Perfil de coordenação intersegmentar da pelve-joelho-pé em corredores recreacionais : diferença entre homens e mulheres
Data
2024-07-04
Autores
Brito, Rodrigo Paiva Martins 
Orientadores
Soares, Gustavo Leporace de Oliveira Lomelino
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O objetivo geral dessa dissertação foi comparar a coordenação motora intersegmentar entre corredores de ambos os sexos. Os objetivos específicos foram: (1) comparar a confiabilidade entre sessões da técnica de “Modified Vector Coding” (MVC) durante a corrida e (2) descrever e comparar entre os sexos a coordenação entre eversão do pé, flexão do joelho e drop pélvico contralateral durante a corrida usando a técnica de MVC. Métodos: Para essa dissertação no formato de copilado de artigos científicos, estão apresentados dois artigos submetidos a publicação. No primeiro artigo, selecionamos vinte e cinco corredores saudáveis de ambos os sexos que participaram de duas análises biomecânica da corrida em esteira utilizando um sistema de captura de movimento 3D. O MVC foi aplicado para avaliar a coordenação motora tridimensional entre diversos acoplamentos segmentares da pelve e dos membros inferiores. A confiabilidade entre sessões foi avaliada usando o coeficiente de correlação intraclasse, erro padrão de medida, mudança mínima detectável e análise de Bland-Altman para verificar a consistência das medidas, a concordância e a menor mudança clinicamente significativa que excede o erro da medida. No segundo artigo, participaram 73 corredores de ambos os sexos, onde foram verificados os padrões de coordenação intersegmentar e variabilidade da eversão do pé, flexão do joelho e drop pélvico contralateral durante a fase de apoio da corrida utilizando o MVC. Os ângulos da pelve, joelho e pé foram comparados entre homens e mulheres, durante a fase de apoio, usando Mapeamento Paramétrico Estatístico (SPM). Resultados. No primeiro artigo observamos que a confiabilidade teste-reteste para 33 dos 42 acoplamentos segmentares analisados foi de boa a excelente, o que comprova a robustez da técnica de MVC na biomecânica da corrida. No entanto, nove acoplamentos, especialmente fêmur-tíbia no plano sagital durante a fase de apoio médio e pé (plano frontal) – tíbia (plano transverso) durante a fase de apoio terminal, exibiram confiabilidade de pobre a moderada. Além disso, os resultados obtidos no segundo artigo, demonstraram que durante a fase de apoio terinal, entre outros achados, as mulheres mostraram maior predominância proximal em fase no acoplamento entre drop pélvico – flexão do joelho. A análise usando SPM não identificou diferenças significativas na variabilidade da coordenação ou nos ângulos de flexão do joelho e eversão do tornozelo entre os grupos. Os ângulos pélvicos mostraram diferenças entre homens e mulheres durante as fases de apoio inicial e médio.Conclusões: a maior parte dos acoplamentos determinados com a técnica de MVC para análise biomecânica da corrida apresentam de boa a excelente confiabilidade. Os acoplamentos que apresentaram baixa a moderada confiabilidade deverão ser observados com cautela para evitar erros na interpretação. Além disso, existem diferenças significativas entre os sexos na coordenação intersegmentar durante a corrida. As mulheres parecem apresentar uma maior dominância pélvica e os homens uma maior demanda do pé. Esses achados ressaltam a necessidade de abordagens específicas para cada sexo para otimizar a mecânica da corrida e as estratégias de prevenção de lesões.
