Marlon Francys Vidmar

Efeitos da fisioterapia convencional e da wiiterapia na dor e capacidade funcional de mulheres idosas com osteoartrite de joelho

JUSTIFICATIVA E OBJETIVOS: A osteoartrite (OA) e uma das doencas reumaticas mais prevalentes em idosos, sendo causa frequente de incapacidade nesta populacao. E mais comum na articulacao do joelho e se caracterizam por dor, rigidez e perda da funcao. A fisioterapia convencional por meio do treinamento de forca muscular e descrita como uma forma satisfatoria de melhora das limitacoes funcionais nestes individuos. A wiiterapia, por meio da utilizacao do videogame Nintendo Wii e da plataforma Wii Fit, vem sendo utilizada como recurso terapeutico na reabilitacao de portadores de doencas musculoesqueleticas. O objetivo deste estudo foi comparar os efeitos da fisioterapia convencional e da wiiterapia na dor, rigidez, incapacidade funcional e equilibrio em mulheres idosas com OA de joelho. METODOS: A amostra foi composta por 71 mulheres portadoras de OA de joelho usuarias de um grupo de convivencia para idosos no municipio de Passo Fundo-RS, sendo 33 no grupo I, submetidas a fisioterapia convencional e 38 no grupo II, que realizaram wiiterapia. Foram avaliados dor, rigidez e incapacidade funcional pelo questionario The Western Ontario and McMaster Osteoarthritis Index (WOMAC) e o equilibrio pela escala de equilibrio de Berg. RESULTADOS: As idosas submetidas a fisioterapia convencional (grupo I) apresentaram em relacao a wiiterapia (grupo II) menores escores de dor (11,05 ± 8,15 versus 19,24 ± 16,96; p = 0,00) e incapacidade (12,42 ± 7,91 versus 17,42 ± 14,08; p = 0,06) apos a intervencao. Os escores de rigidez (25,13 ± 15,99 versus 14,39 ± 17,43; p = 0,00) e equilibrio (50,94 ± 1,45 versus 53,45 ± 5,16; p = 0,00) foram melhores nas pacientes que fizeram wiiterapia, com significância estatistica em ambos os itens. CONCLUSAO: Foi observada uma superioridade da wiiterapia na melhora da rigidez e equilibrio em mulheres idosas portadoras de osteoartrite em relacao a fisioterapia convencional.

Twenty-Year Follow-up Study Comparing Operative Versus Nonoperative Treatment of Anterior Cruciate Ligament Ruptures in High-Level Athletes: Letter to the Editor:

