Efeito de um programa de fortalecimento dos músculos rotadores do ombro sobre o equilíbrio muscular e a eficácia do arremesso
Data
2014-08-31
Autores
Mascarin, Naryana Cristina 
Orientadores
Papa, Marilia Andrade
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O desequilíbrio entre os músculos rotadores dos ombros tem sido considerado um fator de risco para lesões desta articulação, principalmente para atletas de arremesso. Objetivos: verificar a efetividade do programa de treinamento de força (PTF) direcionado para o reequilíbrio entre os músculos rotadores do ombro e a possível influência deste programa na qualidade do arremesso do handebol. Métodos: Noventa e sete articulações do ombro de jogadoras de handebol (14 a 17 anos) foram avaliadas e divididas aleatoriamente em grupo experimental [GE (n=50)] e grupo controle [GC (n=47)], todas apresentaram desequilíbrio muscular caracterizado pela fraqueza de RMs e RLs. O GE participou do PTF com resistência progressiva de faixa elástica realizado por seis semanas, três vezes por semana. Os treinamentos de handebol foram mantidos para ambos os grupos. Antes e após o PTF os GE e GC realizaram teste de força isocinética de RMs e RLs dos ombros. O pico de torque (PT), trabalho total (TT) e potência média (PM) foram medidos em 60⁰/s e 240⁰/s no modo concêntrico e em 240⁰/s no modo excêntrico. Foram calculadas as relações de equilíbrio convencional (RC) (PT concêntrico de RMs / PT concêntrico de RLs) e relação de equilíbrio funcional (RF) (PT excêntrico de RLs /PT concêntrico de RMs). Foram realizados dois testes de acurácia e velocidade do arremesso, posição parada (marca do pênalti) e saltando (linha dos nove metros). Resultados: Após o PTF de RLs houve uma melhora do PT (p=0,00) e TT (p=0,00) do lado dominante e melhora do PT (p=0,01) e do TT (p=0,01) do lado não dominante em 60⁰/s. As mesmas variáveis medidas na velocidade de 240⁰/s não melhoraram. As RC e RF não melhoraram do lado dominante, apesar de terem ficado dentro do limite de normalidade após o PTF. Do lado não dominante houve melhora significativa da RC (p=0,03) e RF (p=0,00). A velocidade da bola melhorou no teste 1 realizado de forma parada pelo lado dominante, sem alteração da acurácia do arremesso. No lado não dominante não houve variação da velocidade e acurácia do arremesso. O GE que participou do PTF de RMs apresentou melhora bilateral da PM, sem variação do PT, TT e das RC e RF. Houve também melhora significativa da velocidade da bola no teste 2 parado (p=0,04) e saltando (p=0,00). Conclusão: O PTF direcionado para RLs foi eficiente para melhorar o PT e também a relação de equilíbrio muscular, sem qualquer prejuízo da velocidade ou acurácia do arremesso. O PTF direcionado para RMs mostrou-se eficiente para melhorar a PM e a velocidade da bola, sem maximizar a melhora do PT e das relações de equilíbrio muscular.
