Modulação da força de preensão palmar por overflow motor de flexor de quadril contralateral: ensaio clínico controlado e randomizado
DOI:
https://doi.org/10.11606/issn.2317-0190.v32i2a236056Palavras-chave:
Força da Mão, Contração Isométrica, Quadril, ReabilitaçãoResumo
Objetivo: Avaliar se o overflow motor gerado pela contração isométrica contralateral dos flexores do quadril atenua a queda da força de preensão palmar (FPP) em protocolo de força máxima repetitiva em adultos saudáveis. Método: Noventa participantes foram randomizados em grupos controle e overflow. A FPP foi mensurada em fases basal e de teste com dinamômetro manual. Na fase de teste, o grupo overflow realizou contrações isométricas máximas dos flexores do quadril simultaneamente às tarefas de FPP (6 segundos, 9 segundos de descanso). Análise de variância multivariada (MANOVA) avaliou diferenças por grupo, sexo, mão e fase. Resultados: O grupo controle apresentou redução significativa da FPP entre as fases (p<0,05), enquanto o grupo overflow manteve a FPP na fase de teste (p>0,05). Tamanhos de efeito (Cohen’s d=0,71-0,87) indicaram relevância clínica média a alta, sugerindo facilitação neural pela ativação contralateral. Conclusão: O overflow motor dos flexores do quadril sustenta a FPP em tarefas repetitivas, com potencial aplicação em reabilitação neuromuscular. Estratégias baseadas em overflow motor podem otimizar força e reduzir fadiga em protocolos terapêuticos.
Downloads
Referências
Calvert GHM, Carson RG. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. Neurosci Biobehav Rev. 2022;132:260-288. Doi: https://doi.org/10.1016/j.neubiorev.2021.11.025
Taylor JL, Gandevia SC. A comparison of central aspects of fatigue in submaximal and maximal voluntary contractions. J Appl Physiol (1985). 2008;104(2):542-50. Doi: https://doi.org/10.1152/japplphysiol.01053.2007
Sharman MJ, Cresswell AG, Riek S. Proprioceptive neuro-muscular facilitation stretching: mechanisms and clinical implications. Sports Med. 2006;36(11):929-39. Doi: https://doi.org/10.2165/00007256-200636110-00002
Surburg PR, Schrader JW. Proprioceptive neuromuscular facilitation techniques in sports medicine: a reassessment. J Athl Train. 1997;32(1):34-9.
Damiano DL, Arnold AS, Steele KM, Delp SL. Can strength training predictably improve gait kinematics? A pilot study on the effects of hip and knee extensor strengthening on lower-extremity alignment in cerebral palsy. Phys Ther. 2010;90(2):269-79. Doi: https://doi.org/10.2522/ptj.20090062
Zijdewind I, Kernell D. Bilateral interactions during contrac-tions of intrinsic hand muscles. J Neurophysiol. 2001;85(5):1907-13. Doi: https://doi.org/10.1152/jn.2001.85.5.1907
Lee JH, Kim EJ. The Effect of Diagonal Exercise Training for Neurorehabilitation on Functional Activity in Stroke Patients: A Pilot Study. Brain Sci. 2023;13(5):799. Doi: https://doi.org/10.3390/brainsci13050799
Knott M, Voss DE. Proprioceptive neuromuscular facilitation: patterns and techniques. 2nd ed. New York: Hoeber Medical Division, Harper & Row; 1968.
Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. 3rd ed. Berlin: Springer; 2008.
Latash ML, Turvey MT. Dexterity and its development. Mah-wah, NJ: Lawrence Erlbaum Associates; 1996.
