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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(05): 540-548
DOI: 10.1055/s-0039-1693743
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Variáveis biomecânicas dos membros inferiores são indicadores do padrão de apresentação da tendinopatia patelar em atletas de elite africanos de basquetebol e voleibol[*]

Article in several languages: português | English
Ayoola Aiyegbusi 
1   Departament of Physiotherapy, College of Medicine, University of Lagos, Nigéria
,
Bidemi Tella
1   Departament of Physiotherapy, College of Medicine, University of Lagos, Nigéria
,
Chukwuebuka Okeke
1   Departament of Physiotherapy, College of Medicine, University of Lagos, Nigéria
› Author Affiliations
Further Information

Publication History

19 December 2018

13 May 2019

Publication Date:
02 September 2019 (online)

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Resumo

Objetivo Este estudo determinou o padrão de apresentação e gravidade da tendinopatia patelar (TP) e sua relação com variáveis biomecânicas selecionadas em atletas de elite.

Métodos O estudo envolveu 98 jogadores de elite nigerianos de basquetebol e voleibol com idades entre 18 e 35 anos. Testes clínicos e ultrassonografia foram usados para separar os participantes em grupos sintomáticos e assintomáticos. Procedimentos padrão foram utilizados para avaliar o ângulo do quadríceps (ângulo Q), a torção da tíbia, a dorsiflexão do tornozelo, a flexibilidade dos isquiotibiais, e a postura do pé. Usou-se o questionário Victorian Institute of Sport Assessment Questionnaire, Patellar Tendon (VISA-P) para avaliar a gravidade dos sintomas nos grupos sintomáticos. A análise estatística foi realizada por meio de análise de variância (ANOVA, na sigla em inglês), análise post hoc, e correlação de Pearson, com nível de significância estabelecido em p < 0,05.

Resultados Pontuações significativamente menores de sentar e alcançar (p = 0,01), aumento da pontuação do índice de postura do pé (p = 0,01), e redução da amplitude de dorsiflexão do tornozelo (p = 0,03) foram encontrados em participantes de ambos os sexos com TP sintomática. Ângulos Q (p = 0,02) maiores nos homens e ângulos de torção tibial maiores (p = 0,001) nas mulheres também foram encontrados nos grupos de TP sintomática. A gravidade dos sintomas foi significativamente maior no grupo que tinha apenas sintomas clínicos (p = 0,042), e estava significativamente correlacionada com a flexibilidade dos isquiotibiais tanto nos homens (r = -0,618) quanto nas mulheres (r = -0,664).

Conclusão A redução da flexibilidade dos isquiotibiais, o aumento da pronação do pé, e a redução da amplitude de dorsiflexão do tornozelo foram significativos em participantes com TP sintomática.

Palavras-chave

tendinopatia - patela - traumatismos em atletas - fenômenos biomecânicos - voleibol - basquetebol

* Estudo realizado no Departamento de Fisioterapia, College of Medicine, University of Lagos, Nigéria.


 

