Efetividade do método McKenzie de diagnóstico e terapia mecânica para incapacidade funcional específica em praticantes do Brazilian jiu jitsu com dores crônicas no joelho: um ensaio clínico pragmático, controlado e randomizado
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2022-07-05
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Tese de doutorado
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Introdução: O Brazilian Jiu Jitsu (BJJ) é uma modalidade individual de combate de solo que apresenta alta prevalência de sintomas musculoesqueléticos, sendo o joelho a região mais acometida. Como opção de tratamento fisioterapêutico, encontramos na literatura o método McKenzie de Diagnóstico e Terapia Mecânica (MDT), sistema que possui metodologia própria de avaliação e tratamento para sintomas musculoesquelético no âmbito axial e/ou apendicular. Objetivos: O Objetivo principal do presente estudo foi investigar a efetividade do MDT no tratamento de PBJJ com dores crônicas no joelho, portadores da classificação diagnóstica de Síndrome do Desarranjo, através do desfecho primário de incapacidade funcional específica e desfechos secundários de intensidade da dor e evitação do medo, através do índice de simetria dos membros inferiores. Para que o desfecho primário pudesse ser atingido, ainda como desfecho secundário, foi investigado a prevalência de classificação diagnóstica MDT em PBJJ com dores crônicas no joelho. Métodos: Sessenta e cinco PBJJ com dores crônicas no joelho foram avaliados e classificados de acordo com as próprias diretrizes do MDT. Após a classificação, 28 PBJJ, diagnosticados com a Síndrome do Desarranjo, foram randomizados aos pares em grupos de intervenção (GI) e controle (GC). O período de intervenção foi de 6 semanas e acompanhado por mais 4 semanas. Resultados: Os PBJJ alocados para o GI tiveram reduções maiores na incapacidade funcional específica e na intensidade da dor nas semanas 6 e 10 e tiveram melhoras na simetria dos membros inferiores na semana 6. Conclusão: A intervenção pelos conceitos do MDT mostrou efeitos clínicos positivos na incapacidade funcional específica e na intensidade da dor que foram permanentes por quatro semanas. Para a evitação do medo, através do índice de simetria dos membros inferiores, efeitos positivos também foram obtidos após a intervenção. Assim podemos concluir que o MDT é eficaz para o tratamento da incapacidade funcional específica, intensidade da dor e evitação do medo de PBJJ diagnosticados com a classificação de Síndrome do Desarranjo.
Introduction: Brazilian Jiu Jitsu (BJJ) is an individual ground combat modality that has a high prevalence of musculoskeletal symptoms, with the knee being the most affected region. As a physiotherapeutic treatment option, we found in the literature the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), a system that has its own methodology for evaluating and treating musculoskeletal symptoms in the axial and/or appendicular scope. Objectives: The main objective of the present study was to investigate the effectiveness of MDT in the treatment of PBJJ with chronic knee pain, with the diagnostic classification of Derangement Syndrome, through the primary outcome of specific functional disability and secondary outcomes of pain intensity and avoidance of pain. fear, through the symmetry index of the lower limbs. In order to reach the primary outcome, still as a secondary outcome, the prevalence of MDT diagnostic classification in PBJJ with chronic knee pain was investigated. Methods: Sixty-five PBJJs with chronic knee pain were evaluated and classified according to the MDT's own guidelines. After classification, 28 PBJJ, diagnosed with Derangement Syndrome, were randomized in pairs into intervention (IG) and control (CG) groups. The intervention period was 6 weeks and was followed up for another 4 weeks. Results: Intervention by MDT concepts showed positive clinical effects on specific functional disability and pain intensity that were permanent for four weeks. For fear avoidance, through the lower limb symmetry index, positive effects were also obtained after the intervention. Thus, we can conclude that MDT is effective for the treatment of specific functional disability, pain intensity and fear avoidance of PBJJ diagnosed with the classification of Derangement Syndrome.
Introduction: Brazilian Jiu Jitsu (BJJ) is an individual ground combat modality that has a high prevalence of musculoskeletal symptoms, with the knee being the most affected region. As a physiotherapeutic treatment option, we found in the literature the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), a system that has its own methodology for evaluating and treating musculoskeletal symptoms in the axial and/or appendicular scope. Objectives: The main objective of the present study was to investigate the effectiveness of MDT in the treatment of PBJJ with chronic knee pain, with the diagnostic classification of Derangement Syndrome, through the primary outcome of specific functional disability and secondary outcomes of pain intensity and avoidance of pain. fear, through the symmetry index of the lower limbs. In order to reach the primary outcome, still as a secondary outcome, the prevalence of MDT diagnostic classification in PBJJ with chronic knee pain was investigated. Methods: Sixty-five PBJJs with chronic knee pain were evaluated and classified according to the MDT's own guidelines. After classification, 28 PBJJ, diagnosed with Derangement Syndrome, were randomized in pairs into intervention (IG) and control (CG) groups. The intervention period was 6 weeks and was followed up for another 4 weeks. Results: Intervention by MDT concepts showed positive clinical effects on specific functional disability and pain intensity that were permanent for four weeks. For fear avoidance, through the lower limb symmetry index, positive effects were also obtained after the intervention. Thus, we can conclude that MDT is effective for the treatment of specific functional disability, pain intensity and fear avoidance of PBJJ diagnosed with the classification of Derangement Syndrome.
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SILVA, Douglas Roberto. Efetividade do método McKenzie de diagnóstico e terapia mecânica para incapacidade funcional específica em praticantes do Brazilian jiu jitsu com dores crônicas no joelho: um ensaio clínico pragmático, controlado e randomizado. 2022. 76 f. Tese (Doutorado em Ciências do Movimento Humano e Reabilitação) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2022.