Li S, Chen YT, Magat E, Li S, Zhou P. Motor overflow in spastic hemiplegia after stroke. APRM. 2018;61:e204–5. Doi: https://doi.org/10.1016/j.rehab.2018.05.472
Nakada CS, Meningroni PC, Ferreira ACS, Hata L, Fuzaro AC, Júnior WM, et al. Ipsilateral proprioceptive neuromuscular facilitation patterns improve overflow and reduce foot drop in patients with demyelinating polyneuropathy. J Exerc Rehabil. 2018;14(3):503-8. Doi: https://doi.org/10.12965/jer.1836178.089
Cleland BT, Madhavan S. Motor overflow in the lower limb after stroke: Insights into mechanisms. Eur J Neurosci. 2022;56(4):4455-4468. Doi: https://doi.org/10.1111/ejn.15753
Perez MA, Cohen LG. Mechanisms underlying functional changes in the primary motor cortex ipsilateral to an active hand. J Neurosci. 2008;28(22):5631-40. Doi: https://doi.org/10.1523/JNEUROSCI.0093-08.2008
Cronin J, Lawton T, Harris N, Kilding A, McMaster DT. A Brief Review of Handgrip Strength and Sport Performance. J Strength Cond Res. 2017;31(11):3187-3217. Doi: https://doi.org/10.1519/JSC.0000000000002149
Lemon RN. Descending pathways in motor control. Annu Rev Neurosci. 2008;31:195-218. Doi: https://doi.org/10.1146/annurev.neuro.31.060407.125547
Espírito-Santo H, Pires CF, Garcia IQ, Daniel F, Silva AG, Fazio RL. Preliminary validation of the Portuguese Edinburgh Handedness Inventory in an adult sample. Appl Neuropsychol Adult. 2017;24(3):275-287. Doi: https://doi.org/10.1080/23279095.2017.1290636
Przybyla A, Good DC, Sainburg RL. Dynamic dominance varies with handedness: reduced interlimb asymmetries in left-handers. Exp Brain Res. 2012;216(3):419-31. Doi: https://doi.org/10.1007/s00221-011-2946-y
Nalçaci E, Kalaycioğlu C, Ciçek M, Genç Y. The relationship between handedness and fine motor performance. Cortex. 2001;37(4):493-500. Doi: https://doi.org/10.1016/s0010-9452(08)70589-6
Fess EE. Grip strength. In: Casanova JS, editor. Clinical assessment recommendations. 2nd ed. Chicago: American Society of Hand Therapists; 1992. p. 41-45.
Kuypers HGJM. Anatomy of the descending pathways. In: Brookhart JM, Mountcastle VB, editors. Handbook of physiology: the nervous system. Bethesda: American Physiological Society; 1981. p. 597-666.
Benwell NM, Mastaglia FL, Thickbroom GW. Reduced functional activation after fatiguing exercise is not confined to primary motor areas. Exp Brain Res. 2006;175(4):575-83. Doi: https://doi.org/10.1007/s00221-006-0573-9
Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3-10. Doi: https://doi.org/10.1519/00139143-200831010-00002
Carson RG, Riek S, Mackey DC, Meichenbaum DP, Willms K, Forner M, et al. Excitability changes in human forearm corticospinal projections and spinal reflex pathways during rhythmic voluntary movement of the opposite limb. J Physi-ol. 2004;560(Pt 3):929-40. Doi: https://doi.org/10.1113/jphysiol.2004.069088
Hortobágyi T, Taylor JL, Petersen NT, Russell G, Gandevia SC. Changes in segmental and motor cortical output with contralateral muscle contractions and altered sensory inputs in humans. J Neurophysiol. 2003;90(4):2451-9. Doi: https://doi.org/10.1152/jn.01001.2002
Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, et al. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and re-search application. An updated report from an I.F.C.N. Com-mittee. Clin Neurophysiol. 2015;126(6):1071-1107. Doi: https://doi.org/10.1016/j.clinph.2015.02.001
Gardner EB. The neurophysiological basis of motor learning. A review. Phys Ther. 1967;47(12):1115-22. Doi: https://doi.org/10.1093/ptj/47.12.1115
Benitez B, Kwak M, Succi PJ, Mitchinson C, Bergstrom HC. No sex differences in time-to-task failure and neuromuscular patterns of response during submaximal, bilateral, isometric leg extensions. Eur J Appl Physiol. 2024;124(10):2993-3004. Doi: https://doi.org/10.1007/s00421-024-05508-0
Hunter SK. Sex differences in human fatigability: mechanisms and insight to physiological responses. Acta Physiol (Oxf). 2014;210(4):768-89. Doi: https://doi.org/10.1111/apha.12234
Lee M, Carroll TJ. Cross education: possible mechanisms for the contralateral effects of unilateral resistance training. Sports Med. 2007;37(1):1-14. Doi: https://doi.org/10.2165/00007256-200737010-00001
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2025 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
O conteúdo do periódico está licenciado sob uma Licença Creative Commons BY-NC-SA. Esta licença permite que outros remixem, adaptem e criem a partir do seu trabalho para fins não comerciais, desde que atribuam ao autor o devido crédito e que licenciem as novas criações sob termos idênticos.
Dados de financiamento
-
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Números do Financiamento 88887.817054/2023-00