Dear Editor: We read with great interest and would like to congratulate van Yperen et al for their very interesting study that contributes to the understanding of the long-term degenerative effects in the knee joint after anterior cruciate ligament (ACL) rupture and reconstruction. We would like to emphasize the importance of the study since the consequences are still unclear in terms of adopting a conservative or surgical approach for dealing with an ACL rupture and knee osteoarthritis 20 years after injury. The findings of this study aid in the decision making of clinicians, policy makers, and, ultimately, patients. Precisely because of the significant influence that these findings may have on clinical practice, we would like to raise some topics that we believe might complement the discussions provided by the authors and enhance the interpretation of the study results. Specifically, in what follows, we discuss the (1) statistics, (2) description of the participants, (3) osteoarthritis classification, (4) functional assessment, (5) ACL reconstruction procedure and meniscectomy, and (6) rehabilitation and return-to-play criteria. 1. No sample size calculation was reported in this publication or in the previous 10-year follow-up study. This is one of the recommendations of the STROBE statment to avoid biases in the results. Additionally, no primary outcome is explicitly designated by the authors; therefore, it is difficult to determine the power of this sample. Usually, at least 80% power is recommended in medical reasearch; however, underpowered studies are very common in the literature, which could lead to 3 main problems: higher chance of not finding statistically significant differences when they exist (type II error), inflated effect sizes, and lower positive predictive value. Hence, it is important to stress that the lack of a difference in the outcomes between operative and nonoperative groups found by Yperen et al is perhaps due a high chance of a false negative. The authors were able to maintain follow-up over 20 years without sample losses, which is very challenging. However, for some functional outcomes, some patients were not evaluated because of kinesophobia or pain. In these cases, they used multiple imputation for missing data by creating 5 new data sets and using the pooled variable for further analysis. Nevertheless, we deem it important to present which variables and how many data were missing in each group, as it could result in postintervention bias. Thus, the potential bias of these losses would be clear. 2. In respect of the description of the participants, the authors did not report which sport modality participants were involved in, whether they continued to perform this activity in a competitive level after the treatment, and for how long. Such information seems to be relevant since the prevalence of knee osteoarthritis, ACL rupture, and other knee injuries were found to be different among sport modalities. Although the authors used the Tegner score to classify participants’ levels of physical activity, there was no information about the sport category of the participants. The prevalence of knee osteoarthritis was higher among elite versus nonelite athletes. Finally, previous studies suggested a set of tests for prospectively identifying patients with good nonoperative care potential. In the present study, no objective criterion was adopted to decide between operative and nonoperative treatment. Such information would allow a better understanding of the profile of the individuals and improve the external validation of the findings. 3. The well-accepted classification of Kellgren and Lawrence was used to determine the level of osteoarthritis. We would like to add that such interpretations are subjective and that, especially in studies comparing 2 groups, to blind the examiners is highly recommended to avoid increasing the risk of bias. In addition, the reliability of this classification between the examiners was below the threshold considered acceptable (kappa, 0.58). As a consequence, the authors used the results of only 1 examiner. In the previous study from the authors (10-year followup), 2 independent and blinded examiners were involved. This low agreement between examiners reinforces the subjectivity of the evaluation and poses another important source of risk of bias. 4. The 1-legged hop test was used to measure functional stability. This test consists of straight movements in the sagittal plane, and it does not seem to reflect the real-life multiple directions of sport. In addition, the measurement properties of this test have been questioned. Finally, this test strictly focuses on a quantitative measure, and no information on the quality of movement is considered. A battery of tests has been recommended, including strength tests, hop tests, and video analysis for measuring quality of movement. 5. The authors acknowledged the evolution in surgical techniques for the knee. We would like to expand this topic and make some considerations with the current clinical practice. The surgical technique adopted in the present study, with a transtibial tunnel, was suggested to promote a vertical femoral tunnel and then a vertical orientation of the ACL. This ACL vertical position showed lower capability to control rotational external moments in the knee. For example, individuals with transtibial ACL reconstruction showed excessive tibial internal rotation The American Journal of Sports Medicine 2018;46(11):NP55–NP58 2018 The Author(s)

Análise do perfil oxidativo de diferentes amostras biológicas de pacientes com lesão de ligamento cruzado anterior

La rodilla es una de las articulaciones mas importantes para locomocion. Sin embargo, debido a su complejidad, se torna susceptible a diversos tipos de lesiones, como la ruptura del ligamento cruzado anterior (LCA). Esa complicacion desencadena un proceso inflamatorio, que puede culminar en formacion de radicales libres y, en consecuencia, en estres oxidativo (EO). El objectivo del estudio fue comparar el perfil oxidativo de pacientes con lesion del LCA, analizando dos muestras biologicas: fluido sinovial y suero. Fueron analizados 11 individuos del genero masculino, con ruptura total del LCA, con edad superior a 18 anos. Se recogio muestras de sangre y fluido sinovial 15 minutos antes de la artroplastia y se analizo biomarcadores de EO, catalasa, flavonoides y peroxidacion de las grasas, o sea, substancias reactivas al acido tiobarbiturico (TBARS). Los resultados apuntan menor concentracion de flavonoides, combinada a aumento de TBARS e de actividad de catalasa en el suero cuando comparado con el fluido sinovial. El analisis de los resultados indica que la lesion de LCA induce a cuadro de EO, caracterizado por consumo de antioxidantes y elevacion de dano de las grasas en el fluido sinovial cuando comparado con el suero, indicando que analisis sericas pueden no ser adecuadas para medir EO en partes como la articulacion de la rodilla

