Atividade elétrica muscular de vasto medial, vasto medial oblíquo, vasto lateral, glúteo médio e tensor da fáscia lata no exercício footwork realizado no reformer segundo o método Pilates
DOI:
https://doi.org/10.33233/fb.v20i4.3066Abstract
Introdução: Rael Isacowitz preconiza que o vasto medial obliquo (VMO) pode ter sua ação privilegiada durante o exercício Footwork quando os pés estão afastados e o quadril em rotação externa. Objetivos: Verificar a influência de cinco variações do exercício Footwork no Reformer na ativação do VMO, vasto medial (VM), vasto lateral (VL), glúteo médio (GM) e tensor da fáscia lata (TFL). Metodologia: Vinte mulheres realizaram cinco variações do exercício footwork: Parallel Toes (PT), V–Position Toes (VT), Open V–Position Toes (OVT), PT com overball (PTO) e PT com banda elástica ao redor dos joelhos (PTBE). Eletromiografia de superfície foi utilizada para avaliar a atividade muscular com base na contração voluntária máxima. ANOVA de medidas repetidas de dois fatores (músculos e variações) foi utilizada para análise estatística (p < 0,05). Resultados: Os resultados mostraram que houve diferença significativa do TFL e do GM em relação ao VM, VL e VMO quando comparados entre todas variações, mas não foi detectada diferença entre estes dois músculos. O músculo GM apresentou diferença entre a situação PTBE com todas as outras variações. O músculo TFL apresentou diferença nas situações PTO e PTBE em comparação com as demais variações, mas não entre si. Conclusão: Não houve diferença clinicamente relevante na atividade elétrica do músculo vasto medial obliquo, conforme preconizado por Rael Isacowitz.
Palavras-chave: reabilitação, eletromiografia, síndrome de dor patelofemoral.
References
Wood L, Muller S, Peat G. The epidemiology of patellofemoral disorders in adulthood: a review of routine general practice morbidity recording. Prim Health Care Res Dev 2011;12:157-64. https://doi.org/10.1017/s1463423610000460
Rathleff MS. Patellofemoral pain during adolescence: much more prevalent than appreciated. Br J Sports Med 2016;50: 831-2. https://doi.org/10.1136/bjsports-2016-096328
Lankhorst NE, Bierma-Zeinstra SMA, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013;47:193-206. https://doi.org/10.1136/bjsports-2011-090369
Crossley KM Staefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM et al. Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med 2016;50(14):839-43. https://doi.org/10.1136/bjsports-2016-096384
Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. Am J Sports Med 2009;37(11):2108-16. https://doi.org/10.1177/0363546509337934
Bolgla LA, Earl-Boehm J, Emery C, Hamstra-Wright K, Ferber R. Pain, function, and strength outcomes for males and females with patellofemoral pain who participate in either a hip/core or knee-based rehabilitation. Int J Sports Phys Ther 2016;11(6):926-35.
Selfe J, Janssen J, Callaghan M, Witvrouw E, Sutton C, Richards J, Stokes M et al. Are there three main subgroups within the patellofemoral pain population? A detailed characterisation study of 127 patients to help develop targeted intervention (TIPPs). Br J Sports Med 2016;50:873-80. https://doi.org/10.1136/bjsports-2015-094792
Briani RV, Silva DO, Pazzinatto MF, Ferreira AS, Ferrari D, Azevedo FM. Delayed onset of electromyographic activity of the vastus medialis relative to the vastus lateralis may be related to physical activity levels in females with patellofemoral pain. J Electromyogr Kinesiol 2016;26:137-42. https://doi.org/10.1016/j.jelekin.2015.10.012
Silva DO, Magalhães FH, Faria NC, Pazzinatto MF, Ferrari D, Pappas E, Azevedo FM. Lower amplitude of the Hoffmann reflex in women with patellofemoral pain: thinking beyond proximal, local, and distal factors. Arch Phys Med Rehabil 2016;97:1115-20. https://doi.org/10.1016/j.apmr.2015.12.017
Chester R, Smith TO, Sweeting D, Dixon J, Wood S, Song F. The relative timing of VMO and VL in the aetiology of anterior knee pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2008;9(64):9-64. https://doi.org/10.1186/1471-2474-9-64
