Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/2293 |
Resumo: | Introduction: Patellofemoral pain (PFP) has a multifactorial etiology and among the factors associated with PFP, the biomechanical are the most discussed in the literature. Kinematics changes in trunk, pelvis and lower limbs are normally associated with PFP patients, but not all changes appear in all patients and in all assessed tasks. Identify which task that most differentiates the subjects with and without PFP could help to make clinical decision regarding assessment of these patients and then guide the identification of possible causes of kinematic changes, since muscle strength appears to be unrelated with kinematic. We know that muscle activities depend on the neural control that activates the musculature by muscle synergies and the motor control could be influenced by pain, to investigate if there are changes in neuromuscular organization could contribute to a better understanding of PFP and help to improve the treatment and assessment strategies to PFP patients. Objective: 1. Identify which functional tasks differentiates the three-dimensional kinematic of women with and without PFP. 2. Analyze the muscle synergies of women with PFP and correlate with the kinematic of the trunk, pelvis and lower limbs during the lateral step down (LSD). Methods: 1. Cross-sectional study that evaluated 35 women with PFP and 35 asymptomatic women during the execution of seven functional tasks. Three-dimensional kinematic data were analyzed through the Movement Deviation Profile (MDP). To identify which task presented the most differences between the groups, the Z-score of the mean MDP was calculated. 2. Cross-sectional study with 15 women with PFP and 14 asymptomatic submitted to three-dimensional kinematic and electromyography (EMG) assessment during the LSD. Muscle synergies were extracted from EMG signals using a non-negative matrix factorization algorithm. Kinematics data were analyzed through MDP. The data were compared by independence t test and correlated by Pearson correlation test. Results: 1. For all tasks, the groups presented differences, but according with Z-score the LSD (7.97) and forward step down (7.62) were the tasks that most differentiate the kinematic of the groups. 2. Women with PFP showed no differences in the minimum number of muscle synergies necessary to explain most variability of EMG (VAF) to perform the LSD, but showed higher VAFtotal and VAFmuscle for rectus femoris and vastus medialis compared to asymptomatic women. For PFP, the lower the similarity in the muscle participation in each muscle synergies (W2, W3 e Wmean) compared to control, the higher the differences in trunk, pelvis and lower limbs during the LSD. Conclusion: Step down tests are the tasks that most differentiate the kinematic of women with and without PFP, the LSD was the tasks with the highest sensitivity to detect differences. During the LSD, PFP women showed poor muscle control and coordination, mainly for the rectus femoris and vastus medialis muscles and these findings have correlation with the higher changes kinematics during the task execution. |
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Lucareli, Paulo Roberto GarciaBarroso, Filipe André OliveiraLucareli, Paulo Roberto GarciaPolitti, FabianoFreitas, Sandra Maria Sbeghen Ferreira deCosta, Leonardo Oliveira Penahttp://lattes.cnpq.br/3078580296713478Ferreira, Cintia Lopes2020-10-28T16:37:24Z2019-12-11Ferreira, Cintia Lopes. Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar. 2019. 129 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/2293Introduction: Patellofemoral pain (PFP) has a multifactorial etiology and among the factors associated with PFP, the biomechanical are the most discussed in the literature. Kinematics changes in trunk, pelvis and lower limbs are normally associated with PFP patients, but not all changes appear in all patients and in all assessed tasks. Identify which task that most differentiates the subjects with and without PFP could help to make clinical decision regarding assessment of these patients and then guide the identification of possible causes of kinematic changes, since muscle strength appears to be unrelated with kinematic. We know that muscle activities depend on the neural control that activates the musculature by muscle synergies and the motor control could be influenced by pain, to investigate if there are changes in neuromuscular organization could contribute to a better understanding of PFP and help to improve the treatment and assessment strategies to PFP patients. Objective: 1. Identify which functional tasks differentiates the three-dimensional kinematic of women with and without PFP. 2. Analyze the muscle synergies of women with PFP and correlate with the kinematic of the trunk, pelvis and lower limbs during the lateral step down (LSD). Methods: 1. Cross-sectional study that evaluated 35 women with PFP and 35 asymptomatic women during the execution of seven functional tasks. Three-dimensional kinematic data were analyzed through the Movement Deviation Profile (MDP). To identify which task presented the most differences between the groups, the Z-score of the mean MDP was calculated. 2. Cross-sectional study with 15 women with PFP and 14 asymptomatic submitted to three-dimensional kinematic and electromyography (EMG) assessment during the LSD. Muscle synergies were extracted from EMG signals using a non-negative matrix factorization algorithm. Kinematics data were analyzed through MDP. The data were compared by independence t test and correlated by Pearson correlation test. Results: 1. For all tasks, the groups presented differences, but according with Z-score the LSD (7.97) and forward step down (7.62) were the tasks that most differentiate the kinematic of the groups. 