SUPLEMENTACIÓN CON OMEGA-3 DESPUÉS DE LA RECONSTRUCCIÓN DEL LIGAMENTO CRUZADO ANTERIOR

Introduccion: Las lesiones del ligamento cruzado anterior (LCA) contribuyen a la formacion de radicales libres de oxigeno, que en exceso pueden desencadenar dano oxidativo en la articulacion de la rodilla. Objetivo: Evaluar los efectos de la suplementacion oral con acidos grasos omega-3 en los marcadores de estres oxidativo en pacientes sometidos a reconstruccion del LCA. Metodos: Este estudio es un ensayo clinico prospectivo, aleatorizado, controlado, simple ciego, con una muestra de 25 pacientes que se sometieron a la reconstruccion del LCA, divididos aleatoriamente en: grupo omega-3 (GO), suplementado diariamente con 2 g de omega-3 por 15 dias despues de la reconstruccion del LCA y grupo control (GC), sin suplementos. Se hizo la recogida de sangre y de liquido sinovial inmediatamente antes de la cirugia y 15 dias despues de la reconstruccion del LCA. El analisis bioquimico evaluo los niveles de productos de la peroxidacion lipidica (MDA); la actividad catalasa; polifenoles y el total de grupos sulfhidrilo y la proteina C reactiva (PCR). Resultados: Se observo una disminucion significativa en los niveles de MDA en GO en comparacion con el GC (p < 0,05) de la misma manera que la actividad de la enzima antioxidante catalasa fue significativamente menor en GO en comparacion con el CG (p < 0,001). Tambien se observaron niveles significativamente elevados de grupos sulfhidrilo totales en plasma de individuos suplementados en comparacion con el GC (p < 0,001). Ademas, se observaron niveles significativamente mas altos de polifenoles (p < 0,05) en el plasma y en el liquido sinovial de pacientes que recibieron acidos grasos omega-3 en el postoperatorio en comparacion con el preoperatorio. Sin embargo, no se observo un efecto protector con la administracion de omega-3 en la funcion anti-inflamatoria. Conclusion: Se encontro un efecto protector del omega-3 en la modulacion de marcadores de estres oxidativo en pacientes sometidos a la reconstruccion del LCA.

SUPPLEMENTATION WITH OMEGA-3 AFTER RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT

Introduccion: Las lesiones del ligamento cruzado anterior (LCA) contribuyen a la formacion de radicales libres de oxigeno, que en exceso pueden desencadenar dano oxidativo en la articulacion de la rodilla. Objetivo: Evaluar los efectos de la suplementacion oral con acidos grasos omega-3 en los marcadores de estres oxidativo en pacientes sometidos a reconstruccion del LCA. Metodos: Este estudio es un ensayo clinico prospectivo, aleatorizado, controlado, simple ciego, con una muestra de 25 pacientes que se sometieron a la reconstruccion del LCA, divididos aleatoriamente en: grupo omega-3 (GO), suplementado diariamente con 2 g de omega-3 por 15 dias despues de la reconstruccion del LCA y grupo control (GC), sin suplementos. Se hizo la recogida de sangre y de liquido sinovial inmediatamente antes de la cirugia y 15 dias despues de la reconstruccion del LCA. El analisis bioquimico evaluo los niveles de productos de la peroxidacion lipidica (MDA); la actividad catalasa; polifenoles y el total de grupos sulfhidrilo y la proteina C reactiva (PCR). Resultados: Se observo una disminucion significativa en los niveles de MDA en GO en comparacion con el GC (p < 0,05) de la misma manera que la actividad de la enzima antioxidante catalasa fue significativamente menor en GO en comparacion con el CG (p < 0,001). Tambien se observaron niveles significativamente elevados de grupos sulfhidrilo totales en plasma de individuos suplementados en comparacion con el GC (p < 0,001). Ademas, se observaron niveles significativamente mas altos de polifenoles (p < 0,05) en el plasma y en el liquido sinovial de pacientes que recibieron acidos grasos omega-3 en el postoperatorio en comparacion con el preoperatorio. Sin embargo, no se observo un efecto protector con la administracion de omega-3 en la funcion anti-inflamatoria. Conclusion: Se encontro un efecto protector del omega-3 en la modulacion de marcadores de estres oxidativo en pacientes sometidos a la reconstruccion del LCA.