  • Referências

  • 1 Schwartz A, Watson JN, Hutchinson MR. Patellar Tendinopathy. Sports Health 2015; 7 (05) 415-420
    CrossrefPubMedGoogle Scholar
  • 2 Reinking MF. Current concepts in the treatment of patellar tendinopathy. Int J Sports Phys Ther 2016; 11 (06) 854-866
    PubMedGoogle Scholar
  • 3 Rudavsky A, Cook J. Physiotherapy management of patellar tendinopathy (jumper's knee). J Physiother 2014; 60 (03) 122-129
    CrossrefPubMedGoogle Scholar
  • 4 Malliaras P, Cook J, Purdam C, Rio E. Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations. J Orthop Sports Phys Ther 2015; 45 (11) 887-898
    CrossrefPubMedGoogle Scholar
  • 5 Comin J, Cook JL, Malliaras P. , et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med 2013; 47 (02) 89-92
    CrossrefPubMedGoogle Scholar
  • 6 Docking SI, Daffy J, van Schie HT, Cook JL. Tendon structure changes after maximal exercise in the Thoroughbred horse: use of ultrasound tissue characterisation to detect in vivo tendon response. Vet J 2012; 194 (03) 338-342
    CrossrefPubMedGoogle Scholar
  • 7 Oliva F, Piccirilli E, Berardi AC, Frizziero A, Tarantino U, Maffulli N. Hormones and tendinopathies: the current evidence. Br Med Bull 2016; 117 (01) 39-58
    CrossrefPubMedGoogle Scholar
  • 8 Scattone Silva R, Nakagawa TH, Ferreira AL, Garcia LC, Santos JE, Serrão FV. Lower limb strength and flexibility in athletes with and without patellar tendinopathy. Phys Ther Sport 2016; 20: 19-25
    CrossrefPubMedGoogle Scholar
  • 9 Pruna R, Clos E, Bahdur K, Artells R. Influence of genetics on sports injuries. J Nov Physiother 2017; 7: 359
    Google Scholar
  • 10 van der Worp H, van Ark M, Zwerver J, van den Akker-Scheek I. Risk factors for patellar tendinopathy in basketball and volleyball players: a cross-sectional study. Scand J Med Sci Sports 2012; 22 (06) 783-790
    CrossrefPubMedGoogle Scholar
  • 11 Morgan S, Janse van Vuuren EC, Coetzee FF. Causative factors and rehabilitation of patellar tendinopathy: A systematic review. S Afr J Physiother 2016; 72 (01) 338
    PubMedGoogle Scholar
  • 12 Aiyegbusi AI, Okafor UA, Leke OP. Prevalence of Achilles tendinopathy and its association with physical characteristics in recreational sport participants in Lagos, Nigeria. J Clin Sci. 2016; 13: 163-166
    CrossrefGoogle Scholar
  • 13 Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench 2013; 6 (01) 14-17
    Google Scholar
  • 14 Maffulli N, Oliva F, Loppini M, Aicale R, Spiezia F, King JB. The Royal London Hospital Test for the clinical diagnosis of patellar tendinopathy. Muscles Ligaments Tendons J 2017; 7 (02) 315-322
    PubMedGoogle Scholar
  • 15 de Groot R, Malliaras P, Munteanu S, Payne C, Morrissey D, Maffulli N. Foot posture and patellar tendon pain among adult volleyball players. Clin J Sport Med 2012; 22 (02) 157-159
    CrossrefPubMedGoogle Scholar
  • 16 Langley B, Cramp M, Morrison SC. Clinical measures of static foot posture do not agree. J Foot Ankle Res 2016; 9: 45-57
    CrossrefPubMedGoogle Scholar
  • 17 Redmond AC. The foot posture index: FPI user guide and manual. 2009 . Disponível em: www.Leeds.Ac.Uk/medicine/FASTER/fpi.htm . Accessed 25, April, 2018
  • 18 Tarawneh I, AL-Ajoulin O, Alkhawaldah A. , et al. Normal values of quadriceps angle and its correlation with anthropometric measures in a group of Jordanians. J Royal Med Serv 2016; 23 (02) 53-58
    Google Scholar
  • 19 Chhabra PK, Setiya M, Godwin R. “Quadriceps angle”: An important indicator of biomechanical function of lower extremity and its relation with anterior knee pain. Int J Sci Stud 2016; 4 (07) 173-176
    Google Scholar
  • 20 Bozic PR, Pazin NR, Berjan BB, Planic NM, Cuk ID. Evaluation of the field tests of flexibility of the lower extremity: reliability and the concurrent and factorial validity. J Strength Cond Res 2010; 24 (09) 2523-2531
    CrossrefPubMedGoogle Scholar
  • 21 Mayorga-Vega D, Merino-Marban R, Viciana J. Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. J Sports Sci Med 2014; 13 (01) 1-14
    PubMedGoogle Scholar
