Análise da postura, mobilidade e força da coluna vertebral em indivíduos saudáveis com e sem discinese escapular
DOI:
https://doi.org/10.11606/issn.2317-0190.v28i1a182017Palavras-chave:
Dor de Ombro, Escápula, Postura, ReabilitaçãoResumo
A postura, mobilidade e força da coluna podem estar associadas com mudanças no movimento da escápula e dor no ombro. Objetivo: Analisar a postura da coluna vertebral, mobilidade e força em indivíduos saudáveis com e sem discinese escapular. Método: Estudo transversal com cinquenta e dois indivíduos em idade universitária foram divididos em dois grupos, de acordo com o teste de discinese escapular: um grupo sem discinese escapular (n= 19; idade= 22,95±2,86 anos; IMC= 22,97±3,12 kg/m²; 10 masculino) e outro com discinese escapular (n= 33; idade= 22,06±2,73 anos; IMC= 22,14±3,22 kg/m²; 10 masculino). A postura da cabeça e dos ombros foi analisada a partir de fotografias por um software de avaliação postural (PAS/SAPO). A cifose torácica e a amplitude de movimento da coluna cervical e torácica foram medidas por um inclinômetro digital, e a força dos músculos cervical e torác lombar por um dinamômetro portátil. A comparação intergrupo para todas as variáveis foi realizada utilizando-se a análise de variância (ANOVA unidirecional), considerando p≤0,05 como significativa. Resultados: Não foi encontrada diferença entre grupos postura (p= 0,18-0,99), mobilidade (p= 0,23-0,96) e força da coluna (p= 0,42-0,99). Conclusão: Postura, mobilidade e força da coluna vertebral não diferem entre indivíduos saudáveis com e sem discinese escapular. Os resultados sugerem que a discinese escapular pode estar relacionada a variações interpessoais. Estudos prospectivos futuros devem ser conduzidos afim de verificar se essas variáveis podem modificar e influenciar o desenvolvimento da dor no ombro.
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Referências
Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the 'Scapular Summit'. Br J Sports Med. 2013;47(14):877-85. Doi: http://dx.doi.org/10.1136/bjsports-2013-092425
Huang TS, Ou HL, Huang CY, Lin JJ. Specific kinematics and associated muscle activation in individuals with scapular dyskinesis. J Shoulder Elbow Surg. 2015;24(8):1227-34. Doi: http://dx.doi.org/10.1016/j.jse.2014.12.022
Seitz AL, McClelland RI, Jones WJ, Jean RA, Kardouni JR. A comparison of change in 3d scapular kinematics with maximal contractions and force production with scapular muscle tests between asymptomatic overhead athletes with and without scapular dyskinesis. Int J Sports Phys Ther. 2015;10(3):309-18.
Lopes AD, Timmons MK, Grover M, Ciconelli RM, Michener LA. Visual scapular dyskinesis: kinematics and muscle activity alterations in patients with subacromial impingement syndrome. Arch Phys Med Rehabil. 2015;96(2):298-306. Doi: http://dx.doi.org/10.1016/j.apmr.2014.09.029
Yeşilyaprak SS, Yüksel E, Kalkan S. Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis. Phys Ther Sport. 2016;19:7-13. Doi: http://dx.doi.org/10.1016/j.ptsp.2015.08.002
Lee JH, Cynn HS, Choi WJ, Jeong HJ, Yoon TL. Reliability of levator scapulae index in subjects with and without scapular downward rotation syndrome. Phys Ther Sport. 2016;19:1-6. Doi: http://dx.doi.org/10.1016/j.ptsp.2015.07.002
Ludewig PM, Braman JP. Shoulder impingement: biomechanical considerations in rehabilitation. Man Ther. 2011;16(1):33-9. Doi: http://dx.doi.org/10.1016/j.math.2010.08.004
