Ângulo quadricipital e postura do retropé em membros inferiores com sí­ndrome da dor patelofemoral

Autores

  • Katy Andrade Monteiro Zacaron Faculdade Estácio de Sá de Juiz de Fora (FESJF)

DOI:

https://doi.org/10.33233/fb.v14i2.382

Resumo

Introdução: Sí­ndrome da dor patelofemoral (SDPF) é a patologia mais comum do joelho, porém sua etiologia permanece obscura. Objetivos: Comparar as medidas do ângulo Q e do retropé em joelhos com e sem SDPF. Analisar a associação entre o ângulo Q e do retropé com SDPF. Métodos: A amostra constitui-se de 24 participantes com SDPF unilateral (12-30 anos). Os mesmos foram separados em grupos de joelhos com dor patelofemoral (DPF+) e sem dor patelofemoral (DPF-). O alinhamento do retropé e do ângulo Q foram avaliados através da goniometria. A escala visual análoga numérica de dor (EVN) foi utilizada para o registro da dor usual no joelho. Foram empregados teste t-Student para comparar as variáveis ângulo Q e ângulo do retropé entre os grupos DPF+ e DPF- e coeficientes de correlação de Pearson para verificar a associação entre ângulo Q e ângulo do retropé com SDPF. Resultados: Tanto o valgismo do retropé quanto o ângulo Q apresentaram-se significantemente maior (p ≤ 0,02) no grupo DPF+. Não houve associação entre a SDPF e as variáveis ângulo do retropé e do ângulo Q. Conclusão: As medidas do ângulo Q e do valgismo do retropé, embora superiores no grupo DPF+, não demonstraram associação com a SDPF.

Palavras-chave: sí­ndrome da dor patelofemoral, condromalácia da patela, deformidade do pé, alinhamento patelar e ângulo Q.

Biografia do Autor

Katy Andrade Monteiro Zacaron, Faculdade Estácio de Sá de Juiz de Fora (FESJF)

Ft., M.Sc.,  

Docente do curso de Fisioterapia, Faculdade Estácio de Sá de Juiz de Fora (FESJF) e Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (FCMSJF)

Referências

Pagenstert GI, Bachmann M. Clinical examination for patellofemoral problems. Orthopade 2008;37(9):890-903.

Nguyen AD, Boling MC, Levine B, Shultz SJl., Relationships between lower extremity alignment and the quadriceps angle. Clin J Sport Med 2009;19(3):201-6.

Davis IS, Powers CM. Patellofemoral pain syndrome: proximal, distal, and local factors, an international retreat. J Orthop Sports Phys Ther 2010;40(3):11-6.

Powers CM, Maffucci R, Hampton S. Rearfoot posture in subjects with patellofemoral pain. J Orthop Sports Phys Ther 1995;22(4):155-60.

Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med 2008;7:9.

Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013;47(4):193-206.

Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther 2010;40(2):42-51.

Magee DJ. Avaliação Musculoesquelética. Manole: São Paulo; 2010.

Salsich GB, Perman WH, Patellofemoral joint contact area is influenced by tibiofemoral rotation alignment in individuals who have patellofemoral pain. J Orthop Sports Phys Ther 2007;37(9):521-8.

Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther 2010;40(5):286-96.

Aliberti S, Costa MS, Passaro AC, Arnone AC. Medial contact and smaller plantar loads characterize individuals with patellofemoral pain syndrome during stair descent. Phys Ther Sport 2010;11(1):30-4.

Levinger P, Gilleard WL, Sprogis K. Frontal plane motion of the rearfoot during a one-leg squat in individuals with patellofemoral pain syndrome. J Am Podiatr Med Assoc 2006;96(2):96-101.

McPoil TG, Warren M, Vicenzino B, Cornwall MW. Variations in foot posture and mobility between individuals with patellofemoral pain and those in a control group. J Am Podiatr Med Assoc 2011;101(4):289-96.

