Efeitos do alongamento muscular e condicionamento físico no tratamento fisioterápico de pacientes com fibromialgia Effects of muscle stretching and physical conditioning as physical therapy treatment for patients with fibromyalgia

OBJETIVO: Verificar os efeitos de exercícios de alongamento muscular e condicionamento físico no tratamento fisioterápico da fibromialgia (FM). CASUÍSTICA E MÉTODOS: Foram avaliadas 15 mulheres com diagnóstico de FM, segundo os critérios do Colégio Americano de Reumatologia, divididas em dois grupos: Grupo 1 (G1) com oito pacientes, realizou tratamento por meio de alongamentos musculares e Grupo 2 (G2), sete pacientes, condicionamento físico. Foram avaliados qualidade do sono, fatores de piora e melhora da dor, sintomas associados e medicamentos utilizados. Além disso, foi aplicado o Fibromyalgia Impact Questionnaire (FIQ), para avaliar o impacto da FM. O tratamento durou oito semanas, sendo uma sessão semanal com duração de 40 a 45 minutos. As variáveis do FIQ antes e depois dos tratamentos foram comparadas pelo teste t para amostras dependentes (alfa< 0,05) e as demais foram analisadas descritivamente. RESULTADOS: A maioria das pacientes apresentava sono não reparador (86,67%), piora da dor com serviços domésticos (40%), nenhum fator de melhora da dor (28,57%), distúrbios do sono como sintomas associados (100%) e utilizava antidepressivos (69,23%). Em relação às variáveis do FIQ, observaram-se diferenças estatisticamente significantes no sono (p= 0,0428) e rigidez matinal (p= 0,0130) nas pacientes do G1. Já no G2, não foram observadas diferenças significantes após o tratamento. CONCLUSÕES: Sugere-se que os alongamentos musculares realizados podem gerar impacto positivo na FM, promovendo melhora do sono e rigidez matinal das pacientes avaliadas.<br>OBJECTIVE: To investigate the effects of muscle stretching exercises and physical conditioning as physical therapy treatment for fibromyalgia. METHODS: Fifteen women with a diagnosis of fibromyalgia in accordance with the criteria of the American College of Rheumatology were evaluated and divided into two groups: Group 1 (G1, eight patients) underwent treatment consisting of muscle stretching and Group 2 (G2, seven patients), participated in a physical conditioning program. Sleep quality, pain-modulating factors, associated symptoms and medications used were evaluated. Furthermore, the Fibromyalgia Impact Questionnaire (FIQ) was applied to evaluate the impact of fibromyalgia. The treatment lasted for eight weeks, with one session per week of 40 to 45 minutes in duration. The FIQ data obtained before and after treatment were analyzed by means of Student’s t test for dependent samples (alpha< 0.05) and other variables were analyzed descriptively. RESULTS: Most of the patients presented poor quality of sleep (86.67%). Many presented worsening of their pain when doing domestic tasks (40%) and there were no factors that relieved their pain (28.57%). All presented sleep disorders with associated symptoms (100%) and most used antidepressives (69.23%). For the FIQ data, statistically significant differences were observed in morning tiredness (p= 0.0428) and stiffness (p= 0.0130) among the G1 patients. Conversely, no difference was observed in G2 after the treatment. CONCLUSIONS: It is suggested that the muscle stretching may have had a positive impact on fibromyalgia, with reductions in morning tiredness and stiffness among the patients evaluated

Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press

Objectives: To evaluate the electrical activity of the vastus medialis obliquus (VMO) and vastus lateralis longus (VLL) with the tibia in neutral, medial and lateral rotation on the horizontal leg press. Design: Repeated measures analysis of the effects of tibia rotation on VMO and VLL activity. Setting: Evaluation and intervention in orthopaedics and traumatology laboratory. Participants: Fifteen healthy participants, no previous musculoskeletal damage of the lower limb. Main outcome measures: Electrical activity (Root Mean Square) of the VMO and VLL was measured during submaximal isometric contractions (SIC) with the knee at 90 degrees of flexion. The effect of tibia rotation in electrical activity of the VMO and VLL was measured. Results: VLL activity was significantly higher than VMO activity with the tibia in medial rotation (p = 0.03). Tibia rotation did not influence the activity of the VMO muscle (p = 0.26). VLL activity was significantly higher with medial than neutral tibia rotation (p = 0.005). Conclusions: The results suggest that tibia rotation does not strengthen selectively the VMO muscle during isometric leg press at 90 degrees knee flexion. (c) 2004 Elsevier Ltd. All rights reserved.61152

