funcionales y la plataforma de fuerza en los atletas. OBJETIVO: Determinar la relacion entre tres pruebas de equilibrio funcionales con las principales medidas de la fuerza en la plataforma de los atletas. METODO: Quince atletas del sexo femenino que practican el futbol de salon y balonmano, entre 13 y 17 anos participaron en el estudio. Los atletas realizaron tres pruebas funcionales: 1) Star excursion balance test, 2) salto lateral y 3) salto figura ocho, ademas de una prueba unipodal sobre una plataforma de fuerza con los ojos abiertos durante 30 segundos. Los parametros del centro de la presion de los pies (COP) se calcularon por analisis estabilografica. Para todas las pruebas (funcionales y plataforma), se llevaron a cabo tres ensayos y el promedio fue utilizado para su analisis. RESULTADOS: Las correlaciones entre las pruebas funcionales y la plataforma de fuerza fueron r = 0,01 a -0,69 (leve a moderada), en funcion de la variable COP. La mejor correlacion (r = -0,69) se encontro entre el rango de la prueba Star Excursion Balance y el area del COP, lo que indica que cuanto mayor es la distancia que se logra, mejor es el equilibrio. En segundo lugar, se encontro correlacion debil a moderada entre la prueba en figura de ocho y el area del COP (por ejemplo, r = 0,43). La prueba de salto lateral mostro una buena correlacion con las pruebas en la plataforma de fuerza. CONCLUSION: Este estudio demostro que para la evaluacion del equilibrio de los atletas del sexo femenino de futbol de salon y balonmano, el Star excursion balance test se puede utilizar en la ausencia de una plataforma de fuerza para identificar posibles deficiencias en el equilibrio.

Estudo da validade e confiabilidade intra e interobservador da versão modificada do teste de Schöber modificado em indivíduos com lombalgia

Em pacientes com lombalgia, mensura-se a amplitude de movimento (ADM) da coluna lombar por meio da versao modificada do teste de Schober modificado (MTSM), mas suas propriedades psicometricas nao sao comprovadas para uso clinico. Este estudo verificou a validade e confiabilidade intra e interobservador do MTSM em individuos com lombalgia, comparando as medidas da ADM com as obtidas por meio de radiografia, metodo considerado padrao-ouro. Participaram 20 voluntarios com lombalgia, de ambos os sexos, funcionarios de um Hospital Universitario. O MTSM foi aplicado duas vezes por dois avaliadores. As medidas obtidas pelo teste e por radiografia foram comparadas usando o coeficiente de correlacao de Pearson, obtendo-se r=0,14, ou seja, correlacao fraca. O coeficiente de correlacao intraclasse (CCI) dos MTSM intra-observador foi 0,96 (IC 95% 0,91;0,98) e interobservador 0,93 (IC 95% 0,84;0,97), indicando alta confiabilidade; o teste de Bland & Altman mostrou alta concordância intra e interobservador, com valores de -0,21 e -0,28, respectivamente. Embora tenha sido encontrada alta confiabilidade intra e interobservador na aplicacao da versao modificada do teste de Schober modificado, este apresentou baixa validade para medir a ADM da coluna lombar, quando comparado ao padrao-ouro.In patients with low-back pain the lumbar spine range of motion (ROM) is often measured by the modified version of the modified Schober test (MMST), but its psychometric properties have not been ascertained for clinical use. The purpose here was to verify intra and inter-observer validity and reliability of the MMST in subjects with low-back pain, and to compare obtained ROM measures to those obtained by radiography, taken as gold standard. The study involved 20 subjects with chronic low-back pain, of both sexes, employees at a university hospital. The MMST was applied twice by two examiners each. The Pearson correlation coefficient found when comparing measures obtained via MMST and radiography was r=0.14, showing a poor correlation between the tests. The intra-observer intraclass correlation coefficient (ICC) found was 0.96 (CI 95% 0.91;0.98), and the interobserver ICC was 0.93 (IC 95% 0.84;0.97), showing high reliability; the Bland & Altman agreement test showed high agreement intra (-0.21) and inter-observer (0.21). Although a high reliability both intra and inter-observer was found for the modified-modified Schober test, the latter showed low validity in assessing lumbar spine range of motion, when compared to the gold standard.

