Estudo da associação entre dor patelofemoral e retropé varo
DOI:
https://doi.org/10.11606/issn.2317-0190.v13i2a102584Palavras-chave:
Dor, Joelho, Tornozelo, PéResumo
A dor patelofemoral, também denominada dor anterior do joelho está presente em 25% da população, onde 36% são adolescentes e com maior prevalência no sexo feminino e atletas. Objetivo: Verificar a associação entre a presença de retropé varo a partir da posição neutra da subtalar e a dor patelofemoral. Métodos: Foram recrutados 10 voluntários com dor patelofemoral unilateral ou bilateral. Os voluntários foram submetidos à avaliação do alinhamento do retropé a partir da posição neutra da subtalar. Para isso, os voluntários foram posicionados em decúbito ventral, com o pé pendente para fora da mesa. Os ângulos formado pelas retas que dividem as pernas e os calcâneos ao meio foram medidas através de um goniômetro universal. O teste de Fisher foi utilizado para verificar a associação entre dor patelofemoral e varismo de retropé maior ou igual ou menor que 8 graus. Resultados: Os resultados do presente estudo demonstraram que todos os membros com grau de retropé maior que 8 (75%) apresentavam dor, totalizando 15 joelhos. Já os joelhos avaliados com retropé menor ou igual a 8; 2 (10%) apresentavam dor e 3 (15%) não apresentaram dor. Associação estatisticamente significativa entre o grau de retropé e a presença de dor foram encontrados (p= 0,009). Discussão: O varismo de retropé leva a pronação excessiva da subtalar associada à rotação interna da tíbia com conseqüente alteração do alinhamento do membro inferior e dor patelofemoral, Conclusão: Os resultados desse estudo sugerem que existe a associação entre o retropé varo e a dor patelofemoral.
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Referências
Austermuehle PD. Common knee injuries in primary care. Nurse Pract. 2001;26(10):26,32-45; quiz 46-7.
Hanten WP, Schulthies SS. Exercise effect on electromyographic activity of the vastus medialis oblique and vastus lateralis muscles. Phys Ther. 1990;70(9):561-5.
Karst GM, Willett GM. Onset timing of electromyographic activity in the vastus medialis oblique and vastus lateralis muscles in subjects with and without patellofemoral pain syndrome. Phys Ther. 1995;75(9):813-23.
McConnel J. The management of chondromalacia patellae: a long-term solution. Aust J Physioth. 1986;32:215-23.
McPoil TH, Knecht HG, Schuit D. A survey of foot types in normal females between the ages of 18 and 30 years. J Orthop Sports Phys Ther. 1988;9:406-409.
Ogilvie SW, Rendall GC, Abboud RJ. Reliability of open kinetic chain subtalar joint measurement. The Foot . 1997;7(3):128-134.
Fredericson M, Powers CM. Practical management of patellofemoral pain. Clin J Sport Med. 2002;12(1):36-8.
Tiberio D. Pathomechanics of structural foot deformities. Phys Ther. 1988;68(12):1840-9.
Thomee R, Renstrom P, Karlsson J, Grimby G. Patellofemoral pain syndrome in young women. I. A clinical analysis of alignment, pain parameters, common symptoms and functional activity level. Scand J Med Sci Sports. 1995;5(4):237-44.
Buchbinder MR, Napora NJ, Biggs EW. The relationship of abnormal pronation to chondromalacia of the patella in distance runners. J Am Podiatry Assoc. 1979;69(2):159-62.
Donatelli R. Abnormal biomechanics of the foot and ankle. J Orthop Sports Phys Ther. 1987;9:11-16.
Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med. 1999;27(5):585-93.
Jernick S, Heifitz NM. An investigation into the relationship of foot pronation to chondromalacia patellae. Arch Podiatr Med Foot Surg. 1977;1:1-31.
Sobel E, Levitz SJ, Caselli MA, Tran M, Lepore F, Lilja E, et al. Reevaluation of the relaxed calcaneal stance position. Reliability and normal values in children and adults. J Am Podiatr Med Assoc. 1999;89(5):258-64.
Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003;33(11):639-46.
Tiberio D. The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther. 1987;9(4):160-165.
Levinger P, Gilleard W. AN evaluatio of the reafoot posture in individuals with patellofemoral pain syndrome. J Sport Sci Med. 2004;3(1):8-14.
Astrom M, Arvidson T. Alignment and joint motion in the normal foot. J Orthop Sports Phys Ther. 1995;22(5):216-22.
McPoil TG, Brocato RS. The foot and ankle: biomechanical evaluation and treatment. In: Gould JA, Davies GJ. Orthopaedic and Sports Physical Therapy. St. Louis: Mosby; 1985. p. 313-41.
McClay I, Manal K. A comparison of three-dimensional lower extremity kinematics during running between excessive pronators and normals. Clin Biomech (Bristol, Avon). 1998;13(3):195-203.
Lattanza L, Gray GW, Kantner RM. Closed versus open kinematic chain measurements of subtalar joint eversion: implication for clinical practice. J Orthop Sports Phys Ther. 1988;9:310-314.
Elveru RA, Rothstein JM, Lamb RL. Goniometric reliability in a clinical setting. Subtalar and ankle joint measurements. Phys Ther. 1988;68(5):672-7.
Root ML, Orien WP, Weed JH. Normal and abnormal function of foot: clinical biomechanics. Los Angeles: Clinical Biomechanics Corp; 1977.
Wernick J, Launger S. A Practical manual for a basic approach to biomechanics. New York: Launger Acrylic Laboratory; 1972.
Dahlman BG, Kernozek TW, Palmer-McLean K, Davies GJ. The role of static measurements of the lower extremity in predicting dynamic rearfoot motion and subsequent injury. Crit Rev Phys Rehabil Med. 2002;14(3):235-46.
Portney LG, Watkins MP. Reliability. In: Portney LG; Watkins MP. Foundations of clinical research applications to pratice. New Jersey: Prentice-Hall; 2000. p. 61-75
Elveru RA, Rothstein JM, Lamb RL, Riddle DL. Methods for taking subtalar joint measurements: a clinical report. Phys Ther. 1988;68(5):678-82.
Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;25(4):253-63.
Vogelbach W D, Combs L C. A biomechanical approach to the management of chronic lower extremity pathologies as they relate to excessive pronation. J Athl Train. 1987;22:6-16.
Powers CM, Maffucci R, Hampton S. Rearfoot posture in subjects with patellofemoral pain. J Orthop Sports Phys Ther. 1995;22(4):155-60.
Grelsamer RP, Klein JR. The biomechanics of the patellofemoral joint. J Orthop Sports Phys Ther. 1998;28(5):286-98.
Reischl SF, Powers CM, Rao S, Perry J. Relationship between foot pronation and rotation of the tibia and femur during walking. Foot Ankle Int. 1999;20(8):513-20.
McPoil TG, Cornwall MW. The relationship between static lower extremity measurements and rearfoot motion during walking. J Orthop Sports Phys Ther. 1996;24(5):309-14.
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