Importância do treinamento da propriocepção e do controle motor na reabilitação após lesões músculo-esqueléticas
DOI:
https://doi.org/10.11606/issn.2317-0190.v16i3a103214Palavras-chave:
Propriocepção, Atividade Motora, Sistema Musculosquelético/ lesões, ReabilitaçãoResumo
A propriocepção e o controle muscular possuem um papel fundamental na estabilidade articular dinâmica. Após lesões ortopédicas algumas características sensório-motoras são alteradas e devem ser focadas em programas de reabilitação, para que haja sucesso no retorno às atividades realizadas previamente a lesão. Desta forma, devem ser realizados exercícios proprioceptivos específicos desde início do período pós operatório ou após a fase aguda de lesões tratadas conservadoramente, com o objetivo de melhorar a acuidade proprioceptiva e a resposta muscular antecipatória e reativa, restabelecendo a estabilidade articular dinâmica. Neste artigo abordaremos o conceito original de propriocepção, a contribuição para a manutenção da estabilidade articular dinâmica, a influência da lesão na acuidade proprioceptiva e o treinamento da propriocepção e do controle neuromuscular.
Downloads
Referências
Riemann BL, Lephart SM. The Sensorimotor System, Part I: The Physiologic Basis of Functional Joint Stability. J Athl Train. 2002;37(1):71-79.
Sherrington CS. The integrative action of the nervous system. New York: Scribner's Son; 1906.
Matthews PB. Where does Sherrington's "muscular sense" originate? Muscles, joints, corollary discharges? Annu Rev Neurosci. 1982;5:189-218.
Lephart SM, Fu FH. Proprioception and neuromuscular control in joint stability. Champaigne (IL): Human Kinetics; 2000.
Guyton AC, Hall JE. Textbook of medical physiology. 11 ed. Philadelphia: WB Saunders; 2006.
McGill SM, Cholewicki J. Biomechanical basis for stability: an explanation to enhance clinical utility. J Orthop Sports Phys Ther. 2001;31(2):96-100.
Johansson H, Sjolander P. The neurophysiology of joints. In: Wright V, Radin EL, editors. Mechanics of joints: physiology, pathophysiology and treatment. New York: Marcel Dekker; 1993. p.243-90.
Snyder-Mackler L, Ladin Z, Schepsis AA, Young JC. Electrical stimulation of the thigh muscles after reconstruction of the anterior cruciate ligament. Effects of electrically elicited contraction of the quadriceps femoris and hamstring muscles on gait and on strength of the thigh muscles. J Bone Joint Surg Am. 1991;73(7):1025-36.
Barrett DS. Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg Br. 1991;73(5):833-7.
Harrison EL, Duenkel N, Dunlop R, Russell G. Evaluation of single-leg standing following anterior cruciate ligament surgery and rehabilitation. Phys Ther. 1994;74(3):245-52.
Solomonow M, Krogsgaard M. Sensorimotor control of knee stability. A review. Scand J Med Sci Sports. 2001;11(2):64-80.
Knatt T, Guanche C, Solomonow M, Lu Y, Baratta R, Zhou BH. The glenohumeral-biceps reflex in the feline. Clin Orthop Relat Res. 1995;(314):247-52.
Solomonow M, Zhou BH, Harris M, Lu Y, Baratta RV. The ligamento-muscular stabilizing system of the spine. Spine. 1998;23(23):2552-62.
Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther. 2006;11(3):197-201.
Markolf KL, Graff-Radford A, Amstutz HC. In vivo knee stability. A quantitative assessment using an instrumented clinical testing apparatus. J Bone Joint Surg Am. 1978;60(5):664-74.
Williams GN, Chmielewski T, Rudolph K, Buchanan TS, Snyder-Mackler L. Dynamic knee stability: current theory and implications for clinicians and scientists. J Orthop Sports Phys Ther. 2001;31(10):546-66.
Butler RJ, Crowell HP 3rd, Davis IM. Lower extremity stiffness: implications for performance and injury. Clin Biomech (Bristol, Avon). 2003;18(6):511-7.
Krosshaug T, Nakamae A, Boden BP, Engebretsen L, Smith G, Slauterbeck JR, et al. Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases. Am J Sports Med. 2007;35(3):359-67.
Bastian AJ. Learning to predict the future: the cerebellum adapts feedforward movement control. Curr Opin Neurobiol. 2006;16(6):645-9.
Dietz V, Noth J, Schmidtbleicher D. Interaction between pre-activity and stretch reflex in human triceps brachii during landing from forward falls. J Physiol. 1981;311:113-25.
Lephart SM, Fu FH, Borsa JP, Warner JP. Proprioceptive of the shoulder joint in healthy, unstable, and surgically repaired shoulders. J Shoulder Elbow Surg. 1994;3:371-380.
Zuckerman JD, Gallagher MA, Cuomo F, Rokito A. The effect of instability and subsequent anterior shoulder repair on proprioceptive ability. J Shoulder Elbow Surg. 2003;12(2):105-9.
Myers JB, Ju YY, Hwang JH, McMahon PJ, Rodosky MW, Lephart SM. Reflexive muscle activation alterations in shoulders with anterior glenohumeral instability. Am J Sports Med. 2004;32(4):1013-21.
Swanik CB, Lephart SM, Giannantonio FP, Fu FH. Re-establishing proprioception and neuromuscular control in the ACL-injured athlete. J Sport Rehabil. 1997;6:182-206.
Lephart SM, Henry TJ. The physiological basis for open and closed kinetic chain rehabilitation for the upper extremity. J Sport Rehabil. 1996;5:71-87.
Lephart SM, Henry TJ. Functional rehabilitation for the upper and lower extremity. Orthop Clin North Am. 1995;26(3):579-92.
Fellows SJ, Thilmann AF. The role of joint biomechanics in determining stretch reflex latency at the normal human ankle. Exp Brain Res. 1989;77(1):135-9.
Hurd WJ, Chmielewski TL, Snyder-Mackler L. Perturbation-enhanced neuromuscular training alters muscle activity in female athletes. Knee Surg Sports Traumatol Arthrosc. 2006;14(1):60-9.
Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. 3rd ed. Berlin: Springer; 2008.
Swanik KA, Lephart SM, Swanik CB, Lephart SP, Stone DA, Fu FH. The effects of shoulder plyometric training on proprioception and selected muscle performance characteristics. J Shoulder Elbow Surg. 2002;11(6):579-86.
Smith CE, Nyland J, Caudill P, Brosky J, Caborn DN. Dynamic trunk stabilization: a conceptual back injury prevention program for volleyball athletes. J Orthop Sports Phys Ther. 2008;38(11):703-20.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2009 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