Mcconnell’s patellar taping does not alter knee and hip muscle activation differences during proprioceptive exercises: A randomized placebo-controlled trial in women with patellofemoral pain syndrome☆

The purpose of this study was to assess the effect of patellar taping on muscle activation of the knee and hip muscles in women with Patellofemoral Pain Syndrome during five proprioceptive exercises. Forty sedentary women with syndrome were randomly allocated in two groups: Patellar Taping (based in McConnell) and Placebo (vertical taping on patella without any stretching of lateral structures of the knee). Volunteers performed five proprioceptive exercises randomly: Swing apparatus, Mini-trampoline, Bosu balance ball, Anteroposterior sway on a rectangular board and Mediolateral sway on a rectangular board. All exercises were performed in one-leg stance position with injured knee at flexion of 30° during 15s. Muscle activation was measured by surface electromyography across Vastus Medialis, Vastus Lateralis and Gluteus medius muscles. Maximal voluntary contraction was performed for both hip and knee muscles in order to normalize electromyography signal relative to maximum effort during the exercises. ANOVA results reported no significant interaction (P>0.05) and no significant differences (P>0.05) between groups and intervention effects in all exercise conditions. Significant differences (P<0.01) were only reported between muscles, where hip presented higher activity than knee muscles. Patellar taping is not better than placebo for changes in the muscular activity of both hip and knee muscles during proprioceptive exercises. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT02322515.

Comparison of postural balance between professional tae kwon do athletes and young adults

Este estudio tuvo como objetivo comparar el equilibrio postural de atletas de tae kwon do profesionales con un grupo de adultos que no practican esto deporte. Diecinueve participantes (nueve practicantes profesionales de tae kwon do y diez no practicantes) se pusieron a prueba. Para evaluar la oscilacion postural, se utilizo una plataforma de fuerza y el equipo registro los parametros principales: el centro de la zona de presion; la frecuencia y la velocidad del centro de la presion tanto para la direccion anteroposterior, y para la medio-lateral. Estas mediciones se registraron para todos los participantes. Antes de iniciar la evaluacion, los sujetos recibieron instrucciones y se familiarizaron con el equipo y el protocolo. Tambien fueron instruidos para realizar tres pruebas de equilibrio en un solo pie con los ojos abiertos. Los valores obtenidos en la evaluacion postural de los atletas profesionales utilizando la plataforma de fuerza eran mas bajos para todos los parametros en comparacion con aquellos de los no profesionales, con la excepcion de la frecuencia del centro de presion de la direccion medial-lateral. Sin embargo, se encontro una diferencia significativa (p=0,021) entre los grupos solo con respecto a la velocidad anteroposterior del centro de presion. Esos resultados tienen implicaciones para los deportes de los programas de rehabilitacion para la evaluacion del equilibrio postural en los atletas.

Influência das fases do ciclo menstrual no desempenho funcional de mulheres jovens e saudáveis

Os hormonios sexuais femininos como estrogenio e progesterona tem relacao com receptores especificos localizados em regioes cerebrais e podem influenciar o controle motor. Analisou-se o desempenho funcional nas diversas fases do ciclo menstrual em mulheres jovens e saudaveis. O estudo caracteriza-se como transversal e incluiu 13 mulheres saudaveis com ciclo menstrual regular e que nao faziam uso de contraceptivo oral. Para a avaliacao do desempenho funcional foram utilizados os testes Side Hop Test (SHT), Figure of Eight Hop Test (F8T) e Modified Star Excursion Balance Test (mSEBT) aplicados em tres fases do ciclo menstrual (menstrual, ovulatoria e lutea). Este estudo estabeleceu diferenca significativa para os testes funcionais SHT e F8T entre as fases do ciclo menstrual, com piores resultados para a fase menstrual. O mSEBT nao estabeleceu qualquer diferenca. Concluiu-se que o desempenho funcional nos testes SHT e F8T foi significativamente pior na fase menstrual, quando comparado a ovulatoria e lutea. Estes resultados podem ser considerados para avaliacao e prescricao de condutas fisioterapeuticas para mulheres na fase menstrual, ja que seu desempenho funcional pode estar comprometido.

