Luiz Fernando Approbato Selistre

Incidência de lesões nos jogadores de futebol masculino sub-21 durante os Jogos Regionais de Sertãozinho-SP de 2006

INTRODUCAO: O futebol, o esporte mais popular e praticado pelo mundo, e tambem uma das modalidades esportivas onde o atleta e submetido a diversos tipos e intensidades de esforcos. Atualmente essa modalidade sofreu modificacoes, deixando de dar enfase a tecnica e passando a privilegiar os componentes fisicos, aumentando assim a probabilidade da ocorrencia de lesoes. OBJETIVO: Realizar um levantamento epidemiologico das lesoes no Futebol de Campo Sub-21 durante os 50°s Jogos Regionais de Sertaozinho de 2006. METODOLOGIA: Este e um trabalho do tipo epidemiologico descritivo e analitico, com desenho transversal. Realizou-se o acompanhamento de todas as partidas da modalidade, registrando as lesoes ocorridas, seguido de um levantamento e caracterizacao das lesoes. As mesmas foram classificadas de acordo com seu perfil e segmento anatomico, posteriormente divididas por posicao dos atletas. RESULTADOS: Houve maior incidencia das lesoes nos membros inferiores, com 127 (74,7%); quanto ao perfil, as lesoes musculares foram mais prevalentes, com 64 (37,6%) lesoes. Os atletas do meio-campo foram os mais acometidos, com 72 (42,4%) lesoes. Dentro da classe de goleiros e defensores a maior prevalencia de contusoes foi de sete (63,6%) e 11 (50%), respectivamente. Ja os atacantes, laterais e meio-campistas apresentaram como predominio as lesoes musculares, sendo os primeiros com 11 (36,7%), seguidos de 12 (34,3%) dos laterais e 33 (45,8%) dos meio-campistas. CONCLUSAO: Constatou-se que ocorreu maior indice de lesoes em membros inferiores, sendo estas caracterizadas como as musculares de maior prevalencia. Demonstrou-se ainda que as lesoes apresentadas estao diretamente relacionadas com as caracteristicas de cada posicao.

Relação entre torque extensor e relação I: Q com salto unipodal triplo horizontal em jogadores profissionais de futebol

OBJECTIVE: The aims of this study were: 1) to determine and compare the extensor torque, H:Q ratio and triple hop distance in functional test between lower extremities; 2) to identify the relationship between extensor torque and H:Q ratio with the performance in triple hop distance in professional soccer players. MATERIALS AND METHODS: Twenty-one healthy male professional soccer players, average 23.2 (± 3.6) years old, without history of injury were selected. The athletes were assessed in an isokinetic dynamometer at three angular velocities: 60, 180 and 300°/s, and from this assessment the peak of torque and calculated H:Q ratio at the three velocities were obtained. The triple hop distance was also used to calculate the hopped distance in meters. RESULTS: No significant difference was found between the lower extremities (dominant and non-dominant) (p = 0.23). Also, a weak relationship between extensor torque and functional test at the three velocities was observed (Dominant: 60°/s_r = 0.38; 180°/s_r = 0.43*; 300°/s_r = 0.26. Non dominant: 60°/s_r = 0.36; 180°/s_r = 0.30; 300°/s_r = 0.48*) (*p < 0.05). Similar results were found for H:Q ratio (Dominant: 60_r = 0.01; 180_r = 0.11; 300_r = - 0.02. Non-dominant: 60_r = - 0.20; 180_r = - 0.15; 300_r = - 0.18). CONCLUSION: Due to a weak relationship, the isokinetic test cannot be replaced by the triple hop distance (functional test) for muscular function assessment.

Kinematic alterations of the lower limbs and pelvis during an ascending stairs task are associated with the degree of knee osteoarthritis severity

BACKGROUND Individuals with knee osteoarthritis (OA) generally demonstrate great difficulty in ascending stairs. The strategies and compensations used by these individuals in stair activities have not been fully established. The purpose of this study was to investigate the joint kinematics of the pelvis, hip, knee and ankle throughout the gait cycle, in the sagittal and frontal planes, in individuals with mild and moderate knee OA, during an ascending stairs task. METHODS Thirty-one individuals with knee OA and 19 controls were subjected to clinical and radiographic analysis, divided into three groups: control, mild knee OA, and moderate knee OA. Participants answered a self-reported questionnaire, carried out performance-based tests, and their kinematic data were recorded during an ascending stairs task using an eight-camera Qualisys 3D-Motion analysis system. RESULTS The individuals with moderate degrees of knee OA demonstrated kinematic alterations in the pelvis, hip, knee, and ankle in the sagittal plane. The individuals with mild degrees of knee OA demonstrated kinematic alterations of the hip in the frontal plane, and kinematic alterations of the ankle in the sagittal plane. CONCLUSIONS The ascending stairs task allowed verification of meaningful information regarding gait strategies used by individuals with mild and moderate knee OA. The strategies of these two groups of individuals are different for this task, although more pronounced in individuals with moderate knee OA. The findings should be taken into account in the development of rehabilitation programs.