SUPLEMENTAÇÃO COM ÔMEGA-3 PÓS-RECONSTRUÇÃO DO LIGAMENTO CRUZADO ANTERIOR

Introduccion: Las lesiones del ligamento cruzado anterior (LCA) contribuyen a la formacion de radicales libres de oxigeno, que en exceso pueden desencadenar dano oxidativo en la articulacion de la rodilla. Objetivo: Evaluar los efectos de la suplementacion oral con acidos grasos omega-3 en los marcadores de estres oxidativo en pacientes sometidos a reconstruccion del LCA. Metodos: Este estudio es un ensayo clinico prospectivo, aleatorizado, controlado, simple ciego, con una muestra de 25 pacientes que se sometieron a la reconstruccion del LCA, divididos aleatoriamente en: grupo omega-3 (GO), suplementado diariamente con 2 g de omega-3 por 15 dias despues de la reconstruccion del LCA y grupo control (GC), sin suplementos. Se hizo la recogida de sangre y de liquido sinovial inmediatamente antes de la cirugia y 15 dias despues de la reconstruccion del LCA. El analisis bioquimico evaluo los niveles de productos de la peroxidacion lipidica (MDA); la actividad catalasa; polifenoles y el total de grupos sulfhidrilo y la proteina C reactiva (PCR). Resultados: Se observo una disminucion significativa en los niveles de MDA en GO en comparacion con el GC (p < 0,05) de la misma manera que la actividad de la enzima antioxidante catalasa fue significativamente menor en GO en comparacion con el CG (p < 0,001). Tambien se observaron niveles significativamente elevados de grupos sulfhidrilo totales en plasma de individuos suplementados en comparacion con el GC (p < 0,001). Ademas, se observaron niveles significativamente mas altos de polifenoles (p < 0,05) en el plasma y en el liquido sinovial de pacientes que recibieron acidos grasos omega-3 en el postoperatorio en comparacion con el preoperatorio. Sin embargo, no se observo un efecto protector con la administracion de omega-3 en la funcion anti-inflamatoria. Conclusion: Se encontro un efecto protector del omega-3 en la modulacion de marcadores de estres oxidativo en pacientes sometidos a la reconstruccion del LCA.

Oxidative profile of patients with osteoarthrosis undergoing total knee arthroplasty

Introduction Total knee arthroplasty may be the most appropriate method of treatment in several cases of osteoarthritis. This disease causes tissue damage, which is closely related to the production of free radicals, leading to oxidative stress and to lipid damage. Because of that, the body has several antioxidative defense systems involved in detoxification (antioxidants).Objective Based on the previous information, the goal of this study was to establish the systemic and local oxidative profile of individuals with osteoarthritis submitted to total knee arthroplasty.Materials and methods The sample consisted of four female patients (65.5 ± 0.7 years) with osteoarthritis of the knee. Blood and synovial fluid (SF) samples were collected from the patients 15 minutes before surgery. The concentrations of flavonoids, catalase, and TBARS were then quantified.Results The results indicate a higher catalase activity in the SF than in the serum (S), (SF = 1 S = 14.3 ± 3.1 ± 0.8). The concentration of TBARS proved to be higher in the SF (SF = 0.29 ± 0.02 S = 0.09 ± 0.05), whereas the concentration of phenols was higher in the serum (SF = 3.2 S = 5.2 ± 0.2 ± 0.6).Conclusion Osteoarthritis is a disease that increases the oxidative stress markers in the serum and in the SF.

Avaliação isocinética, dor e funcionalidade de sujeitos com síndrome da dor patelofemoral

| This study aimed at determining the influence of patellofemoral pain syndrome (PFPS) on torque peak and the work of knee flexor and extensor muscles, in addition to evaluating the pain and functionality of individuals that have this dysfunction. Fifty-two female subjects, 23 with diagnosis of PFPS, and 29 control subjects, clinically healthy and similar in age, height, and body mass participated in this study. The isokinetic evaluation was performed on concentric mode for knee flexors and extensors at speeds of 60° and 180°/s. The Visual Numerical Scale and the Kujala questionnaire were also applied before and after each speed of isokinetic testing. The data were analyzed through descriptive and inferential statistics (U Mann–Whitney, Wilcoxon, and independent t-tests) with a significance level of α=0.05. The patellofemoral pain syndrome group had lower scores (p=0.01) on the Kujala questionnaire (75.7±12.3 points) in relation to the control group (100±0.0 points), and lower peak torque of knee flexors (0.82±0.24 Nm/kg; 0.51±0.22 Nm/kg) and extensors (1.85±0.48 Nm/kg; 1.13±0.44 Nm/kg) at 60° and 180°/s as well as lower total work of knee extensors at 180°/s (6.46±2.54 Joules/kg) and 60°/s (9.42±3.27 Joules/kg). In addition, there was exacerbation of pain in the patellofemoral pain syndrome group after the isokinetic evaluation at 180°/s (0.9 cm) and 60°/s (2.3 cm). The results evidenced that individuals with PFPS have lower functional capacity, lower torque peak, and decreased function of knee flexors and extensors, which suggests that strengthening these muscles must be considered in the rehabilitation of these subjects.Este estudo visou determinar a influencia da Sindrome da Dor Patelofemoral (SDPF) sobre o pico de torque e trabalho da musculatura flexora e extensora do joelho, alem de avaliar a dor e funcionalidade de sujeitos com a disfuncao. Participaram 52 sujeitos do genero feminino, 23 com SDPF e 29 clinicamente saudaveis similares em idade, estatura e massa corporal. A avaliacao isocinetica foi realizada no modo concentrico para os flexores e extensores do joelho nas velocidades de 60 e 180°/s. Tambem foi aplicada a Escala Visual Numerica antes e apos cada velocidade do teste isocinetico e o questionario de Kujala. Os dados foram analisados pela estatistica descritiva e inferencial (testes U de Mann-Whitney, Wilcoxon e t independente) com nivel de significância de α=0,05. O Grupo com Sindrome da Dor Patelofemoral (GSDPF) apresentou menor pontuacao (p=0,01) no questionario de Kujala (75,7±12,3 pontos) em relacao ao Grupo Controle (GC) (100±0,0 pontos), alem de menor pico de torque, tanto em 60 como 180°/s, dos flexores (0,82±0,24 Nm/kg; 0,51±0,22 Nm/kg) e extensores (1,85±0,48 Nm/kg; 1,13±0,44 Nm/kg) do joelho, bem como menor trabalho total dos extensores do joelho a 180°/s (6,46±2,54 J/kg) e 60°/s (9,42±3,27 J/kg). Alem disso, foi observado aumento da dor do GSDPF apos a avaliacao isocinetica a 180°/s (0,9 cm) e 60°/s (2,3 cm). Os resultados evidenciaram que sujeitos com SDPF possuem menor capacidade funcional e menor pico de torque e trabalho dos flexores e extensores do joelho, sugerindo que o fortalecimento desta musculatura deve ser considerado na reabilitacao destes sujeitos.