  • 22 Schulze C, Lindner T, Woitge S. , et al. Influence of footwear and equipment on stride length and range of motion of ankle, knee and hip joint. Acta Bioeng Biomech 2014; 16 (04) 45-51
    PubMedGoogle Scholar
  • 23 Stevens PM, Gililland JM, Anderson LA, Mickelson JB, Nielson J, Klatt JW. Success of torsional correction surgery after failed surgeries for patellofemoral pain and instability. Strateg Trauma Limb Reconstr 2014; 9 (01) 5-12
    CrossrefPubMedGoogle Scholar
  • 24 Hernandez-Sanchez S, Hidalgo MD, Gomez A. Responsiveness of the VISA-P scale in athletes. Br J Sports Med 2014; 48 (06) 453-457
    CrossrefPubMedGoogle Scholar
  • 25 van Schie HT, de Vos RJ, de Jonge S. , et al. Ultrasonographic tissue characterisation of human Achilles tendons: quantification of tendon structure through a novel non-invasive approach. Br J Sports Med 2010; 44 (16) 1153-1159
    CrossrefPubMedGoogle Scholar
  • 26 Visnes H, Tegnander A, Bahr R. Ultrasound characteristics of the patellar and quadriceps tendons among young elite athletes. Scand J Med Sci Sports 2015; 25 (02) 205-215
    CrossrefPubMedGoogle Scholar
  • 27 Fredberg U, Bolvig L, Pfeiffer-Jensen M, Clemmensen D, Jakobsen BW, Stengaard-Pedersen K. Ultrasonography as a tool for diagnosis, guidance of local steroid injection and, together with pressure algometry, monitoring of the treatment of athletes with chronic jumper's knee and Achilles tendinitis: a randomized, double-blind, placebo-controlled study. Scand J Rheumatol 2004; 33 (02) 94-101
    CrossrefPubMedGoogle Scholar
  • 28 Stephen T, Miltiadias H, Joseph B. Patella tendinopathy. Orthop Surg 2012; 8: 6
    Google Scholar
  • 29 Nejati P, Forogh B, Moeineddin R, Baradaran HR, Nejati M. Patellofemoral pain syndrome in Iranian female athletes. Acta Med Iran 2011; 49 (03) 169-172
    PubMedGoogle Scholar
  • 30 Kujala UM, Osterman K, Kvist M, Aalto T, Friberg O. Factors predisposing to patellar chondropathy and patellar apicitis in athletes. Int Orthop 1986; 10 (03) 195-200
    PubMedGoogle Scholar
  • 31 Almeida GP, Silva AP, França FJ, Magalhães MO, Burke TN, Marques AP. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop 2016; 51 (02) 181-186
    Google Scholar
  • 32 Reisler CT. Analysis of patellar tendinopathy risk factors among intercollegiate athletes [thesis]. San Marcos, TX: Texas State University; 2016
    Google Scholar
  • 33 Cook JL, Purdam CR. The challenge of managing tendinopathy in competing athletes. Br J Sports Med 2014; 48 (07) 506-509
    CrossrefPubMedGoogle Scholar
  • 34 van der Worp H, van Ark M, Roerink S, Pepping GJ, van den Akker-Scheek I, Zwerver J. Risk factors for patellar tendinopathy: a systematic review of the literature. Br J Sports Med 2011; 45 (05) 446-452
    CrossrefPubMedGoogle Scholar
  • 35 Alonso J, McHugh MP, Mullaney MJ, Tyler TF. Effect of hamstring flexibility on isometric knee flexion angle-torque relationship. Scand J Med Sci Sports 2009; 19 (02) 252-256
    PubMedGoogle Scholar
  • 36 Morton S, Williams S, Valle X, Diaz-Cueli D, Malliaras P, Morrissey D. Patellar Tendinopathy and Potential Risk Factors: An International Database of Cases and Controls. Clin J Sport Med 2017; 27 (05) 468-474
    CrossrefPubMedGoogle Scholar
  • 37 Backman LJ, Danielson P. Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study. Am J Sports Med 2011; 39 (12) 2626-2633
    CrossrefPubMedGoogle Scholar
  • 38 Grossman G, Waninger KN, Voloshin A. , et al. Reliability and validity of goniometric turnout measurements compared with MRI and retro-reflective markers. J Dance Med Sci 2008; 12 (04) 142-152
    PubMedGoogle Scholar
  • 39 Neal BS, Griffiths IB, Dowling GJ. , et al. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. J Foot Ankle Res 2014; 7 (01) 55-68
    CrossrefPubMedGoogle Scholar
  • 40 Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009; 43 (06) 409-416
    CrossrefPubMedGoogle Scholar
  • 41 Pieretti S, Di Giannuario A, Di Giovannandrea R. , et al. Gender differences in pain and its relief. Ann Ist Super Sanita 2016; 52 (02) 184-189
    PubMedGoogle Scholar