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Efeitos de um Programa de Exercícios com Recurso ao Biofeedback Eletromiográfico comparativamente a um Programa de Exercícios Isolado, ao nível da Dor, Funcionalidade e Intensidade de Ativação dos Músculos do Complexo Articular do Ombro, em Atletas Femininas de Voleibol
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Abstract(s)
INTRODUÇÃO: A disfunção do complexo articular do ombro (DCAO) ocorre em 8%
a 20% das lesões no voleibol. A evidência sugere os efeitos de um programa de exercício
escapulo-torácico (ET) em DCAO, com alteração na estabilidade dinâmica da omoplata,
focados na ativação seletiva dos músculos estabilizadores locais (Trapézio Inferior – TI;
Grande Dentado – GD) e redução da hiperatividade do Trapézio Superior (TS). O
Biofeedback Eletromiográfico (BEMG) pode promover a ativação muscular seletiva dos
músculos ET em sujeitos com DCAO, porém não existe investigação do seu efeito em
overhead sports (OHS). OBJETIVO: Comparar os efeitos de um protocolo de exercícios
ET com recurso ao BEMG comparativamente a um protocolo de exercícios ET ao nível
da intensidade da dor, funcionalidade e intensidade de ativação muscular em atletas
voleibolistas femininas com DCAO. METODOLOGIA: A amostra foi constituída por
14 atletas da equipa de voleibol feminina da Universidade Lusófona de Lisboa com
DCAO, dividida em dois grupos (n=7 no Grupo Exercício – GEXC; n=7 no Grupo
Exercício com recurso ao BEMG - GBEMG). Os dois grupos avaliaram-se em três
momentos (T0 – avaliação inicial; T1 – avaliação às 4 semanas; T2 – avaliação às 8
semanas) na intensidade de ativação muscular (eletromiografia de superfície - EMGs) dos
músculos TI, GD e TS em duas tarefas (lenta e balística), intensidade da dor (escala
numérica da dor - END) e funcionalidade (DASH - Disabilities of the arm, shoulder and
hand). Foi feita uma análise dos resultados das intervenções entre os dois grupos, em T1
e T2 e uma comparação dos resultados das intervenções em cada grupo, ao longo das três
avaliações. RESULTADOS: Não se obtiveram quaisquer diferenças estatisticamente
significativas (p>0.05) na avaliação entre os dois grupos nos três outcomes avaliados. Na
tarefa lenta, o GEXC obteve diferenças estatisticamente significativas na intensidade de
ativação no TS (p=0.028) e GD (p=0.028), entre T0 e T1, e no GBEMG, entre T1 e T2
na ativação no TI (p=0.028). Na tarefa balística, obtiveram-se diferenças significativas
no GEXC entre T1 e T2 (no TS; p=0.028) e no GBEMG entre T0 e T2 (no TS; p=0.018).
Para a intensidade da dor, obtiveram-se diferenças significativas no GEXC (T0-T2;
p=0.024) e no GBEMG (T1-T2; p=0.026 / T0-T2; p=0.046). Para a Funcionalidade
apenas o GBEMG obteve uma diferença significativa (T0-T2; p=0.028). DISCUSSÃO
E CONCLUSÃO: O BEMG não apresentou efeitos adicionais significativos
comparativamente ao exercício isolado.