Isokinetic evaluation, pain and functionality of subjects with patellofemoral pain syndrome

| This study aimed at determining the influence of patellofemoral pain syndrome (PFPS) on torque peak and the work of knee flexor and extensor muscles, in addition to evaluating the pain and functionality of individuals that have this dysfunction. Fifty-two female subjects, 23 with diagnosis of PFPS, and 29 control subjects, clinically healthy and similar in age, height, and body mass participated in this study. The isokinetic evaluation was performed on concentric mode for knee flexors and extensors at speeds of 60° and 180°/s. The Visual Numerical Scale and the Kujala questionnaire were also applied before and after each speed of isokinetic testing. The data were analyzed through descriptive and inferential statistics (U Mann–Whitney, Wilcoxon, and independent t-tests) with a significance level of α=0.05. The patellofemoral pain syndrome group had lower scores (p=0.01) on the Kujala questionnaire (75.7±12.3 points) in relation to the control group (100±0.0 points), and lower peak torque of knee flexors (0.82±0.24 Nm/kg; 0.51±0.22 Nm/kg) and extensors (1.85±0.48 Nm/kg; 1.13±0.44 Nm/kg) at 60° and 180°/s as well as lower total work of knee extensors at 180°/s (6.46±2.54 Joules/kg) and 60°/s (9.42±3.27 Joules/kg). In addition, there was exacerbation of pain in the patellofemoral pain syndrome group after the isokinetic evaluation at 180°/s (0.9 cm) and 60°/s (2.3 cm). The results evidenced that individuals with PFPS have lower functional capacity, lower torque peak, and decreased function of knee flexors and extensors, which suggests that strengthening these muscles must be considered in the rehabilitation of these subjects.Este estudo visou determinar a influencia da Sindrome da Dor Patelofemoral (SDPF) sobre o pico de torque e trabalho da musculatura flexora e extensora do joelho, alem de avaliar a dor e funcionalidade de sujeitos com a disfuncao. Participaram 52 sujeitos do genero feminino, 23 com SDPF e 29 clinicamente saudaveis similares em idade, estatura e massa corporal. A avaliacao isocinetica foi realizada no modo concentrico para os flexores e extensores do joelho nas velocidades de 60 e 180°/s. Tambem foi aplicada a Escala Visual Numerica antes e apos cada velocidade do teste isocinetico e o questionario de Kujala. Os dados foram analisados pela estatistica descritiva e inferencial (testes U de Mann-Whitney, Wilcoxon e t independente) com nivel de significância de α=0,05. O Grupo com Sindrome da Dor Patelofemoral (GSDPF) apresentou menor pontuacao (p=0,01) no questionario de Kujala (75,7±12,3 pontos) em relacao ao Grupo Controle (GC) (100±0,0 pontos), alem de menor pico de torque, tanto em 60 como 180°/s, dos flexores (0,82±0,24 Nm/kg; 0,51±0,22 Nm/kg) e extensores (1,85±0,48 Nm/kg; 1,13±0,44 Nm/kg) do joelho, bem como menor trabalho total dos extensores do joelho a 180°/s (6,46±2,54 J/kg) e 60°/s (9,42±3,27 J/kg). Alem disso, foi observado aumento da dor do GSDPF apos a avaliacao isocinetica a 180°/s (0,9 cm) e 60°/s (2,3 cm). Os resultados evidenciaram que sujeitos com SDPF possuem menor capacidade funcional e menor pico de torque e trabalho dos flexores e extensores do joelho, sugerindo que o fortalecimento desta musculatura deve ser considerado na reabilitacao destes sujeitos.