The imbalance between the shoulder rotator muscles has been considered a risk factor for injuries, especially for throwing athletes. Objetives: verify the effectiveness of a strength training program (STP) directed to the rebalance shoulder rotator muscles strength and the program influence on the movement quality of throwing a ball by handball players. Methods: Ninety-seven shoulder joints of handball players (14-17years) were evaluated and randomly assigned to either experimental group [EG (n=50)] or control group [CG (n=47)], all showed muscle imbalance characterized by weakness of MRs and LRs. The EG participated in the STP with progressive resistance of elastic band performed for six weeks, three times a week. The handball training was maintained for both groups. Before and after the STP, both groups performed a isokinetic strength test of shoulder MRs and LRs shoulders. Peak torque (PT), total work (TT) and mean power (MP) were measured at 60⁰/s and 240⁰/s in concentric mode and at 240⁰/s in eccentric mode. Convectional balance ratio (CR) (MRs concentric PT/LRs concentric PT) and functional balance ratio (FR) (LRs eccentric PT/MRs concentric PT) were calculated. Two tests of accuracy and speed of the throwing were performed in standing position (penalty spot) and preceded by jumping (line meters nine). Results: After the STP LRs PT (p=0.00) and TT (p=0.00) at 60⁰/s improved in dominant side LRs PT (p=0.01) and TT (p=0.01) at 60⁰/s in the non-dominant side. At 240⁰/s there were no changes pre versus post STP. The CR and FR were not improved in the dominant side, although they were within the normal range after the STP. The non-dominant side presented no significant improvement of CR (p=0.03) and FR (p=0.00). The throwing speed improved in tests 1 performed by the subject´s dominant side in standing position, with no change in accuracy. The non-dominant side presented unchanged speed and accuracy. The MRs of EG who attended the STP presented a bilateral improvement of MP without variation of PT, TT, CR and FR. There was also a significant improvement in the speed of the throw at test 2 both at standing position (p=0.04) and at the jumping movement (p=0.00). Conclusions: The STP directed to LRs was efficient to improve LRs PT and muscle balance ratio as well, without any injury to the speed or to the accuracy of the throw. The STP direted to MRs proved efficient to improve the MP and the speed of the ball, without maximizing the improvement of the PT and muscle balance ratio.
The imbalance between the shoulder rotator muscles has been considered a risk factor for injuries, especially for throwing athletes. Objetives: verify the effectiveness of a strength training program (STP) directed to the rebalance shoulder rotator muscles strength and the program influence on the movement quality of throwing a ball by handball players. Methods: Ninety-seven shoulder joints of handball players (14-17years) were evaluated and randomly assigned to either experimental group [EG (n=50)] or control group [CG (n=47)], all showed muscle imbalance characterized by weakness of MRs and LRs. The EG participated in the STP with progressive resistance of elastic band performed for six weeks, three times a week. The handball training was maintained for both groups. Before and after the STP, both groups performed a isokinetic strength test of shoulder MRs and LRs shoulders. Peak torque (PT), total work (TT) and mean power (MP) were measured at 60⁰/s and 240⁰/s in concentric mode and at 240⁰/s in eccentric mode. Convectional balance ratio (CR) (MRs concentric PT/LRs concentric PT) and functional balance ratio (FR) (LRs eccentric PT/MRs concentric PT) were calculated. Two tests of accuracy and speed of the throwing were performed in standing position (penalty spot) and preceded by jumping (line meters nine). Results: After the STP LRs PT (p=0.00) and TT (p=0.00) at 60⁰/s improved in dominant side LRs PT (p=0.01) and TT (p=0.01) at 60⁰/s in the non-dominant side. At 240⁰/s there were no changes pre versus post STP. The CR and FR were not improved in the dominant side, although they were within the normal range after the STP. The non-dominant side presented no significant improvement of CR (p=0.03) and FR (p=0.00). The throwing speed improved in tests 1 performed by the subject´s dominant side in standing position, with no change in accuracy. The non-dominant side presented unchanged speed and accuracy. The MRs of EG who attended the STP presented a bilateral improvement of MP without variation of PT, TT, CR and FR. There was also a significant improvement in the speed of the throw at test 2 both at standing position (p=0.04) and at the jumping movement (p=0.00). Conclusions: The STP directed to LRs was efficient to improve LRs PT and muscle balance ratio as well, without any injury to the speed or to the accuracy of the throw. The STP direted to MRs proved efficient to improve the MP and the speed of the ball, without maximizing the improvement of the PT and muscle balance ratio.
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Citação
MASCARIN, Naryana Cristina. Efeito de um programa de fortalecimento dos músculos rotadores do ombro sobre o equilíbrio muscular e a eficácia do arremesso. 2014. Tese (Doutorado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.