Evaluation of adaptive/nonadaptive filtering and wavelet transform techniques for noise reduction in EMG mobile acquisition equipment

The myoelectric signal can be used to control many rehabilitation systems, for instance, prostheses and artificial neuromuscular electrical stimulation toward restoring movement to spinal cord injured subjects. These mobile systems are usually used in different environments and thus are being exposed to different noise levels with characteristics not completely known. In this article, three main techniques for noise reduction Were evaluated: wavelet transform (WT), adaptive digital filters, and nonadaptive digital filters. The WT was used to reconstruct the signal with the components without noise information. Adaptive filters were designed using least mean square (LMS) and recursive least square (RLS) algorithms. Finite-impulse response (FIR) and infinite-impulse response (IIR) nonadaptive filters were used for comparison to both the adaptive filters and the signal reconstruction through the WT.111606

Atividade eletromiográfica do vasto medial oblíquo em portadoras da síndrome da dor patelofemoral Electromyographyc activity of the vastus medialis oblique muscle in female patients with patellofemoral syndrome

A síndrome da dor patelofemoral (SDPF) é uma das afecções que mais acometem a articulação do joelho. Embora sua etiologia não seja completamente conhecida, uma disfunção do músculo vasto medial oblíquo (VMO) tem sido apontada como possível fator desencadeante. Este estudo visou avaliar, por meio de eletromiografia, se algum exercício, dentre dez exercícios resistidos usuais, produz ativação seletiva do VMO, com vistas a sua utilização clínica. Vinte voluntárias do sexo feminino, sendo dez com SDPF (24,7±4,35 anos) e dez saudáveis, controle (22,5±1,58 anos), foram submetidas à avaliação eletromiográfica dos músculos VMO, vasto lateral longo e vasto lateral oblíquo (VLO) durante a realização de 10 exercícios, incluindo cadeia cinética aberta e fechada, em diferentes angulações do joelho e posições do quadril. Os resultados mostram que nenhum dos exercícios se revelou seletivo para o VMO, tendo alguns mostrado ativação seletiva do VLO. No grupo com SDPF observou-se menor atividade eletromiográfica de todos os vastos em oito dos dez exercícios propostos, quando comparado ao controle; observou-se ainda, no grupo SDPF, menor relação VMO/VLO (0,63) do que no grupo controle (0,82, p<0,05). Embora, dentre os propostos, nenhum exercício tenha se mostrado eficaz para promover a ativação seletiva do VMO, os exercícios de agachamento unipodal com rotação medial e lateral da tíbia mostraram-se mais indicados para sujeitos com SDPF.<br>The patellofemoral pain syndrome (PFPS) is among the most common knee pathologies. Although its etiology is not fully known, a dysfunction of the vastus medialis oblique (VMO) muscle has been pointed out as a possible cause. This study aimed at assessing, by means of electromyography, whether one or more, among ten usual resisted exercises, might produce VMO selective activation, in view of its clinic application. Twenty female volunteers, ten with PFPS (aged 24.7±4.35) and ten healthy ones (aged 22.5±1.58) were submitted to electromyographic evaluation of VMO, vastus lateralis longus and vastus lateralis oblique (VLO) muscles during ten exercises, including open and closed kinetic chain, at different degrees of knee flexion and of hip positions. None of the exercises showed to be selective for VMO activation, but some showed selective activation of the VLO. In the PFPS group all vastii showed lesser electromyographic activity than control group, in eight of the ten exercises; the VMO/VLO ratio was also lower (0.63) in PFPS group than in control (0.82, p<0.05). Although none of the proposed exercises showed efficient to promote VMO selective activation, squatting on one foot, with medial and lateral tibia rotation, seemed appropriate for treating PFPS