Síndrome da dor fêmoro-patelar: implicações para a fisioterapia
DOI:
https://doi.org/10.33233/fb.v8i5.1806Resumo
A proposta deste artigo foi sintetizar o conhecimento científico relevante a respeito da síndrome da dor fêmoro-patelar (SDFP) e discutir as implicações para a fisioterapia. A análise da literatura corrente revela que a causa da SDFP é multifatorial, tendo várias particularidades anatômicas, mecânicas e neuromusculares, as quais podem atuar como fatores geradores dessa síndrome. Essas observações exigem que o fisioterapeuta busque uma análise criteriosa e individual dos portadores de SDFP, a fim de propor estratégias adequadas a cada caso.
Palavras-chave: fisioterapia, patela, traumatismos do joelhoReferências
Huberti HH, Hayes WC. Patellofemoral contact pressures: The influence of Q-angle and tendofemoral contact. J Bone Joint Surg 1984;66A:715-23.
Johnson DP, Eastwood DM, Witherow PJ. Symptomatic sinovial plicae of the knee. J Bone Joint Surg 1993;75A:1485-96.
Jackson AM. Anterior knee pain. J Bone Joint Surg 2001;83B:937-48.
McConnell J. The management of chondromalacia patellae: A long-term solution. Austr J Physiother 1986;32:215-23.
Powers CM. Rehabilitation of patellofemoral joint disorders: A critical review. J Orthop Sports Phys Ther 1998;28:345-354.
Powers CM, Maffucci R, Hampton S. Rearfoot posture in subjects with patellofemoral pain. J Orthop Sports Phys Ther 1995;22:155-60.
Fairbank JCT, Pynsent PB, Poortvliet JA, Phillips H. Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg 1984;66B:685-93.
Messier SP, Davo SE, Curl WW, Lowery RB, Pack RJ. Etiologic factors associated with patellofemoral pain in runners. Med Sci Sports Exerc 1991;23:1008-15.
Brody LT, Thein JM. Nonoperative treatment for patellofemoral pain. J Orthop Sports Phys Ther 1998;28:336-44.
Karst GM, Willet GM. Onset timing of electromyographic activity in vastus medialis oblique and vastus lateralis muscles in subjects with and without patellofemoral pain syndrome. Phys Ther 1995;75:813-23.
Kapandji IA. Fisiologia articular: membro inferior. 5a ed. São Paulo: Manole, 1990. p.74-157.
Lieb FJ, Perry J. Quadriceps function: An anatomical and mechanical study using amputated limbs. J Bone Joint Surg 1968;50:1535-48.
Wiberg G. Roentgenographic and anatomic studies on the femoropatellar joint. Acta Orthop Scand 1941;12:319-410.
Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971;101:101-4.
Skalley TC, Terry GC, Teitge RA. The quantitative measurement of normal passive medial and lateral patellar motion limits. Am Sports Med 1993;21:728-732.
Tomisich DA, Nitz AJ, Threlkeld AJ, Shapiro R. Patellofemoral alignment: reliability. J Orthop Sports Phys Ther 1996;23:200-8.
Grabiner MD, Koh TJ, Draganich LF. Neuromechanics of the patellofemoral joint. Med Sci Sports Exerc 1994;26:10-21.
Livingston LA. The quadriceps angle: A review of the literature. J Orthop Sports Phys Ther 1998;28:105-9.
Caylor D, Fites R, Worrell TW. The relationship between quadriceps angle and anterior knee pain syndrome. J Orthop Sports Phys Ther 1993;17:11-16.
Hvid I, Andersen LI. The quadriceps angle and its relation to femoral torsion. Acta Orthop Scand 1982;53:577-79.
Olerud C, Berg P. The variation of the Q angle with different positions of the foot. Clin Orthop Related Res 1984;191:162-65.
Shellock FG, Mink JH, Deutsch, AL, Foo TKF. Kinematic MR imaging of the patellofemoral joint: Comparison of passive positioning and active movement techniques. Radiology 1992;184:574-77.
Voight ML, Wieder DL. Comparative reflex response times of vastus medialis obliquus and vastus lateralis in normal subjects and subjects with extensor mechanism dysfunction. Am J Sports Med 1991;10:131-37.
