Artículos de revistas
Effectiveness Of The Open And Closed Kinetic Chain Exercises In The Treatment Of The Patellofemoral Pain Syndrome [efetividade Dos Exercícios Em Cadeia Cinética Aberta E Cadeia Cinética Fechada No Tratamento Da Síndrome Da Dor Femoropatelar]
Registro en:
Revista Brasileira De Medicina Do Esporte. , v. 12, n. 2, p. 56e - 60e, 2006.
15178692
2-s2.0-34248373832
Autor
Fehr G.L.
Cliquet Jr. A.
Cacho E.W.A.
De Miranda J.B.
Institución
Resumen
The aim of this study was to analyze the therapeutic effects of the open kinetic chain (OKC) and closed kinetic chain (CKC) exercises to treat the patellofemoral syndrome (PFSD). For this, 24 volunteers, bearers of the PFSD were randomly divided in two groups: group I (n = 12) performed the OKC exercises; group II (n = 12) performed the CKC exercises. Both groups were submitted to eight consecutive weeks of treatment consisting of three weekly sessions performed in alternate days. To analyze the activation pattern of the vastus medialis oblique (VMO) and the vastus lateralis (VL) muscles, the electromyographic signals (EMG) were collected using bipolar surface electrodes quantified by the root mean square (RMS) normalized by the maximal voluntary isometric contraction of the quadriceps. The pain intensity and the functionality of the volunteers were assessed using scales. The analysis of the amounts of the VMO/VL ratio in both groups I and II showed no significant differences as to the pre- and post-treatment times in the concentric (p > 0.05) and eccentric (p > 0.05) phases of the OKC and CKC exercises. Despite of this, the VMO muscle presented a lower activation rate compared to the VL in the eccentric phase of the CKC exercise. It was found significant increases in the functionality (p < 0.05), and a reduction in the pain intensity (p < 0.05) between the pre- and post-treatment times in both groups, but group II showed higher amounts compared to group I in both variables. The results found in this study suggest that according to the conditions of the trial, the OKC and CKC exercises provoke no changes in the patterns of the EMG activation in the VMO and VL muscles. However, they promoted an improvement in the functionality and a reduction in the pain intensity after the eight week intervention, and the CKC exercises presented better performances than OKC exercises. 12 2 56e 60e Owings, T.M., Grabiner, M., Motor control of the vastus medialis oblique and vastus lateralis is disrupted during eccentric contractions in subjects with patellofemoral pain (2002) Am J Sports Med, 30, pp. 483-487 Brody, L.T., Thein, J.M., Nonoperative treatment for patellofemoral pain (1998) J Orthop Sports Phys Ther, 28, pp. 336-344 Karst, G.M., Jewett, P.D., Electromyographic analysis of exercises proposed for differential activation of medial and lateral quadriceps femoris muscle components (1993) Phys Ther, 73, pp. 286-295 Hanten, W.P., Schulthies, S.S., Exercise effect on electromyographic activity of the vastus medialis oblique and vastus lateralis muscles (1990) Phys Ther, 70, pp. 561-565 Lam, P.L., Gabriel, Y.F., Activation of the quadriceps muscle during semisquatting with different hip and knee positions in patients with anterior knee pain (2001) Am J Phys Med Rahabil, 80, pp. 804-808 Wilk, K.E., Escamilla, R.F., Fleisig, G.S., Barrentine, S.W., Andrews, J.R., Boyd, M.L., A comparison of tibiofemoral joint forces and electromyographic activity during open and closed kinetic chain exercises (1996) Am J Sports Med, 24, pp. 518-527 Steinkamp, L.A., Dillingham, M.F., Markel, M.D., Hill, J.A., Kaufman, K.R., Biomechanical considerations in patellofemoral joint rehabilitation (1993) Am J Sports Med, 21, pp. 438-444 