Treinamento de funcionalidade e controle postural em pacientes com fasciíte plantar
Data
2021-10-01
Autores
Martinez, Bruna Reclusa 
Orientadores
Yi, Liu Chiao
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Comparar o efeito do (i) fortalecimento dos músculos estabilizadores centrais do tronco (Pilates) e (ii) fortalecimento dos músculos estabilizadores centrais e dos pés (Pilates + Foot Core) em pacientes com fasciíte plantar, nos desfechos dor, função, mobilidade dos pés e mudança global, oito semanas após a randomização. Método: Trata-se de um ensaio controlado aleatorizado com cegamento do avaliador. Participaram do estudo 35 voluntários com diagnóstico de fasciíte plantar unilateral ou bilateral, de ambos os sexos e idade entre 35 e 65 anos. Os pacientes que preencheram os critérios do estudo foram avaliados e randomizados em dois grupos de tratamento para a fasciíte plantar. Os voluntários alocados para o Grupo Pilates receberam fortalecimento dos músculos estabilizadores centrais do tronco. Aqueles alocados para Grupo Pilates + Foot Core, receberam fortalecimento dos músculos estabilizadores centrais do tronco acrescido do fortalecimento dos músculos estabilizadores dos pés. As intervenções tiveram duração de oito semanas, com frequência semanal de dois dias, durante 50-60 minutos. Os voluntários foram avaliados antes (T0) e após as oito semanas de intervenção (T1) em relação aos desfechos dor (escala numérica de dor), função (domínios incapacidade, dificuldade, dor e score total do questionário Foot Function Index – FFI), mobilidade dos pés (índice do arco longitudinal medial – ALM) e mudança global relatada pelo paciente (escala Global Rating of Change – GRC). Após os intervalos de cinco e oito meses os voluntários foram reavaliados pelos desfechos dor e função, utilizando um formulário eletrônico. Para comparar o efeito das intervenções entre os grupos, nos intervalos de oito semanas, cinco e oito meses, foi utilizado o teste de Mann-Whitney com nível de significância de p< 0,05. Resultados: Até o momento, foram avaliados 59 participantes. Destes, 35 foram randomizados em dois grupos de tratamento, 15 alocados para o Grupo Pilates e 20 alocados para o Grupo Pilates + Foot Core. Ao analisar as diferenças entre os dois grupos de intervenção, foram encontradas diferenças estatisticamente significativas apenas para os desfechos função (incapacidade, p= 0,030) e mobilidade dos pés (índice do ALM, p= 0,013), ambos no intervalo de oito semanas, apresentando tamanho de efeito moderado. Conclusão: O estudo concluiu que o efeito do Grupo Pilates + Foot Core foi superior ao Grupo Pilates apenas para a variável incapacidade do questionário FFI e para o desfecho mobilidade dos pés, após oito semanas de intervenção. O método Pilates promoveu redução da dor e melhora da função em indivíduos com fasciíte plantar. Ao adicionar o fortalecimento da musculatura estabilizadora dos pés, os efeitos da intervenção mantiveram-se até oito meses após a randomização.
