Função muscular isocinética de acordo com o nível de atividade física em adultos entre 20 e 80 anos
Data
2020-10-08
Autores
Navarro, Renato Caleiro 
Orientadores
Dourado, Victor Zuniga
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A avaliação isocinética é o método padrão-ouro para avaliar a função muscular periférica. Sua maior vantagem está no controle da velocidade do movimento, possibilitando uma medição detalhada ao longo de toda amplitude de movimento. Os valores de normalidade para a dinamometria isocinética são escassos e restritos ao joelho. Tendo em vista que a função muscular dos membros inferiores e superiores apresentam alterações em proporções diferentes em relação à idade e sexo, é necessário avaliar os percentis de normalidade da função muscular tanto da função muscular isocinética de joelho quanto de cotovelo. Objetivos: Avaliar os percentis de normalidade da função muscular isocinética do joelho e cotovelo e elaborar equações de referência em adultos saudáveis entre 20 e 80 anos. Secundariamente, avaliar a influência do nível de atividade física na função muscular isocinética desses adultos, bem como os atributos cardiometabólicos, clínicos e fisiológicos determinantes da função muscular em adultos assintomáticos. Materiais e métodos: Foram avaliados 1334 indivíduos adultos entre 20-80 anos selecionados do estudo Epidemiológico do Movimento Humano (EPIMOV). A priori, foi realizada uma avaliação clínica, seguida da obtenção das medidas antropométricas. A composição corporal foi obtida por meio de bioimpedância elétrica e o nível de atividade física habitual foi avaliado através de acelerometria triaxial. A função muscular tanto de joelho quanto de cotovelo foi avaliada por meio de dinamometria isocinética. Por meio de modelos de regressão múltipla lineares do tipo stepwise, foram elaboradas equações de predição da função muscular isocinética de cotovelo e joelho. Os percentis de normalidade da função muscular foram descritos segundo o sexo abaixo de 20-39 anos, 40-59 anos e com 60 anos ou mais. Resultados: A amostra foi composta sobretudo por mulheres de meia-idade, com sobrepeso e alta prevalência de inatividade física. Após análise de regressão linear múltipla do tipo stepwise ajustada por variáveis demográficas e antropométricas, a atividade física modera a intensa (AFMI) e os fatores de risco para doenças cardiovasculares foram considerados preditores significativos da função muscular de joelho e cotovelo. Apesar dos modelos explicarem de 49,6 a 70,9% da variabilidade total da função muscular de joelho e cotovelo, a AFMI e os fatores de risco para doença cardiovascular pouco contribuíram para o coeficiente de determinação (R2 = 0,003 a 0,006). Sendo assim, as variáveis demográficas e antropométricas foram preditores mais importantes em comparação à AFMI e os fatores de risco cardiovasculares nos modelos construídos, explicando de 52,5-70,9% e 49-70,7% da variabilidade da função muscular de joelho e cotovelo, respectivamente. Conclusão: Apesar de se correlacionar com a função muscular tanto de joelho quanto de cotovelo, o nível de atividade física habitual pouco explica a variabilidade da função muscular, a qual é amplamente determinada por variáveis antropométricas e sociodemográficas em adultos sem doenças crônicas sintomáticas. As tabelas de percentis e as equações desenvolvidas irão contribuir para melhor capacidade interpretativa da avaliação da função muscular avaliada por meio do dinamômetro isocinético, e, consequentemente, favorecer ainda mais sua aplicabilidade clínica.