Ankle strength impairments associated with knee osteoarthritis

Background Knee Osteoarthritis seems to negatively impact ankle biomechanics. However, the effect of knee osteoarthritis on ankle muscle strength has not been clearly established. This study aimed to evaluate the ankle strength of the plantar flexors and dorsiflexors of patients with knee osteoarthritis in different degrees of severity. Methods Thirty‐seven patients with knee osteoarthritis and 15 controls, subjected to clinical and radiographic analysis, were divided into three groups: control, mild, and moderate knee osteoarthritis. Participants answered a self‐reported questionnaire and accomplished a muscle torque assessment of the ankle using the Biodex dynamometer in isometric, concentric and eccentric modes. Findings The mild osteoarthritis group (peak torque = 26.85(SD 3.58)) was significantly weaker than the control (peak torque = 41.75(SD 4.42)) in concentric plantar flexion (P < 0.05). The control and mild osteoarthritis groups were not significantly different from the moderate osteoarthritis group (peak torque = 36.12(SD 4.61)) in concentric plantar flexion. There were no significant differences for dorsiflexion among the groups; however the control and moderate osteoarthritis groups presented large and medium standardized mean differences. The mild osteoarthritis group was significantly lower than the control and moderate osteoarthritis groups in the concentric plantar flexion by concentric dorsiflexion torque ratio. Interpretation Ankle function exhibited impairments in patients with knee osteoarthritis, especially in the plantar flexion torque, in which the mild osteoarthritis group was weaker than the control. Interestingly, patients with moderate knee osteoarthritis showed results similar to the control group in plantar flexion torque. The results raise the possibility of a compensatory mechanism of the plantar flexors developed by patients in more advanced degrees to balance other muscle failures. HighlightsKnee osteoarthritis subjects exhibit impairment in muscle strength of the ankle.Mild osteoarthritis subjects had lower plantar flexion torque than healthy subjects.Moderate osteoarthritis subjects had similar plantar flexion torque to healthy subjects.The results suggest a possible compensation mechanism carried out by the plantar flexors.

FRI0580-HPR Correlation between Self-Reported Physical Function and Isokinetic Total Muscle Work in Early Degrees of Knee Osteoarthritis

Background Knee osteoarthritis (OA) is the most common chronic joint disease. Quadriceps is the muscle around the knee joint more affected by the disease, resulting in a reduction in functional muscle parameters. This may contribute to substantial functional deficits, however it is not clear if functional muscle parameters, like total muscle work, correlates to physical function in early degrees of knee osteoarthritis. Objectives The aim of this study was to evaluate the correlation between functional impairment and knee extensor total muscle work in men with Grades I or II knee OA. Methods Fourteen men with knee OA grade I or II (according to Kellgren & Lawrance criteria) participated in this study. The physical function section of the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) questionnaire was applied before the isokinetic evaluation. The concentric and eccentric knee extensor total muscle work were assessed using Biodex System 3 Pro isokinetic dynamometer, at a speed of 90°/s. Spearmans correlation coefficient was used to detect the relationship between the dependent variables (WOMAC questionnaire physical function section score) and the independent variables (average total muscle work). For all the statistical tests, the significance level was p<0.05. Results The data analysis revealed a moderate and negative correlation between self-reported physical function and eccentric extensor total muscle work (r= -0.8, p=0,001). The self-reported physical function presented no correlation with concentric extensor total muscle work (r= -0.5, p=0,07).These results indicate that the higher the knee extensor eccentric total muscle work, the lower the level of functional impairment self-reported by these individuals. Conclusions Our results indicate that correlation between eccentric knee extensor total muscle work and self-reported physical function are already present in individual with early degrees of knee OA. These results also indicate the lower the total work, the greater the functional deficit.Thus, physical therapy programs are indicated for these patients to improve physical function, especially in functional activities involving eccentric contraction of the quadriceps. References American College of Rheumatology Subcommittee on Osteoarthritis Guidelines.Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum 2000; 43:1905-15. Brandt KD, Dieppe PA, Eric R. Etiopathogenesis of osteoarthritis.Med Clin N Am 2009; 93: 1-24. Kellgren, J H, Lawrence, J S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 1957; 16: 494-502. Weber JC, Lamb DR. Statistics and Research in Physical Education. Saint Luis: C.V; Mosby Company; 1970. Acknowledgements The Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP), São Paulo, Brazil for financial support (#2007/07200-4; #2011/06619-7). Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3807

A biomecânica e a produção do conhecimento em fisioterapia: levantamento baseado nos anais do congresso brasileiro de biomecânica

O aumento gradual da participacao da comunidade academica da Fisioterapia nas edicoes do Congresso Brasileiro de Biomecânica (CBB) e notorio. Os Anais do CBB passaram a ser importantes veiculos para a divulgacao cientifica em Fisioterapia no Brasil; porem, a caracterizacao dessa producao ainda nao foi feita. O objetivo do presente estudo foi realizar um levantamento bibliografico dos estudos em Fisioterapia publicados nas edicoes dos Anais do CBB, desde a primeira edicao em 1992 (Anais do IV CBB) ate a edicao publicada em 2009 (Anais do XIII CBB), a fim de identificar quais especialidades da Fisioterapia tem aplicado o conhecimento em Biomecânica no contexto clinico e/ou cientifico, alem de caracterizar o tipo de pesquisa que se tem desenvolvido. Seis revisores independentes levantaram os estudos pertencentes a area da Fisioterapia e coletaram informacoes de maneira padronizada atraves de questionarios. Os resultados evidenciaram um grande crescimento da participacao das diferentes areas da Fisioterapia ao longo das dez edicoes do CBB. Embora os dados sejam positivos em relacao a ampliacao das pesquisas em Biomecânica, verificou-se uma carencia da utilizacao dos recursos biomecânicos para avaliar efeitos de intervencoes em pacientes. Dessa forma, recomenda-se que mais estudos sejam conduzidos em contextos clinicos e com acompanhamento longitudinal, de modo a ampliar a aplicacao pratica das ferramentas biomecânicas no campo da intervencao, bem como aperfeicoar a avaliacao em Fisioterapia.