Witvrouw E, Sneyers C, Lysens R, Victor J, Bellemans J. Reflex response times of vastus medialis oblique and vastus lateralis in normal subjects and in subjects with patellofemoral pain syndrome. J Orthop Sports Phys Ther 1996;24:160-65.
Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML. Changes in soleus motoroneuron pool excitability after artificial knee joint effusion. Arch Phys Rehabil 2000;81:1199-203.
De Andrade JR, Grant C, Dixon AJ. Joint distension and reflex muscle in the knee. J Bone Joint Surg 1965;47A:313-21.
Leroux A, Bélanger M, Boucher JP. Pain effect on monosynaptic and polysynaptic reflex inhibition. Arch Phys Med Rehabil 1995;76:576-82.
Young A, Stokes M, Iles JF. Effects of joint pathology on muscle. Clin Orthop Rel Research 1987;219:21-7.
Iles JK, Stokes M, Young A. Reflex actions of the knee joint afferents during contraction of the human quadriceps. Clin Physiol 1990;10:489-500.
Hopkins JT, Ingersoll CD, Edwards JE, Cordova ML. Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc 2001;33:123-26.
Palmieri RM, Tom JA, Edwards JE, Weltman A, Saliba EN, Mistry DJ, Ingersoll CD. Arthrogenic muscle response induced by an experimental knee joint effusion is mediated by pre and pos-synaptic spinal mechanisms. J Electromyogr Kinesiol 2004;14:631-40.
Stratford P. Electromyography of the quadriceps femoris muscles in subjects with knees and acutely effused knees. Phys Ther 1981;62:279-83.
Okada Y. Histochemical study on the atrophy of the quadriceps femoris muscle caused by knee joint injuries of rats. Hiroshima J Med Sci 1989;38:13-21.
Mariani PP, Caruso I. An electromyographic investigation of subluxation of the patella. J Bone Joint Surg 1979;61B:169-71.
Spencer JD, Hayes KC, Alexander IJ. Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil 1984;65:171-77.
Boucher JP, King MA, Lefebvre R, Pépin A. Quadriceps femoris muscle activity in patellofemoral pain syndrome. Am J Sports Med 1992;20:527-32.
Thomeé R, Renströn P, Karlsson J, Grimby G. Patellofemoral pain syndrome in young women. II: Muscle function in patients and healthy controls. Scand Sci Sports 1995;5:245-51.
Bennett JG, Stauber WT. Evaluation and treatment of anterior knee pain using eccentric exercise. Med Sci Sports Exerc 1986;18:526-530.
Hess T, Gleitz M, Egert S. Hopf T. Chondropathia patellae and knee muscle control. Arch Orthop Trauma Surg 1996;115:85-89.
Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG. Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: A preliminary study. J Orthop Sports Phys Ther 2003;33:677-85.
Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: A theoretical perspective. J Orthop Sports Phys Ther 2003;33:639-46.
Green ST. Patellofemoral syndrome. J Bodywork Movement Therapies 2005;9:16-26.
Hebert S, Xavier R, Pardini Jr AG, Barros Filho TEP. Ortopedia e traumatologia – princÃpios e prática. 3a ed. Porto Alegre: ArtMed; 2003. p.1632.
Wilk KE. Patellofemoral disorders: A classification system and clinical guidelines for nonoperative rehabilitation. J Orthop Sports Phys Ther 1998;28:307-22.
Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med 2002;12:36-38.
Puniello MS. Iliotibial band tightness and medial patellar glide in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther 1993;17:144-48.
Crossley K, Bennell K, Green S, McConnell J. A systematic review of physical interventions for patellofemoral syndrome. Clin J Sport Med 2001;11:103-10.
Houglum PA. Pain control sets stage for progressive patellofemoral rehab-strength training for trunk, hip complements open and closed kinetic chain exercise for the knee. Biomechanics 2002;1:61-65.
Hodges PW, Richardson CA. The influence of isometric hip adduction on quadriceps femoris activity. Scand J Rehab Med 1993;25:57-62.
Signorile JF. The effect of knee and foot position on the electromyographical activity of the superficial quadriceps. J Orthop Sports Phys Ther 1995;22:2-9.