2. Women with PFP showed no differences in the minimum number of muscle synergies necessary to explain most variability of EMG (VAF) to perform the LSD, but showed higher VAFtotal and VAFmuscle for rectus femoris and vastus medialis compared to asymptomatic women. For PFP, the lower the similarity in the muscle participation in each muscle synergies (W2, W3 e Wmean) compared to control, the higher the differences in trunk, pelvis and lower limbs during the LSD. Conclusion: Step down tests are the tasks that most differentiate the kinematic of women with and without PFP, the LSD was the tasks with the highest sensitivity to detect differences. During the LSD, PFP women showed poor muscle control and coordination, mainly for the rectus femoris and vastus medialis muscles and these findings have correlation with the higher changes kinematics during the task execution.Introdução: A Dor Femoropatelar (DFP) tem etiologia multifatorial e dentre os fatores associados à DFP, os biomecânicos são os mais discutidos na literatura. Alterações cinemáticas de tronco, pelve e membros inferiores são as mais frequentes, porém nem todas as alterações são apresentadas por todos os pacientes e em todas as tarefas realizadas. Identificar uma tarefa que mais diferencia o indivíduo com e sem DFP pode ajudar na tomada de decisão clínica quanto à avaliação dos pacientes e então nortear a identificação das possíveis causas das alterações cinemáticas, uma vez que somente a força muscular parece não ter relação. Sabendo que a ativação muscular depende de controles neurais que ativam a musculatura por meio de sinergias musculares e que a dor pode influenciar o controle motor, investigar se a DFP apresenta alterações na organização neuromuscular pode contribuir ainda mais para o entendimento da DFP e ajudar na busca de melhores estratégias de avaliação e tratamento para os pacientes com DFP. Objetivos: 1. Identificar qual tarefa funcional diferencia mais a cinemática de mulheres com e sem DFP. 2. Analisar a sinergia muscular de mulheres com DFP e correlacionar com a cinemática de tronco, pelve e membros inferiores durante o step down lateral (SDL). Métodos: 1. Estudo transversal que avaliou a cinemática de 35 mulheres com DFP e 35 mulheres assintomáticas durante a execução de sete tarefas funcionais. Os dados da cinemática tridimensional foram analisados através do Movement Deviation Profile (MDP) e para identificar qual tarefa apresentou maior diferença entre os grupos o Z-score da média do MDP foi calculado. 2. Estudo transversal com 15 mulheres com DFP e 14 mulheres assintomáticas submetidas à avaliação da cinemática tridimensional e eletromiográfica (EMG) durante a execução do SDL. As sinergias musculares foram extraídas do sinal EMG usando o algoritmo de fatorização de matriz não negativa e a cinemática analisada por meio do MDP. Os dados foram comparados pelo teste t independente e correlacionados pelo teste de correlação de Pearson. Resultados: 1. Todas as tarefas apresentaram diferenças entre os grupos com e sem DFP, porém de acordo com o Z-score o SDL (7,97) e o step down anterior (7,62) foram as tarefas que mais diferenciaram os grupos. 2. Mulheres com DFP não apresentaram diferenças no número mínimo de sinergias musculares necessárias para explicar a variabilidade da reconstrução do EMG (VAF) para realizar o SDL, porém foi observado maior VAFtotal e VAFmúsculo para o reto femoral e vasto medial comparadas às mulheres assintomáticas. Na DFP, quanto menor a semelhança na participação dos músculos em cada sinergia muscular (W2, W3 e Wmédia) comparado ao controle, maior a diferença na cinemática de tronco, pelve e membros inferiores durante o SDL. Conclusão: As tarefas de step down são as que mais diferenciam a cinemática de mulheres com e sem DFP sendo o SDL aquela com maior poder de diferenciação. Durante o SDL, mulheres com DFP apresentam pior controle e coordenação muscular, principalmente para os músculos vasto medial e reto femoral e este achado tem correlação com as maiores alterações cinemáticas na execução da tarefa.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2020-10-28T16:37:24Z No. of bitstreams: 1 CINTIA LOPES FERREIRA.pdf: 4419535 bytes, checksum: 647f824fec56a44c0225bcdf13973d9c (MD5)Made available in DSpace on 2020-10-28T16:37:24Z (GMT). No. of bitstreams: 1 CINTIA LOPES FERREIRA.pdf: 4419535 bytes, checksum: 647f824fec56a44c0225bcdf13973d9c (MD5) Previous issue date: 2019-12-11application/pdfporUniversidade Nove de JulhoPrograma de Pós-Graduação em Ciências da ReabilitaçãoUNINOVEBrasilSaúdedor femoropatelarcinemáticatarefas funcionaiseletromiografiasinergias muscularespatellofemoral painkinematicfunctional taskselectromyographymuscle synergiesCIENCIAS DA SAUDEAnálise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelarAnalysis of three-dimensional kinematics and muscle synergy of women with patellofemoral paininfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALCINTIA LOPES FERREIRA.pdfCINTIA LOPES FERREIRA.pdfapplication/pdf4419535http://localhost:8080/tede/bitstream/tede/2293/2/CINTIA+LOPES+FERREIRA.pdf647f824fec56a44c0225bcdf13973d9cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/2293/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/22932020-10-28 14:37:24.996oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2020-10-28T16:37:24Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
dc.title.alternative.eng.fl_str_mv |
Analysis of three-dimensional kinematics and muscle synergy of women with patellofemoral pain |
title |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
spellingShingle |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar Ferreira, Cintia Lopes dor femoropatelar cinemática tarefas funcionais eletromiografia sinergias musculares patellofemoral pain kinematic functional tasks electromyography muscle synergies CIENCIAS DA SAUDE |
title_short |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
title_full |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