Effect of cryotherapy on the ankle temperature in athletes: ice pack and cold water immersion

Introduction Cryotherapy is often used for rehabilitation of injured athletes. Objective To compare the effectiveness of ice pack (IP) and cold water immersion (CWI) on lowering the ankle skin surface temperature in athletes. Materials and methods Thirteen athletes (seven women and six men), age 19.53 (± 2.9) years. IP and CWI were applied on the anterior talofibular ligament (ATFL) of the dominant leg for 30 minutes. The skin surface temperature was measured with an infrared digital thermometer prior to the application and during cryotherapy (10, 15, 20, 25 and 30 minutes) and up to two hours of rewarming. During rewarming, the athletes remained at rest and the temperature was measured every 1 minute until 10 minutes, every 5 minutes for up to an hour and every 15 minutes until 2 hours. Results The two types of cold application were effective in lowering the skin surface temperature after the 30-minute procedure. Significant differences were observed among the following temperatures: pre-application (IP = 29.8 ± 2.4 °C and CWI = 27.5 ± 3 °C – P < 0.05); after 30 minutes (IP = 5 ± 2.4 °C and CWI = 7.8 ± 3 °C – P < 0.01). For rewarming, after 25 minutes (IP = 20.8 ± 3.3 °C and CWI = 18.2 ± 2.7 °C – P < 0.04); after 45 minutes (IP = 24.5 ± 2.3 °C and IP = 22.1 ± 3.5 °C – P < 0.05); after 75 minutes (IP = 26.4 ± 2.2 °C and CWI = 24 ± 2.7 °C – P < 0.02). Conclusion After the 30-minute application, both IP and CWI produced the appropriate temperature; however the application of CWI produced the lowest temperature during rewarming.

Relationship between functional tests and force platform measurements in athletes' balance

INTRODUCTION: Few studies have correlated the balance measurements based in functional tests and force platform in athletes.OBJECTIVE: to determine the relationship between three functional balance tests with the main measurements of the force platform in athletes.METHODOLOGY: Fifteen female athletes, indoor soccer and handball players, aged between 13 and 17 years, participated of this study. The athletes performed tree functional tests: 1) the star excursion balance test, 2) the lateral jump, and 3) the figure eight test; as well as the one leg-stance test on a force platform with the eyes open for 30 seconds. The parameters of center of pressure (COP) of the foot were calculated by stabilographic analysis. For all the tests (functional and platform), tree trials attempts were made, and the mean value retained for the analyses.RESULTS: The correlations between the functional tests and the force platform were from r = 0.01 to -0.69 (weak to moderate), depending on the COP variable. The best correlations (r = -0.69) were found between the star excursion balance test and the COP area, indicating that when a greater distance was reached, the better the postural balance. Secondly, a weak to moderate correlation was found between the figure eight test and COP area (e.g. r = 0.43). The side hop test did not present good correlation with the values obtained on the force platform.CONCLUSION: This study shows that to evaluate balance in athletes practicing indoor soccer and handball, the Star excursion balance test may be used in the absence of a force platform, to identify possible balance deficits.INTRODUCCION: Pocos estudios han correlacionado las medidas de equilibrio entre las principales pruebas funcionales y la plataforma de fuerza en los atletas. OBJETIVO: Determinar la relacion entre tres pruebas de equilibrio funcionales con las principales medidas de la fuerza en la plataforma de los atletas. METODO: Quince atletas del sexo femenino que practican el futbol de salon y balonmano, entre 13 y 17 anos participaron en el estudio. Los atletas realizaron tres pruebas funcionales: 1) Star excursion balance test, 2) salto lateral y 3) salto figura ocho, ademas de una prueba unipodal sobre una plataforma de fuerza con los ojos abiertos durante 30 segundos. Los parametros del centro de la presion de los pies (COP) se calcularon por analisis estabilografica. Para todas las pruebas (funcionales y plataforma), se llevaron a cabo tres ensayos y el promedio fue utilizado para su analisis. RESULTADOS: Las correlaciones entre las pruebas funcionales y la plataforma de fuerza fueron r = 0,01 a -0,69 (leve a moderada), en funcion de la variable COP. La mejor correlacion (r = -0,69) se encontro entre el rango de la prueba Star Excursion Balance y el area del COP, lo que indica que cuanto mayor es la distancia que se logra, mejor es el equilibrio. En segundo lugar, se encontro correlacion debil a moderada entre la prueba en figura de ocho y el area del COP (por ejemplo, r = 0,43). La prueba de salto lateral mostro una buena correlacion con las pruebas en la plataforma de fuerza. CONCLUSION: Este estudio demostro que para la evaluacion del equilibrio de los atletas del sexo femenino de futbol de salon y balonmano, el Star excursion balance test se puede utilizar en la ausencia de una plataforma de fuerza para identificar posibles deficiencias en el equilibrio.