Hasler EM, Denoth J, Stacoff A, Herzog W. Influence of hip and knee joint angles on excitation of knee extensor muscles. Electromyogr Clin Neurophysiol 1994;34:355-61.
Cerny K. Vastus medialis oblique/vastus lateralis muscle activity ratios for exercises in persons with and without patellofemoral pain syndrome. Phys Ther 1995;75:672-83.
Väätäinen U, Airaksinen O, Jaroma H, Kiviranta, I. Decreased torque and electromyographic activity in the extensor thigh muscles in chondromalacia patellae. J Sports Med1995;16:45-50.
Laprade J, Culham E, Brouwer B. Comparison of five isometric exercises in the recruitment of the vastus medialis oblique in persons with and without patellofemoral syndrome. J Orthop Sports Phys Ther 1998;27:197-204.
LeVeau BF, Rogers C. Selective training of vastus medialis muscle using EMG biofeedback. Phys Ther 1980;60:1410-15.
Ninos JC, Irrgang, JJ, Burdett R, Weiss JR. Electromyographic analysis of the squat performed in self-selected lower extremity neutral rotation and 30º of lower extremity turn-out from the self-selected neutral position. J Orthop Sports Phys Ther 1997;25:307-15.
Cerulli G, Caraffa A, Ponteggia F. Rehabilitation issues in women with anterior cruciate ligament deficiency. Sports Med Arthrosc 2002;10:76-82.
Yack HJ, Collins CE, Whieldon TJ. Comparison of closed and open kinetic chain exercise in the anterior cruciate ligament-deficient knee. Am J Sports Med 1993;21:49-53.
Steikamp LA, Dillingham, MF, Markel, MD, Hill, JA, Kaufman KR. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med 1993;21:438-447.
Witvrouw E, Bellemans J, Cambier D, Cools A, Danneels L, Bourgois J. Which factors predict outcome in the treatment program of anterior knee pain? Scand J Med Sci Sports 2002;12:p.40-46.
Kuster MS. Exercise recommendations after total joint replacement: A review of the current literature and proposal of scientifically based guidelines. Sports Medicine 2002;32:433-45.
Hertel J. Functional instability following lateral ankle sprain. Sports Medicine 2000;29:361-71.
Hugerford DS, Barry M. Biomechanics of patellofemoral joint. Clin Orthop 1979;144:9-15.
Nyland J, Brosky T, Currier D, Nitz A, Caborn, D. Review of the afferent neural system of the knee and its contribution to motor learning. J Orthop Sports Phys Ther 1994;19:2-11.
Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc 1998;30:556-69.
Escamilla RF, Fleisig GS, Lowry TM, Barrentine SW, Andrews JR. A Three-dimensional biomechanical analysis of the squat during varying stance widths. Med Sci Sports Exerc 2001;33:984-98.
McCaw ST, Melrose DR. Stance width and bar load effects on leg muscle activity during the parallel squat. Med Sci Sports Exerc 1999;31:428-36.
Wretenberg P, Feng YI, Arborelius ULFP. High- and low-bar squatting techniques during weight-training. Med Sci Sports Exerc 1996;28:218-24.
Stensdotter A-K, Hodges PW, Mellor R, Sundelin G, Häger-Ross C. Quadriceps activation in closed and in open kinetic chain exercise. Med Sci Sports Exerc 2003;35:2043-47.
Isear JA, Erickson JC, Worrell TW. EMG analysis of lower extremity muscle recruitment patterns during an unloaded squat. Med Sci Sports Exerc 1997;29:532-39.
Zeller BL, McCrory GL, Kibler WD, Uhl TL. Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med 2003;31:449-56.
DionÃsio VC. Estudo do controle motor nas fases ascendente e descendente do agachamento em sujeitos saudáveis e portadores da sÃndrome da dor fêmoro-patelar (SDFP) [tese]. Campinas: Universidade Estadual de Campinas; 2005.
Hammer WL. Exame funcional dos tecidos moles e tratamento por métodos manuais. 2nd ed. Rio de Janeiro: Guanabara Koogan; 2003. p.528.
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