Objective: the general objective of this dissertation was to compare intersegmental motor coordination between male and female runners. The specific objectives were: (1) to compare the testretest reliability of the “Modified Vector Coding” (MVC) technique during running and (2) to describe and compare foot eversion, knee flexion, and contralateral pelvic drop coordination between sexes during running using the MVC technique. Methods: this dissertation, presented as a compilation of scientific articles, includes two articles submitted for publication. In the first article, twentyfive healthy runners of both sexes participated in a biomechanical treadmill running analysis using a motion capture system. MVC was applied to assess the threedimensional motor coordination among various segmental couplings of the pelvis and lower limbs. Reliability was assessed using the intraclass correlation coefficient, standard error of measurement, minimal detectable change, and BlandAltman analysis to verify measurement consistency, agreement, and the smallest clinically significant change that exceeds measurement error. In the second article, 73 runners of both sexes participated, and the intersegmental coordination patterns and variability of foot eversion, knee flexion, and contralateral pelvic drop during the stance phase of running were assessed using MVC. Pelvis, knee, and foot angles were compared during the stance phase using Statistical Parametric Mapping (SPM). Results: the results of the first article showed that the testretest reliability for 33 out of 42 segmental couplings analyzed was good to excellent, substantiating the robustness of the MVC technique in running biomechanics. However, nine couplings, especially femurtibia in the sagittal plane during midstance and foot (frontal plane) tibia (transverse plane) during terminal stance, exhibited poor to moderate reliability. Additionally, the results obtained in the second article demonstrated that women exhibited greater distal dominance compared to men during the initial stance phase. During the terminal stance phase, among other findings, women showed greater inphase proximal dominance in the coupling between pelvic drop and knee flexion. SPM analysis did not identify significant differences in coordination variability or knee flexion and ankle eversion angles between the groups. Pelvic angles showed differences between men and women during the initial and midstance phases. Conclusions: most of the couplings determined with the MVC technique for biomechanical analysis of running exhibit good to excellent reliability. Couplings that showed poor to moderate reliability should be interpreted cautiously to avoid errors. Additionally, there are significant differences between sexes in intersegmental coordination during running. Women appear to exhibit greater pelvic dominance, whereas men have a higher foot demand. These findings highlight the need for sexspecific approaches to optimize running mechanics and injury prevention strategies.
Objective: the general objective of this dissertation was to compare intersegmental motor coordination between male and female runners. The specific objectives were: (1) to compare the testretest reliability of the “Modified Vector Coding” (MVC) technique during running and (2) to describe and compare foot eversion, knee flexion, and contralateral pelvic drop coordination between sexes during running using the MVC technique. Methods: this dissertation, presented as a compilation of scientific articles, includes two articles submitted for publication. In the first article, twentyfive healthy runners of both sexes participated in a biomechanical treadmill running analysis using a motion capture system. MVC was applied to assess the threedimensional motor coordination among various segmental couplings of the pelvis and lower limbs. Reliability was assessed using the intraclass correlation coefficient, standard error of measurement, minimal detectable change, and BlandAltman analysis to verify measurement consistency, agreement, and the smallest clinically significant change that exceeds measurement error. In the second article, 73 runners of both sexes participated, and the intersegmental coordination patterns and variability of foot eversion, knee flexion, and contralateral pelvic drop during the stance phase of running were assessed using MVC. Pelvis, knee, and foot angles were compared during the stance phase using Statistical Parametric Mapping (SPM). Results: the results of the first article showed that the testretest reliability for 33 out of 42 segmental couplings analyzed was good to excellent, substantiating the robustness of the MVC technique in running biomechanics. However, nine couplings, especially femurtibia in the sagittal plane during midstance and foot (frontal plane) tibia (transverse plane) during terminal stance, exhibited poor to moderate reliability. Additionally, the results obtained in the second article demonstrated that women exhibited greater distal dominance compared to men during the initial stance phase. During the terminal stance phase, among other findings, women showed greater inphase proximal dominance in the coupling between pelvic drop and knee flexion. SPM analysis did not identify significant differences in coordination variability or knee flexion and ankle eversion angles between the groups. Pelvic angles showed differences between men and women during the initial and midstance phases. Conclusions: most of the couplings determined with the MVC technique for biomechanical analysis of running exhibit good to excellent reliability. Couplings that showed poor to moderate reliability should be interpreted cautiously to avoid errors. Additionally, there are significant differences between sexes in intersegmental coordination during running. Women appear to exhibit greater pelvic dominance, whereas men have a higher foot demand. These findings highlight the need for sexspecific approaches to optimize running mechanics and injury prevention strategies.
Descrição
Citação
BRITO, Rodrigo Paiva Martins. Perfil de coordenação intersegmentar da pelve-joelho-pé em corredores recreacionais : diferença entre homens e mulheres. 2024. São Paulo. Dissertação (Mestrado em Medicina: radiologia clínica) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2024.