Análise da qualidade do movimento do joelho em mulheres com osteoartrite de joelho utilizando o lateral step down test
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Data
2019-11-25
Autores
Góes, Mayara Domingues Vieira de [UNIFESP]
Orientadores
Renno, Ana Claudia Muniz [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
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Resumo
A osteoartrite (OA) é uma doença articular crônica degenerativa, de origem multifatorial, que
afeta principalmente quadris, joelhos, mãos e pés, causando dor e limitações funcionais. O
aumento do número de idosos está intimamente associado ao aumento da prevalência de
osteoartrite, sendo a osteoartrite de joelho é o acometimento mais comum entre essa
população e uma das principais causas de dor no joelho e incapacidade nessa faixa etária.
Exercícios físicos são empregados tanto no tratamento quanto na prevenção de desse tipo de
patologia crônico-degenerativa e vêm apresentando resultados importantes.A literatura
também indica a potencialidade da utilização da fotobiomodulação como forma de
tratamento.Assim, Os objetivos do presente estudo foram: (1) avaliar a qualidade do
movimento do joelho através de análise de vídeo antes e após um programa de exercícios
voltados ao fortalecimento muscular e ao equilíbrio associado ou não à fotobiomodulação em
mulheres com osteoartrite de joelho; (2) avaliar a dor e a qualidade de vida relacionada ao
joelho em mulheres com osteoartrite de joelho. Além disso, avaliar a dor e a qualidade de vida
relacionada ao joelho em mulheres com osteoartrite de joelho. Este é um ensaio clínico
randomizado, controlado, cego com placebo. As participantes do presente estudo foram
randomizadas entre dois grupos: Grupo Exercício e Fotobiomodulação Ativa (GEFA, n=15) e
Grupo Exercício e Fotobiomodulação Placebo (GEFP, n=13). As participantes alocadas no
GEFA realizaram o protocolo de exercícios e aplicação de fotobiomodulação ativa, e o GEFP
realizaram o mesmo protocolo de exercício e aplicação de fotobiomodulação placebo. A
fotobiomodulação foi aplicada no joelho mais acometido pela osteoartrite. A avaliação dos
registros de imagem do lateral stepdowntest foi realizada por um pesquisador independente,
que não conhecia a alocação das participantes nos grupos e nem o momento da realização do
teste (antes ou após a intervenção). Foram incluídas no estudo 28 participantes com média de
idade de 63,3 (±4,8) anos, em sua maioria ativas fisicamente e o grau 3 foi a classificação de
OA de joelho mais comum. A análise do lateral stepdowntest indicou que houve diferença
significativa entre os grupos GEFA e GEFP apenas na avaliação final (p<0,001) embora a
mudança não tenha sido suficiente para alterar significativamente a classificação da qualidade
de movimento. Quanto à condição funcional, houve efeito da avaliação em todas as
dimensões do KOOS. Podemos concluir que, embora o programa de exercícios associado à
fotobiomodulação ativa tenha apresentado melhores escores para o teste funcional utilizado
no presente estudo, as alterações não foram suficientes para indicar melhora na classificação
da qualidade do movimento do joelho em mulheres com OA de joelho. No entanto, obtivemos
melhora para da dor e da qualidade de vida relacionada ao joelho ao final do estudo em ambos
os grupos.