Cowan SM, Crossley KM, Bennell KL. Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med 2009;43(8):584-8. https://doi.org/10.1136/bjsm.2008.053553
Bennell K, Duncan M, Cowan S, McConnell J, Hodges P, Crossley KM. Effects of vastus medialis oblique retraining versus general quadriceps strengthening on vasti onset. Med Sci Sports Exerc 2010;42(5):856-64. https://doi.org/10.1249/mss.0b013e3181c12771
Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 2009;39(1):12-9. https://doi.org/10.2519/jospt.2009.2885
Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther 2010;40(2):42-51. https://doi.org/10.2519/jospt.2010.3337
Salsich GB, Graci V, Maxam DE. The effects of movement pattern modification on lower extremity kinematics and pain in women with patellofemoral pain. J Orthop Sports Phys Ther 2012;42(12):1017-24. https://doi.org/10.2519/jospt.2012.4231
Nakagawa TH, Moriya ETU, Maciel CD, Serrão FV. Frontal plane biomechanics in males and females with and without patellofemoral pain. Med Sci Sports Exerc 2012;44(9):1747-55. https://doi.org/10.1249/mss.0b013e318256903a
Magalhães E, Silva AP, Sacramento SN, Martin RL, Fukuda TY. Isometric strength ratios of the hip musculature in females with patelofemoral pain: a comparison to pain-free controls. J Strength Cond Res 2013;27(8):2165-70. https://doi.org/10.1519/jsc.0b013e318279793d
Liao TC, Yang N, Ho KY, Farrokhi S, Powers C. Femur rotation increases patella cartilage stress in females with patellofemoral pain. Med Sci Sports Exerc 2015;47(9):1775-80. https://doi.org/10.1249/mss.0000000000000617
Stickler L, Finley M, Gulgin H. Relationship between hip and core strength and frontal plane alignment during a single leg squat. Phys Ther Sport 2015;16(1):66-71.
Holden S, Boreham C, Doherty C, Delahunt E. Two-dimensional knee valgus displacement as a predictor of patellofemoral pain in adolescent females. Scandinavian J Med Sci Sport 2017;27;188-94. https://doi.org/10.1111/sms.12633
D. Ferrari D, Briani RV, Silva DO, Pazzinatto MF, Ferreira AS, Alves N, zevedo FM. Higher pain level and lower functional capacity are associated with the number of altered kinematics in women with patellofemoral pain. Gait and posture 2018:60:268-72. https://doi.org/10.1016/j.gaitpost.2017.07.034
Barton CJ, Lack S, Hemmings S et al. The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning. Br J Sports Med 2015;499(14): 923-34. https://doi.org/10.1136/bjsports-2014-093637
Lack S, Barton C, Sohan O, Crossley K, Morrissey D. Proximal muscle rehabilitation is effective for patelofemoral pain: a systematic review with meta-analysis. Br J Sports Med 2015;49(21):1365-76. https://doi.org/10.1136/bjsports-2015-094723
Ford KR, Nguyen AD, Dischiavi SL, Hegedus EJ, Zuk E, Taylor J. Na evidence-based review of hip-focused neuromuscular exercise interventions to address dynamics lower extremity valgus. Open acess J Sport Med 2015;6:291-303. https://doi.org/10.2147/oajsm.s72432
Crossley KM, van Middelkoop M, Callaghan MJ et al. Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med 2016;50:844-52. https://doi.org/10.1136/bjsports-2016-096268
Isacowitz R. Pilates. Champaign: Human Kinetics; 2006.
Loss JF, Melo MO, Rosa CH, Santos AB, La Torre M, Silva YO. Electrical activity of external oblique and multifidus muscles during the hip flexion-extension exercise performed in the Cadillac with different adjustments of springs and individual positions. Rev Bras Fisioter 2010;14(6):510-7. https://doi.org/10.1590/s1413-35552010000600010
Cantergi D, Loss JF, Jinha A, Brodt GA, Herzog W. Muscle strategies for leg extensions on a ‘‘Reformer’’ apparatus. J Electromyogr Kinesiol 2015;25(2):260-4. https://doi.org/10.1016/j.jelekin.2014.08.016
Sacco ICN. Comparison of muscle activity and kinematics of knee and ankle among three footwork exercises of the Pilates Method. Fisioter Bras 2015;16(4):305.
SENIAM, Projeto. Surface electromyography for non-invasive assessment of muscles, Enschede; 2005. DisponÃvel em: http://www.seniam.org. [citado 2013 nov 7].
ISEK. International Society of Electrophysiology and Kinesiology. DisponÃvel em: http://www.isek-online.org/standards_emg.html. [citado 2013 nov 7].