title_fullStr |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
title_full_unstemmed |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
title_sort |
Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar |
author |
Ferreira, Cintia Lopes |
author_facet |
Ferreira, Cintia Lopes |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Lucareli, Paulo Roberto Garcia |
dc.contributor.advisor-co1.fl_str_mv |
Barroso, Filipe André Oliveira |
dc.contributor.referee1.fl_str_mv |
Lucareli, Paulo Roberto Garcia |
dc.contributor.referee2.fl_str_mv |
Politti, Fabiano |
dc.contributor.referee3.fl_str_mv |
Freitas, Sandra Maria Sbeghen Ferreira de |
dc.contributor.referee4.fl_str_mv |
Costa, Leonardo Oliveira Pena |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/3078580296713478 |
dc.contributor.author.fl_str_mv |
Ferreira, Cintia Lopes |
contributor_str_mv |
Lucareli, Paulo Roberto Garcia Barroso, Filipe André Oliveira Lucareli, Paulo Roberto Garcia Politti, Fabiano Freitas, Sandra Maria Sbeghen Ferreira de Costa, Leonardo Oliveira Pena |
dc.subject.por.fl_str_mv |
dor femoropatelar cinemática tarefas funcionais eletromiografia sinergias musculares |
topic |
dor femoropatelar cinemática tarefas funcionais eletromiografia sinergias musculares patellofemoral pain kinematic functional tasks electromyography muscle synergies CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
patellofemoral pain kinematic functional tasks electromyography muscle synergies |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Introduction: Patellofemoral pain (PFP) has a multifactorial etiology and among the factors associated with PFP, the biomechanical are the most discussed in the literature. Kinematics changes in trunk, pelvis and lower limbs are normally associated with PFP patients, but not all changes appear in all patients and in all assessed tasks. Identify which task that most differentiates the subjects with and without PFP could help to make clinical decision regarding assessment of these patients and then guide the identification of possible causes of kinematic changes, since muscle strength appears to be unrelated with kinematic. We know that muscle activities depend on the neural control that activates the musculature by muscle synergies and the motor control could be influenced by pain, to investigate if there are changes in neuromuscular organization could contribute to a better understanding of PFP and help to improve the treatment and assessment strategies to PFP patients. Objective: 1. Identify which functional tasks differentiates the three-dimensional kinematic of women with and without PFP. 2. Analyze the muscle synergies of women with PFP and correlate with the kinematic of the trunk, pelvis and lower limbs during the lateral step down (LSD). Methods: 1. Cross-sectional study that evaluated 35 women with PFP and 35 asymptomatic women during the execution of seven functional tasks. Three-dimensional kinematic data were analyzed through the Movement Deviation Profile (MDP). To identify which task presented the most differences between the groups, the Z-score of the mean MDP was calculated. 2. Cross-sectional study with 15 women with PFP and 14 asymptomatic submitted to three-dimensional kinematic and electromyography (EMG) assessment during the LSD. Muscle synergies were extracted from EMG signals using a non-negative matrix factorization algorithm. Kinematics data were analyzed through MDP. The data were compared by independence t test and correlated by Pearson correlation test. Results: 1. For all tasks, the groups presented differences, but according with Z-score the LSD (7.97) and forward step down (7.62) were the tasks that most differentiate the kinematic of the groups. 2. Women with PFP showed no differences in the minimum number of muscle synergies necessary to explain most variability of EMG (VAF) to perform the LSD, but showed higher VAFtotal and VAFmuscle for rectus femoris and vastus medialis compared to asymptomatic women. For PFP, the lower the similarity in the muscle participation in each muscle synergies (W2, W3 e Wmean) compared to control, the higher the differences in trunk, pelvis and lower limbs during the LSD. Conclusion: Step down tests are the tasks that most differentiate the kinematic of women with and without PFP, the LSD was the tasks with the highest sensitivity to detect differences. During the LSD, PFP women showed poor muscle control and coordination, mainly for the rectus femoris and vastus medialis muscles and these findings have correlation with the higher changes kinematics during the task execution. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-12-11 |
dc.date.accessioned.fl_str_mv |
2020-10-28T16:37:24Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Ferreira, Cintia Lopes. Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar. 2019. 129 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/2293 |
identifier_str_mv |
Ferreira, Cintia Lopes. Análise da cinemática tridimensional e sinergia muscular de mulheres com dor femoropatelar. 2019. 129 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo. |
url |
http://bibliotecatede.uninove.br/handle/tede/2293 |
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por |
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por |
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8765449414823306929 |
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600 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Universidade Nove de Julho |
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Programa de Pós-Graduação em Ciências da Reabilitação |
dc.publisher.initials.fl_str_mv |
UNINOVE |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Saúde |
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Universidade Nove de Julho |
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