Escamilla, R.F., Fleisig, G.S., Zheng, N., Barrentine, S.W., Wilk, K., Anderws, J.R., Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises (1998) Med Sci Sports Exerc, 30, pp. 556-569 Cyrino, E.S., Oliveira, A.R., Leite, J.C., Porto, D.B., Dias, R.M.R., Segantin, A.Q., Comportamento da flexibilidade após 10 semanas de treinamento com pesos (2004) Rev Bras Med Esporte, 10, pp. 233-237 Bennell, K., Bartram, S., Crossley, K., Outcome measures in patellofemoral pain syndrome: Test retest reliability and inter-relationships (2000) Phys Ther Sport, 1, pp. 32-34 Kujala, U.M., Jaakola, L.H., Koshinen, S.K., Taimela, S., Hurme, M., Nelimarkka, O., Scoring of patellofemoral disorders (1993) Arthroscopy, 9, pp. 159-163 De Luca, C.J., The use of surface electromyography in biomechanics (1997) J Appl Biomech, 13, pp. 135-163 Lieb, F.J., Perry, J., Quadriceps function: An anatomical and mechanical study using amputated limbs (1968) J Bone Joint Surg, 50, pp. 1535-1548. , Am Araujo, R.C., Amadio, A.C., Análise biomecânica da ativação das porções superficiais do m. quadríceps femoral durante contrações excêntrica e concêntrica (1996) Rev Bras Fisiot, 1, pp. 13-20 Turker, K.S., Electromyography: Some methodological problems and issues (1993) Phys Ther, 73, pp. 698-710 Basmajian, J.V., De Luca, C.J., (1985) Muscle alive: Their function revealed by electromyography, , 5th ed. Baltimore: Willians & Wilkins Witvrouw, E., Lysens, R., Bellemans, J., Peers, K., Vanderstraeten, G., Open versus closed kinetic chain exercises for patellofemoral pain: A prospective, randomized study (2000) Am J Sports Med, 28, pp. 687-694 Witvrouw, E., Cambier, D., Danneels, L., Bellemans, J., Werner, S., Almqvist, F., The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: A prospective randomized intervention study (2003) Scand J Med Sci Sports, 13, pp. 251-258 Stiene, H.A., Brosky, T., Reinking, M.F., Nyland, J., Mason, M.B., A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction (1996) J Orthop Sports Phys Ther, 24, pp. 136-141 Bennett, J.G., Stauber, W.T., Evaluation and treatment of anterior knee pain using eccentric exercise (1986) Med Sci Sports Exerc, 18, pp. 526-530 Doucette, A.S., Child, D., The effect of open and closed chain exercise and knee joint position on patellar tracking in lateral patellar compression syndrome (1996) J Orthop Sports Phys Ther, 23, pp. 104-110 Sheehy, P., Burdett, R.G., Irrgang, J.J., VanSwearingen, J., An electromyographic study of vastus medialis oblique and vastus lateralis activity while ascending and descending steps (1998) J Orthop Sports Phys Ther, 27, pp. 423-429 Souza, D.R., Gross, M.T., Comparison of vastus medialis obliquus: Vastus lateralis muscle integrated electromyographic ratios between healthy subjects and patients with patellofemoral pain (1991) Phys Ther, 71, pp. 310-316 Powers, C.M., Landel, R., Perry, J., Timing and intensity of vastus muscle activity during functional activities in subjects with and without patellofemoral pain (1996) Phys Ther, 76, pp. 946-955 Cerny, K., Vastus medialis oblique/vastus lateralis muscle activity ratios for selected exercises in persons with and without patellofemoral pain syndrome (1995) Phys Ther, 75, pp. 672-683 Merletti, R., Rainold, A., Farina, D., Surface electromyography for noninvasive characterization of muscle (2001) Exerc Sport Sci Rev, 29, pp. 20-25 Powers, C.M., Perry, J., Hsu, A., Hislop, H.J., Are patellofemoral pain and quadriceps femoris muscle torque associated with locomotor function? (1997) Phys Ther, 77, pp. 1063-1078 Wilk, K.E., Reinold, M.M., Principles of patellofemoral rehabilitation (2001) Sports Med Arthrosc, 9, pp. 325-336 Crossley, K., Bennell, K., Green, S., McConnell, J., A systematic review of physical interventions for patellofemoral pain syndrome (2001) Clin J Sport Med, 11, pp. 103-110