Relación entre pruebas funcionales y plataforma de fuerzas en las medidas de balance de los atletas

INTRODUCTION: Few studies have correlated the balance measurements based in functional tests and force platform in athletes.OBJECTIVE: to determine the relationship between three functional balance tests with the main measurements of the force platform in athletes.METHODOLOGY: Fifteen female athletes, indoor soccer and handball players, aged between 13 and 17 years, participated of this study. The athletes performed tree functional tests: 1) the star excursion balance test, 2) the lateral jump, and 3) the figure eight test; as well as the one leg-stance test on a force platform with the eyes open for 30 seconds. The parameters of center of pressure (COP) of the foot were calculated by stabilographic analysis. For all the tests (functional and platform), tree trials attempts were made, and the mean value retained for the analyses.RESULTS: The correlations between the functional tests and the force platform were from r = 0.01 to -0.69 (weak to moderate), depending on the COP variable. The best correlations (r = -0.69) were found between the star excursion balance test and the COP area, indicating that when a greater distance was reached, the better the postural balance. Secondly, a weak to moderate correlation was found between the figure eight test and COP area (e.g. r = 0.43). The side hop test did not present good correlation with the values obtained on the force platform.CONCLUSION: This study shows that to evaluate balance in athletes practicing indoor soccer and handball, the Star excursion balance test may be used in the absence of a force platform, to identify possible balance deficits.INTRODUCCION: Pocos estudios han correlacionado las medidas de equilibrio entre las principales pruebas funcionales y la plataforma de fuerza en los atletas. OBJETIVO: Determinar la relacion entre tres pruebas de equilibrio funcionales con las principales medidas de la fuerza en la plataforma de los atletas. METODO: Quince atletas del sexo femenino que practican el futbol de salon y balonmano, entre 13 y 17 anos participaron en el estudio. Los atletas realizaron tres pruebas funcionales: 1) Star excursion balance test, 2) salto lateral y 3) salto figura ocho, ademas de una prueba unipodal sobre una plataforma de fuerza con los ojos abiertos durante 30 segundos. Los parametros del centro de la presion de los pies (COP) se calcularon por analisis estabilografica. Para todas las pruebas (funcionales y plataforma), se llevaron a cabo tres ensayos y el promedio fue utilizado para su analisis. RESULTADOS: Las correlaciones entre las pruebas funcionales y la plataforma de fuerza fueron r = 0,01 a -0,69 (leve a moderada), en funcion de la variable COP. La mejor correlacion (r = -0,69) se encontro entre el rango de la prueba Star Excursion Balance y el area del COP, lo que indica que cuanto mayor es la distancia que se logra, mejor es el equilibrio. En segundo lugar, se encontro correlacion debil a moderada entre la prueba en figura de ocho y el area del COP (por ejemplo, r = 0,43). La prueba de salto lateral mostro una buena correlacion con las pruebas en la plataforma de fuerza. CONCLUSION: Este estudio demostro que para la evaluacion del equilibrio de los atletas del sexo femenino de futbol de salon y balonmano, el Star excursion balance test se puede utilizar en la ausencia de una plataforma de fuerza para identificar posibles deficiencias en el equilibrio.