Timmons MK, Thigpen CA, Seitz AL, Karduna AR, Arnold BL, Michener LA. Scapular kinematics and subacromial-impingement syndrome: a meta-analysis. J Sport Rehabil. 2012;21(4):354-70. Doi: http://dx.doi.org/10.1123/jsr.21.4.354
Cools AM, Cambier D, Witvrouw EE. Screening the athlete’s shoulder for impingement symptoms: a clinical reasoning algorithm for early detection of shoulder pathology. Br J Sports Med. 2008;42(8):628-35. Doi: http://dx.doi.org/10.1136/bjsm.2008.048074
Andersson SH, Bahr R, Clarsen B, Myklebust G. Preventing overuse shoulder injuries among throwing athletes: A cluster-randomised controlled trial in 660 elite handball players. Br J Sports Med. 2017;51(14):1073-80. Doi: http://dx.doi.org/10.1136/bjsports-2016-096226
Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med. 2014;48(17):1327-33. Doi: http://dx.doi.org/10.1136/bjsports-2014-093702
Hickey D, Solvig V, Cavalheri V, Harrold M, Mckenna L. Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis. Br J Sports Med. 2018;52(2):102-10. Doi: http://dx.doi.org/10.1136/bjsports-2017-097559
Myers JB, Oyama S, Hibberd EE. Scapular dysfunction in high school baseball players sustaining throwing-related upper extremity injury: A prospective study. J Shoulder Elb Surg. 2013;22(9):1154-9. Doi: http://dx.doi.org/10.1016/j.jse.2012.12.029
Andersson SH, Bahr R, Clarsen B, Myklebust G. Risk factors for overuse shoulder injuries in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed. Br J Sports Med. 2018;52(18):1191–8. Doi: http://dx.doi.org/10.1136/bjsports-2017-097648
Plummer HA, Sum JC, Pozzi F, Varghese R, Michener LA. Observational scapular dyskinesis: known-groups validity in patients with and without shoulder pain. J Orthop Sports Phys Ther. 2017;47(8):530-7. Doi: http://dx.doi.org/10.2519/jospt.2017.7268
Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3):S86-92. Doi: http://dx.doi.org/10.1053/j.apmr.2003.12.005
Kebaetse M, McClure P, Pratt NA. Thoracic position effect on shoulder range of motion strength, and three-dimensional scapular kinematics. Arch Phys Med Rehabil. 1999;80(8):945-50. Doi: http://dx.doi.org/10.1016/s0003-9993(99)90088-6
Finley MA, Lee RY. Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors. Arch Phys Med Rehabil. 2003;84(4):563-8. Doi: http://dx.doi.org/10.1053/j.apmr.2003.12.005
Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol. 2010;20(4):701-9. Doi: http://dx.doi.org/10.1016/j.jelekin.2009.12.003
Otoshi K, Takegami M, Sekiguchi M, Onishi Y, Yamazaki S, Otani K, et al. Association between kyphosis and subacromial impingement syndrome: LOHAS study. J Shoulder Elb Surg. 2014;23(12):e300-7. Doi: http://dx.doi.org/10.1016/j.jse.2014.04.010
Tawde P, Dabadghav R, Bedekar N, Shyam A, Sancheti P. Assessment of cervical range of motion, cervical core strength and scapular dyskinesia in violin players. Int J Occup Saf Ergon. 2016;22(4):572-576. Doi: http://dx.doi.org/10.1080/10803548.2016.1181892
Pires ED, Camargo PR. Analysis of the kinetic chain in asymptomatic individuals with and without scapular dyskinesis. Clin Biomech (Bristol, Avon). 2018;54:8-15. Doi: http://dx.doi.org/10.1016/j.clinbiomech.2018.02.017
Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord. 2010;11:39. Doi: http://dx.doi.org/10.1186/1471-2474-11-39
Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115. Doi: http://dx.doi.org/10.1186/1479-5868-8-115
Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-15.
Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire-Brazil Roland-Morris. Braz J Med Biol Res. 2001;34(2):203-10. Doi: http://dx.doi.org/10.1590/s0100-879x2001000200007
Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006;36(3):138-51. Doi: http://dx.doi.org/10.2519/jospt.2006.36.3.138
McClure P, Tate AR, Kareha S, Irwin D, Zlupko E, McClure P, et al. A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train. 2009;44(2):160-4. Doi: http://dx.doi.org/10.4085/1062-6050-44.2.160
Tate AR, McClure P, Kareha S, Irwin D, Barbe MF. A clinical method for identifying scapular dyskinesis, part 2: validity. J Athl Train. 2009;44(2):165-73. Doi: http://dx.doi.org/10.4085/1062-6050-44.2.165
Rossi DM, Resende RA, da Fonseca ST, de Oliveira AS. Scapulothoracic kinematic pattern in the shoulder pain and scapular dyskinesis: A principal component analysis approach. J Biomech. 2018;77:138-145. doi: http://dx.doi.org/10.1016/j.jbiomech.2018.07.010
Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther. 2014;18(4):364-71. Doi: http://dx.doi.org/10.1590/bjpt-rbf.2014.0027
Singla D, Veqar Z, Hussain ME. Photogrammetric assessment of upper body posture using postural angles: a literature review. J Chiropr Med. 2017;16(2):131-8. Doi: http://dx.doi.org/10.1016/j.jcm.2017.01.005
Ferreira EAG, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliabiliy. Clinics. 2010;65(7):675-81. Doi: http://dx.doi.org/10.1590/S1807-59322010000700005
Barrett E, O’Keeffe M, O’Sullivan K, Lewis J, McCreesh K. Is thoracic spine posture associated with shoulder pain, range of motion and function? a systematic review. Man Ther. 2016;26:38-46. Doi: http://dx.doi.org/10.1016/j.math.2016.07.008
Tousignant-Laflamme Y, Boutin N, Dion AM, Vallée CA. Reliability and criterion validity of two applications of the iPhoneTM to measure cervical range of motion in healthy participants. J Neuroeng Rehabil. 2013;10(1):14-20. Doi: http://dx.doi.org/10.1186/1743-0003-10-69
Macedo LB, Borges DT, Melo SA, Costa KSA, Sousa CO, Brasileiro JS. Reliability and concurrent validity of a mobile application to measure thoracolumbar range of motion in low back pain patients. J Back Musculoskelet Rehabil. 2020;33(1):145-51. Doi: http://dx.doi.org/10.3233/BMR-181396
Shahidi B, Johnson CL, Curran-Everett D, Maluf KS. Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain. BMC Musculoskelet Disord. 2012;13:215. Doi: http://dx.doi.org/10.1186/1471-2474-13-215
Valentin G, Maribo T. Hand-held dynamometry fixated with a tripod is reliable for assessment of back extensor strength in women with osteoporosis. Osteoporos Int. 2014;25(8):2143-9. Doi: http://dx.doi.org/10.1007/s00198-014-2743-0
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74.
Cohen J. The concepts of power analysis. In: Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. p. 1-17.
Hannah DC, Scibek JS, Carcia CR. Strength profiles in healthy individuals with and without scapular dyskinesis. Int J Sports Phys Ther. 2017;12(3):305-13.
Malmström EM, Olsson J, Baldetorp J, Fransson PA. A slouched body posture decreases arm mobility and changes muscle recruitment in the neck and shoulder region. Eur J Appl Physiol. 2015;115(12):2491–503. Doi: http://dx.doi.org/10.1007/s00421-015-3257-y
Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther. 2013;18(1):65-71. Doi: http://dx.doi.org/10.1016/j.math.2012.07.005
Lewis JS, Green A, Wright C. Subacromial impingement syndrome: The role of posture and muscle imbalance. J Shoulder Elb Surg. 2005;14(4):385-92. Doi: http://dx.doi.org/10.1016/j.jse.2004.08.007
Schinkel-Ivy A, Pardisnia S, Drake JDM. Head and arm positions that elicit maximal voluntary trunk range-of-motion measures. J Appl Biomech. 2014;30(6):689-96. Doi: http://dx.doi.org/10.1123/jab.2013-0247
Vega Toro AS, Cools AMJ, de Oliveira AS. Instruction and feedback for conscious contraction of the abdominal muscles increases the scapular muscles activation during shoulder exercises. Man Ther. 2016;25:11-8. Doi: http://dx.doi.org/10.1016/j.math.2016.05.331
Shiravi S, Letafatkar A, Bertozzi L, Pillastrini P, Khaleghi Tazji M. Efficacy of abdominal control feedback and scapula stabilization exercises in participants with forward head, round shoulder postures and neck movement impairment. Sports Health. 2019;11(3):272–9. Doi: http://dx.doi.org/10.1177/1941738119835223
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