Cowan SM, Bennell KL, Hodges PW, Crossley KM, Mcconnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil 2001;82(2):183-9. https://doi.org/10.1053/apmr.2001.19022
Herrington L, Pearson S. Does level of load affect relative activation levels of vastus medialis oblique and vastus laterialis? J Electromyogr Kinesiol 2006;16:379-83. https://doi.org/10.1016/j.jelekin.2005.08.003
Ninos JC, Irrgang JJ, Burdett R, Weiss JR. Electromyographic analysis of the squat performed in self-selected lower extremity neutral rotation and 30° of lower extremety turn-out from the self-selected neutral position. J Orthop Sports Phys Ther 1997;25(5):307-15. https://doi.org/10.2519/jospt.1997.25.5.307
Herrington L, Blackera M, Enjuanesa N, Smitha P, Worthington D. The effect of limb position, exercise mode and contraction type on overall activity of VMO and VL. Phys Ther Sport 2006;7:87-92. https://doi.org/10.1016/j.ptsp.2006.01.003
Escamilla RF, Fleisig GS, Zheng N, Lander JE, Barrentine SW, Andrews JR, Bergemann BW, Moorman CT. Effects of technique variations on knee biomechanics during the squat and leg press. Med Sci Sports Exerc 2001;33(9):1552-66. https://doi.org/10.1097/00005768-200109000-00020
Smith TO, Bowyer D, Dixon J, Stephenson R, Chester R, Donell ST. Can vastus medialis oblique be preferentially activated? A systematic review of electromyographic studies. Physiother Theory Pract 2009;25(2):69-98. https://doi.org/10.1080/09593980802686953
Irish SE, Millward AJ, Wride J, Haas BM, Shum GLK. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res 2010;24(5):1256-62. https://doi.org/10.1519/jsc.0b013e3181cf749f
In Hyouk Hyong, Effects of squats accompanied by hip joint adduction on the selective activity of the vastus medialis oblique. J Phys Ther Sci 2015;27(6):1979-81. https://doi.org/10.1589/jpts.27.1979
Boling M, Padua D, Blackburn JT, Petschauer M, Hirth C. Hip adduction does not affect VMO EMG amplitude or VMO:VL ratios during a dynamic squat exercise. J Sport Rehabil 2006;15:195-205. https://doi.org/10.1123/jsr.15.3.195
In Hyouk Hyong, Jong Ho Kang. Activities of the Vastus Lateralis and Vastus Medialis Oblique Muscles during squats on different surfaces. J Phys Ther Sci 2013;25:915-7. https://doi.org/10.1589/jpts.25.915
Toumi H, Best TM, Pinti A, Lavet C, Benhamou CL, Lespessailles E. The role of muscle strenght & activation patterns in patelofemoral pain. Clin Biomech 2013;28:544-8. https://doi.org/10.1016/j.clinbiomech.2013.04.005
Park J, Lee D, Kim JS, Hong JH, You JH, Park IM. Effects of visibility and types of the ground surface on the muscle activities of the vastus medialis oblique and vastus lateralis. J Phys Ther Sci 2015;27:2435-7. https://doi.org/10.1589/jpts.27.2435
Mascal CL, Landel R, Powers CM. Management of patellofemoral pain targeting hip, pélvis, and trunk muscle function: 2 case reports. J Orthop Sports Phys Ther 2003;33:642-60. https://doi.org/10.2519/jospt.2003.33.11.647
Baldon RM, Serrão FV, Silva RS, Piva SR. Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patelofemoral pain: a randomized clinical trial. J Orthop Sports Phys Ther 2014;44(4):240-51. https://doi.org/10.2519/jospt.2014.4940
Selkowitz DM, Beneck GJ, Powers CM. Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes. J Orthop Sports Phys Ther 2013;43(2):54-64. https://doi.org/10.2519/jospt.2013.4116
Willcox EL, Burden AM. The influence of varying hip angle and pelvis position on muscle recruitment patterns of the hip abductor muscles during the clam exercise. J Orthop Sports Phys Ther 2013;43(5):325-31. https://doi.org/10.2519/jospt.2013.4004
Andersen et al. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for rehabilitation. Phys Ther 2006;86(5):683-97. https://doi.org/10.1093/ptj/86.5.683
Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: a systematic review. Complement Ther Med 2012;20(4):253-62. https://doi.org/10.1016/j.ctim.2012.02.005
Published
Issue
Section
License
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
