Comparando exercícios com e sem biofeedback por eletromiografia na Síndrome da Dor Subacromial: estudo aleatorizado e cego

Abstract

Background: Changes in movement and muscle activation of scapulohumeral joint are related to Subacromial Pain Syndrome. Electromyography biofeedback during exercise may enhance muscle activation and coordination, and consequently improve pain and shoulder function. Methods: This study compared the effects of an exercise protocol with and without using electromyographic biofeedback on pain, function and movement of the shoulder complex in subjects with Subacromial Pain Syndrome. A total of 24 volunteers of both genders were randomized into the therapeutic exercises and Biofeedback groups (therapeutic exercises using electromyographic biofeedback in the trapezius and serratus muscles). Pain and shoulder function were evaluated as the primary outcome and range of motion, muscle strength, electromyographic activity and scapulohumeral kinematics as secondary outcomes. The subjects underwent eight weeks of intervention and comparisons were made between groups in baseline, at 4 weeks, 8 weeks, and at 4 weeks post intervention. Findings: There were no differences between groups for shoulder function, muscle strength, range of motion or electromyographic activity variables. The pain was lower after 8 weeks of training in the exercises group (P = 0.01; difference between groups = 1.5) and the scapular external rotation was 90° greater the arm in elevation (P = 0.03, difference between groups = 5.9°) after 4 weeks in the exercise group, while scapular upward rotation was 60° greater the arm in elevation (P = 0.001, difference between groups = 13.9°) at 4 weeks post intervention in the Biofeedback group. Interpretation: Therapeutic exercises have been shown to be effective in reducing pain and improving function in patients with SDS. The addition of EMG-Biofeedback to the exercise protocol increased the scapular upward rotation without, however, to influence the other analyzed variables.