Evaluación isocinética, dolor y funcionalidad de sujetos con síndrome de dolor patelofemoral

| This study aimed at determining the influence of patellofemoral pain syndrome (PFPS) on torque peak and the work of knee flexor and extensor muscles, in addition to evaluating the pain and functionality of individuals that have this dysfunction. Fifty-two female subjects, 23 with diagnosis of PFPS, and 29 control subjects, clinically healthy and similar in age, height, and body mass participated in this study. The isokinetic evaluation was performed on concentric mode for knee flexors and extensors at speeds of 60° and 180°/s. The Visual Numerical Scale and the Kujala questionnaire were also applied before and after each speed of isokinetic testing. The data were analyzed through descriptive and inferential statistics (U Mann–Whitney, Wilcoxon, and independent t-tests) with a significance level of α=0.05. The patellofemoral pain syndrome group had lower scores (p=0.01) on the Kujala questionnaire (75.7±12.3 points) in relation to the control group (100±0.0 points), and lower peak torque of knee flexors (0.82±0.24 Nm/kg; 0.51±0.22 Nm/kg) and extensors (1.85±0.48 Nm/kg; 1.13±0.44 Nm/kg) at 60° and 180°/s as well as lower total work of knee extensors at 180°/s (6.46±2.54 Joules/kg) and 60°/s (9.42±3.27 Joules/kg). In addition, there was exacerbation of pain in the patellofemoral pain syndrome group after the isokinetic evaluation at 180°/s (0.9 cm) and 60°/s (2.3 cm). The results evidenced that individuals with PFPS have lower functional capacity, lower torque peak, and decreased function of knee flexors and extensors, which suggests that strengthening these muscles must be considered in the rehabilitation of these subjects.Este estudo visou determinar a influencia da Sindrome da Dor Patelofemoral (SDPF) sobre o pico de torque e trabalho da musculatura flexora e extensora do joelho, alem de avaliar a dor e funcionalidade de sujeitos com a disfuncao. Participaram 52 sujeitos do genero feminino, 23 com SDPF e 29 clinicamente saudaveis similares em idade, estatura e massa corporal. A avaliacao isocinetica foi realizada no modo concentrico para os flexores e extensores do joelho nas velocidades de 60 e 180°/s. Tambem foi aplicada a Escala Visual Numerica antes e apos cada velocidade do teste isocinetico e o questionario de Kujala. Os dados foram analisados pela estatistica descritiva e inferencial (testes U de Mann-Whitney, Wilcoxon e t independente) com nivel de significância de α=0,05. O Grupo com Sindrome da Dor Patelofemoral (GSDPF) apresentou menor pontuacao (p=0,01) no questionario de Kujala (75,7±12,3 pontos) em relacao ao Grupo Controle (GC) (100±0,0 pontos), alem de menor pico de torque, tanto em 60 como 180°/s, dos flexores (0,82±0,24 Nm/kg; 0,51±0,22 Nm/kg) e extensores (1,85±0,48 Nm/kg; 1,13±0,44 Nm/kg) do joelho, bem como menor trabalho total dos extensores do joelho a 180°/s (6,46±2,54 J/kg) e 60°/s (9,42±3,27 J/kg). Alem disso, foi observado aumento da dor do GSDPF apos a avaliacao isocinetica a 180°/s (0,9 cm) e 60°/s (2,3 cm). Os resultados evidenciaram que sujeitos com SDPF possuem menor capacidade funcional e menor pico de torque e trabalho dos flexores e extensores do joelho, sugerindo que o fortalecimento desta musculatura deve ser considerado na reabilitacao destes sujeitos.