Ribeiro ACSG, Foerster DB, Candolo B, Monteiro CPV. Avaliação eletromiográfica e ressonância magnética do joelho de indivíduos com síndrome da dor femoropatelar. Rev Bras Fisioter 2010;14(3):221-28.

Piva SR, Fitzgerald GK, Irrgang JJ, Fritz JM, Wisniewski S, McGinty GT, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil 2009;90(2):285-95.

Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil 2004;85(5):815-22.

Mendonca LDM, Macedo LG, Fonseca ST, Silva A. Comparação do alinhamento anatômico de membros inferiores entre indivíduos saudáveis e indivíduos com tendinose patelar. Rev Bras Fisioter 2005;9:101-107.

Torburn L, Perry J, Gronley JK. Assessment of rearfoot motion: passive positioning, one-legged standing, gait. Foot Ankle Int 1998;19(10):688-93.

Shultz SJ, Nguyen AD, Levine BJ. The relationship between lower extremity alignment characteristics and anterior knee joint laxity. Sports Health 2009;1(1):54-60.

Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Risk factors for patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther 2012; 42(2):81-94.

Frounfelter GG, Stutzriem DE. Patellofemoral knee pain treatment using neuromuscular retraining of the hip musculature in an adolescent female: a case report. J Strength Cond Res 2011;25(10):2828-34.

Rauh MJ, Macera CA, Trone DW, Reis JP, Shaffer RA. Selected static anatomic measures predict overuse injuries in female recruits. Mil Med 2010;175(5):329-35.

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.

Massada, M, R Aido, C Magalhães, N Puga. Dynamic quadriceps angle: a comparison of female elite volleyball players with and without patellofemoral pain syndrome. Br J Sports Med 2011;45:533-49.

Herrington L. Does the change in Q angle magnitude in unilateral stance differ when comparing asymptomatic individuals to those with patellofemoral pain? Phys Ther Sport; 2012:1-4.

De-hui DH Zhang, Zheng-qing ZQ Wu, Xin-cheng XC Zuo, Jian-wei JW Li, Chang-lin CL Huang. Diagnosis and treatment of excessive lateral pressure syndrome of the patellofemoral joint caused by military training. Orthop Surg 2011;3(1):35-9.

Song CY, Lin YF, Wei TC, Lin DH, Yen TY, Jan MH. Surplus value of hip adduction in leg-press exercise in patients with patellofemoral pain syndrome: a randomized controlled trial. Phys Ther 2009;89(5):409-18.

Song CY, Lin JJ, Jan MH, Lin YF. The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome. Phys Ther Sport 2011; 12(3):140-7.

Haim A, Yaniv M, Dekel S, Amir H. Patellofemoral pain syndrome: validity of clinical and radiological features. Clin Orthop Relat Res 2006;451:223-8.

Park SK, Stefanyshyn DJ. Greater Q angle may not be a risk factor of patellofemoral pain syndrome. Clin Biomech (Bristol, Avon) 2011;26(4):392-6.

Sheehan FT. Q-angle and J-sign: indicative of maltracking subgroups in patellofemoral pain. Clin Orthop Relat Res 2010;468(1):266-75.

Aliberti S, Costa MSX, Campos A. Influence of patellofemoral pain syndrome on plantar pressure in the foot rollover process during gait. Clinics (São Paulo) 2011;66(3):367-72.

Barton CJ, Levinger P, Crossley KM, Webster KE, Menz HB. Relationships between the foot posture index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome. J Foot Ankle Res 2011;4:4-10.

Pohl MB. Are foot kinematics associated with patellofemoral pain in female runners? Med Science Sports Exercise 2011;43(5):119-23.

Filho ACL, Toebe SJ, Silveira M, Schwantes IA.Tamanho de amostra para estimação do coeficiente de correlação de Pearson entre caracteres de Crambe abyssinica. Rev Ciênc Agron 2011;42(1):149-58.

Downloads

Publicado

2016-07-16

Edição

Seção

Artigos originais