Osteoarthritis (OA) is a degenerative chronic joint disease of multifactorial origin that mainly affects hips, knees, hands and feet, injuries and functional applications. The increase in the number of elderly people is closely associated with the increased prevalence of osteoarthritis, being a knee osteoarthritis or the most common involvement among these populations and a major cause of knee pain and disability in this age group. Physicalexercises are employed to treat and prevent this type of chronic degenerative pathology and have important results. The literature also indicates the potential use of photobiomodulation as a form of treatment. Thus, the objectives of the present study were: (1) to evaluate the quality of knee movement through video analysis before and after an exercise program aimed at muscle strengthening and balance associated or not with photobiomodulation in women with knee osteoarthritis; (2) evaluate knee quality of life in women with knee osteoarthritis. In addition, to evaluate the degree of pain and quality of life at the knee in women with knee osteoarthritis. This is a randomized, placebo-controlled controlled trial. As participants in the present study, they were randomized between two groups: Active Exercise and Photobiomodulation Group (GEFA, n = 15) and Placebo Exercise and Photobiomodulation Group (GEFP, n = 13). As GEFA-allocated participants, run the active photobiomodulation exercise protocol and applications, and GEFP run the same exercise photobiomodulation exercise protocol and applications. Photobiomodulationwas applied to the knee most affected by osteoarthritis. The evaluation of the lateral lowering test image records was performed by an independent researcher who received no allocation of participants in groups nor the time of the test (before or after an intervention). Twenty-eight participants with a mean age of 63.3 (± 4.8) years were included in the study, mostly physical activity and grade 3 wasthe most common knee OA classification. An analysis of the lateral reduction test indicated that there was a significant difference between the GEFA and GEFP groups only in the final assessment (p <0.001), although the change was not sufficient to change the quality of movement classification. Regarding the functional condition, there was an effect of the evaluation on all KOOS dimensions. We can conclude that, although the exercise program associated with active photobomodulation presented better results for the functional test used in the present study, since the alterations were not used to indicate improvements in the classification of knee movement quality in women with knee OA. However, there are improvements in pain and knee quality of life at the end of the study in both groups
Osteoarthritis (OA) is a degenerative chronic joint disease of multifactorial origin that mainly affects hips, knees, hands and feet, injuries and functional applications. The increase in the number of elderly people is closely associated with the increased prevalence of osteoarthritis, being a knee osteoarthritis or the most common involvement among these populations and a major cause of knee pain and disability in this age group. Physicalexercises are employed to treat and prevent this type of chronic degenerative pathology and have important results. The literature also indicates the potential use of photobiomodulation as a form of treatment. Thus, the objectives of the present study were: (1) to evaluate the quality of knee movement through video analysis before and after an exercise program aimed at muscle strengthening and balance associated or not with photobiomodulation in women with knee osteoarthritis; (2) evaluate knee quality of life in women with knee osteoarthritis. In addition, to evaluate the degree of pain and quality of life at the knee in women with knee osteoarthritis. This is a randomized, placebo-controlled controlled trial. As participants in the present study, they were randomized between two groups: Active Exercise and Photobiomodulation Group (GEFA, n = 15) and Placebo Exercise and Photobiomodulation Group (GEFP, n = 13). As GEFA-allocated participants, run the active photobiomodulation exercise protocol and applications, and GEFP run the same exercise photobiomodulation exercise protocol and applications. Photobiomodulationwas applied to the knee most affected by osteoarthritis. The evaluation of the lateral lowering test image records was performed by an independent researcher who received no allocation of participants in groups nor the time of the test (before or after an intervention). Twenty-eight participants with a mean age of 63.3 (± 4.8) years were included in the study, mostly physical activity and grade 3 wasthe most common knee OA classification. An analysis of the lateral reduction test indicated that there was a significant difference between the GEFA and GEFP groups only in the final assessment (p <0.001), although the change was not sufficient to change the quality of movement classification. Regarding the functional condition, there was an effect of the evaluation on all KOOS dimensions. We can conclude that, although the exercise program associated with active photobomodulation presented better results for the functional test used in the present study, since the alterations were not used to indicate improvements in the classification of knee movement quality in women with knee OA. However, there are improvements in pain and knee quality of life at the end of the study in both groups
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Citação
GÓES, Mayara Domingues Vieira de. Análise da qualidade do movimento do joelho em mulheres com osteoartrite de joelho utilizando o lateral step down test. 2019. 53 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade (ISS), Universidade Federal de São Paulo (UNIFESP), Santos, 2019.