Objectives: To compare the effect of (i) strengthening the central stabilizing muscles of the trunk (Pilates) and (ii) strengthening the central and distal stabilizer muscles (Pilates + Foot Core) in patients with plantar fasciitis, on the outcomes of pain, function, foot mobility and global change, eight weeks after randomization. Method: This is a randomized controlled trial with an evaluator blinded. The study included 35 volunteers diagnosed with unilateral or bilateral plantar fasciitis, of both genders and aged between 35 and 65 years old. Patients who met study criteria were evaluated and randomized into two treatment groups for plantar fasciitis. The volunteers allocated to the Pilates Group received strengthening of the central stabilizing muscles of the trunk. Those allocated to the Pilates + Foot Core Group received strengthening of the central stabilizing muscles of the trunk plus the strengthening of the distal stabilizer muscles. The interventions lasted eight weeks, with a weekly frequency of two days, for 50-60 minutes. Volunteers were evaluated before (T0) and after eight weeks of intervention (T1) about the outcomes pain (numerical pain scale), function (disability, activity limitation, and pain domains of the Foot Function Index questionnaire – FFI), foot mobility (medial longitudinal arch index – MLA), and patient-reported global change (Global Rating of Change). After intervals of five and eight months, volunteers were evaluated for pain and function outcomes, using an electronic form. To compare the effect of interventions between groups, at intervals of eight weeks, five, and eight months, the Mann-Whitney test was used. A significance level of p< 0.05 was established. Results: 59 participants were evaluated. Of these, 35 were randomized into two treatment groups, 15 allocated to the Pilates Group and 20 allocated to the Pilates + Foot Core Group. When analyzing the differences between the two intervention groups, statistically significant differences were found only for the outcomes function (disability, p= 0.030) and foot mobility (MLA index, p= 0.013), both within an eight-week interval, with moderate effect size. Conclusion: The study concluded that the effect of the Pilates + Foot Core Group was superior to the Pilates Group only for the disability variable and for the foot mobility outcome, after eight weeks of intervention. The Pilates method reduced pain and increased function in individuals with plantar fasciitis. By adding the strengthening of the distal stabilizer musculature, the effects of the intervention were maintained for up to eight months after randomization.
Objectives: To compare the effect of (i) strengthening the central stabilizing muscles of the trunk (Pilates) and (ii) strengthening the central and distal stabilizer muscles (Pilates + Foot Core) in patients with plantar fasciitis, on the outcomes of pain, function, foot mobility and global change, eight weeks after randomization. Method: This is a randomized controlled trial with an evaluator blinded. The study included 35 volunteers diagnosed with unilateral or bilateral plantar fasciitis, of both genders and aged between 35 and 65 years old. Patients who met study criteria were evaluated and randomized into two treatment groups for plantar fasciitis. The volunteers allocated to the Pilates Group received strengthening of the central stabilizing muscles of the trunk. Those allocated to the Pilates + Foot Core Group received strengthening of the central stabilizing muscles of the trunk plus the strengthening of the distal stabilizer muscles. The interventions lasted eight weeks, with a weekly frequency of two days, for 50-60 minutes. Volunteers were evaluated before (T0) and after eight weeks of intervention (T1) about the outcomes pain (numerical pain scale), function (disability, activity limitation, and pain domains of the Foot Function Index questionnaire – FFI), foot mobility (medial longitudinal arch index – MLA), and patient-reported global change (Global Rating of Change). After intervals of five and eight months, volunteers were evaluated for pain and function outcomes, using an electronic form. To compare the effect of interventions between groups, at intervals of eight weeks, five, and eight months, the Mann-Whitney test was used. A significance level of p< 0.05 was established. Results: 59 participants were evaluated. Of these, 35 were randomized into two treatment groups, 15 allocated to the Pilates Group and 20 allocated to the Pilates + Foot Core Group. When analyzing the differences between the two intervention groups, statistically significant differences were found only for the outcomes function (disability, p= 0.030) and foot mobility (MLA index, p= 0.013), both within an eight-week interval, with moderate effect size. Conclusion: The study concluded that the effect of the Pilates + Foot Core Group was superior to the Pilates Group only for the disability variable and for the foot mobility outcome, after eight weeks of intervention. The Pilates method reduced pain and increased function in individuals with plantar fasciitis. By adding the strengthening of the distal stabilizer musculature, the effects of the intervention were maintained for up to eight months after randomization.
Descrição
Citação
MARTINEZ, Bruna Reclusa. Treinamento de funcionalidade e controle postural em pacientes com fasciíte plantar. 2021. 128 f. Tese (Doutorado em Ciências do Movimento Humano e Reabilitação) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2021.