Introduction: Isokinetic dynamometry is the gold standard method for assessing peripheral muscle function, which main advantage is the possibility of control the movement speed allowing a detailed measurement across the entire range of motion. Reference values for isokinetic dynamometry are scarce and restricted to the knee joint. Since muscle function of lower and upper limbs changes in different proportions regarding sex and age, it is necessary to evaluate the normality of the isokinetic muscle function for both elbow and knee. Objectives: To evaluate the percentiles of normality of the isokinetic muscle function of the knee and elbow joints and to develop equations to predict muscle function in healthy adults between 20 and 80 years old. Secondarily, to evaluate whether physical activity level determines the isokinetic muscle function, as well as risk factors for cardiovascular disease, in asymptomatic adults. Methods: 1334 adult subjects aged 20-80 years selected from the Epidemiological Study on Human Movement (EPIMOV Study) were evaluated. At first, a clinical evaluation was carried out, followed by anthropometric measurements. Body composition was assessed using electrical bioimpedance and the physical activity level was obtained through a triaxial accelerometer. Muscle function of knee and elbow was assessed using an isokinetic dynamometer. The equations to predict isokinetic muscle function were developed through linear stepwise multiple regression analysis. The percentiles of normal muscle function were described according to sex and age (20-39 years, 40-59 years and > 60 years). Results: The sample was composed mainly of middle-aged, overweight women with a high prevalence of physical inactivity and risk factors for cardiovascular disease. After stepwise multiple linear regression analysis adjusted for demographic and anthropometric variables, moderate to vigorous physical activity (MVPA) and risk factors for cardiovascular disease were considered significant predictors of isokinetic knee and elbow muscle function. Although the models account for 49.6 to 70.9% of the total variability in isokinetic knee and elbow muscle function, MVPA and risk factors for cardiovascular disease presented a little influence on the determination coefficient (R 2 = 0.003 to 0.006). Thus, demographic and anthropometric variables were more important predictors of isokinetic muscle function in comparison with MVPA and risk factors for cardiovascular disease, explaining 52.5-70.9% and 49-70.7% of the variability of knee and elbow muscle function, respectively. Conclusion: Despite being correlated with muscle function of knee and elbow, the physical activity level does not explain the variability of muscle function, which is largely determined by anthropometric and sociodemographic variables in asymptomatic adults. The percentile tables and developed equations will contribute to a better interpretive capacity of the muscle function assessment through isokinetic dynamometer and hence favor its clinical applicability
Introduction: Isokinetic dynamometry is the gold standard method for assessing peripheral muscle function, which main advantage is the possibility of control the movement speed allowing a detailed measurement across the entire range of motion. Reference values for isokinetic dynamometry are scarce and restricted to the knee joint. Since muscle function of lower and upper limbs changes in different proportions regarding sex and age, it is necessary to evaluate the normality of the isokinetic muscle function for both elbow and knee. Objectives: To evaluate the percentiles of normality of the isokinetic muscle function of the knee and elbow joints and to develop equations to predict muscle function in healthy adults between 20 and 80 years old. Secondarily, to evaluate whether physical activity level determines the isokinetic muscle function, as well as risk factors for cardiovascular disease, in asymptomatic adults. Methods: 1334 adult subjects aged 20-80 years selected from the Epidemiological Study on Human Movement (EPIMOV Study) were evaluated. At first, a clinical evaluation was carried out, followed by anthropometric measurements. Body composition was assessed using electrical bioimpedance and the physical activity level was obtained through a triaxial accelerometer. Muscle function of knee and elbow was assessed using an isokinetic dynamometer. The equations to predict isokinetic muscle function were developed through linear stepwise multiple regression analysis. The percentiles of normal muscle function were described according to sex and age (20-39 years, 40-59 years and > 60 years). Results: The sample was composed mainly of middle-aged, overweight women with a high prevalence of physical inactivity and risk factors for cardiovascular disease. After stepwise multiple linear regression analysis adjusted for demographic and anthropometric variables, moderate to vigorous physical activity (MVPA) and risk factors for cardiovascular disease were considered significant predictors of isokinetic knee and elbow muscle function. Although the models account for 49.6 to 70.9% of the total variability in isokinetic knee and elbow muscle function, MVPA and risk factors for cardiovascular disease presented a little influence on the determination coefficient (R 2 = 0.003 to 0.006). Thus, demographic and anthropometric variables were more important predictors of isokinetic muscle function in comparison with MVPA and risk factors for cardiovascular disease, explaining 52.5-70.9% and 49-70.7% of the variability of knee and elbow muscle function, respectively. Conclusion: Despite being correlated with muscle function of knee and elbow, the physical activity level does not explain the variability of muscle function, which is largely determined by anthropometric and sociodemographic variables in asymptomatic adults. The percentile tables and developed equations will contribute to a better interpretive capacity of the muscle function assessment through isokinetic dynamometer and hence favor its clinical applicability
Descrição
Citação
NAVARRO, Renato Caleiro. Função muscular isocinética de acordo com o nível de atividade física em adultos entre 20 e 80 anos. 2020. 56 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020.