INTRODUCTION: Disorders of the Shoulder Joint Complex (DSJC) account for an estimated 8% to 20% of all volleyball-related injuries. The literature describes the effects of scapula-focused exercises in DSJC with dynamic stability alterations, by selective activation of local stabilizing muscles (increase of lower trapezius – LT; serratus anterior - SA activation) and decrease of UT hyperactivity. Electromyographic biofeedback (EMGB) has been quoted as a way to improve selective muscle activation in subjects with DSJC, however there is no information about the effect of EMGB in overhead athletes. GOAL: To compare the effects of scapula-focused exercises using EMGB versus scapula-focused exercises focused on muscle activation, pain, and function, in female volleyball players with DSJC. METHODOLOGY: A sample of 14 individuals with DSJC (impingement syndrome and shoulder joint instability) was divided into two groups (n=7 – Exercise Group; n=7 – EMGB group). Both groups were evaluated in three moments (T0 – initial evaluation; T1 – after 4 weeks; T2 - after 8 weeks) regarding the intensity of muscle activity of UT, LT and SA (superficial electromyography - EMGs) during two upper limb functional tasks, pain (Numeric Pain Rating Scale - NPRS) and function (Disabilities of the arm, shoulder and hand – DASH). The data was analyzed, by a comparison of results between two groups followed by as analysis of the results in each individual group during the three evaluations. RESULTS: There were no statistically significant differences (p>0.05) of muscle activity between the two groups for the three outcomes. In regards to the slow activity, the Exercise Group had statistically significant differences in UT (p=0.028) and SA (T0-T1; p=0.028), and the EMGB had a significant difference in LT (T1-T2; p=0.028). The data for the ballistic activity revealed a significant difference in Exercise Group in UT (T1-T2; p=0.028), and the EMGB Group had a significant difference in UT (T0-T2; p=0.018). Pain reduced significantly in Exercise Group (T0-T2; p=0.024) and EMGB Group (T1-T2; p=0.026 / T0-T2; p=0.046). Function increased significantly only in EMGB Group (T0-T2; p=0.028). DISCUSSION AND CONCLUSION: The EMGB did not show any additional effects in muscle activity, pain, and function compared to isolated scapular exercises.
INTRODUCTION: Disorders of the Shoulder Joint Complex (DSJC) account for an estimated 8% to 20% of all volleyball-related injuries. The literature describes the effects of scapula-focused exercises in DSJC with dynamic stability alterations, by selective activation of local stabilizing muscles (increase of lower trapezius – LT; serratus anterior - SA activation) and decrease of UT hyperactivity. Electromyographic biofeedback (EMGB) has been quoted as a way to improve selective muscle activation in subjects with DSJC, however there is no information about the effect of EMGB in overhead athletes. GOAL: To compare the effects of scapula-focused exercises using EMGB versus scapula-focused exercises focused on muscle activation, pain, and function, in female volleyball players with DSJC. METHODOLOGY: A sample of 14 individuals with DSJC (impingement syndrome and shoulder joint instability) was divided into two groups (n=7 – Exercise Group; n=7 – EMGB group). Both groups were evaluated in three moments (T0 – initial evaluation; T1 – after 4 weeks; T2 - after 8 weeks) regarding the intensity of muscle activity of UT, LT and SA (superficial electromyography - EMGs) during two upper limb functional tasks, pain (Numeric Pain Rating Scale - NPRS) and function (Disabilities of the arm, shoulder and hand – DASH). The data was analyzed, by a comparison of results between two groups followed by as analysis of the results in each individual group during the three evaluations. RESULTS: There were no statistically significant differences (p>0.05) of muscle activity between the two groups for the three outcomes. In regards to the slow activity, the Exercise Group had statistically significant differences in UT (p=0.028) and SA (T0-T1; p=0.028), and the EMGB had a significant difference in LT (T1-T2; p=0.028). The data for the ballistic activity revealed a significant difference in Exercise Group in UT (T1-T2; p=0.028), and the EMGB Group had a significant difference in UT (T0-T2; p=0.018). Pain reduced significantly in Exercise Group (T0-T2; p=0.024) and EMGB Group (T1-T2; p=0.026 / T0-T2; p=0.046). Function increased significantly only in EMGB Group (T0-T2; p=0.028). DISCUSSION AND CONCLUSION: The EMGB did not show any additional effects in muscle activity, pain, and function compared to isolated scapular exercises.
Description
Relatório do Projeto de Investigação apresentado para cumprimento dos requisitos
necessários à obtenção do grau de Mestre em Fisioterapia, área de especialização em
Fisioterapia em Condições Músculo-Esqueléticas
Keywords
Disfunção do Complexo articular do Ombro Exercício Biofeedback Eletromiográfico Voleibolistas Femininas Intensidade de Ativação Muscular Intensidade da Dor Funcionalidade Disorders of the Shoulder Joint Complex Exercise Electromyographic Biofeedback Female Volleyball Players Muscle Activity Pain Function
Citation
Publisher
Instituto Politécnico de Setúbal. Escola Superior de Saúde