Programa de pós-graduação em Ciências da Reabilitação
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Master Thesis Quão abrangente é a descrição dos participantes em ensaios controlados aleatorizados envolvendo indivíduos com tendinopatia patelar? Uma revisão sistemática(Universidade Federal do Rio Grande do Norte, 2020-12-15) Araújo, Eduardo Henrique Dias; Silva, Rodrigo Scattone da; ; http://lattes.cnpq.br/9953273388451412; ; http://lattes.cnpq.br/3319148986317258; Lobato, Daniel Ferreira Moreira; ; http://lattes.cnpq.br/3736858758375395; Barbosa, Germanna de Medeiros; ; http://lattes.cnpq.br/1702090920424206The prevalence of patellar tendinopathy can be quite high in athletes of different sports modalities. The consequences of this dysfunction can be devastating for an athlete's career. Several randomized controlled trials have been developed in an attempt to identify the best treatment approaches for individuals with patellar tendinopathy. However, the description of study participants is not always clear and comprehensive. This makes it difficult for clinicians to understand how relevant the results of the research in question are to their patients. Recently, an International Tendinopathy Consensus established recommendations on the characteristics of participants that should be reported in clinical trials involving tendinopathies in general, including population demographics, clinical tendinopathy descriptors, general health and comorbidities, and participant recruitment and screening. To our knowledge, however, no study has verified whether the presentation of data from participants included in clinical trials involving patellar tendinopathy is in accordance with the criteria recommended by expert consensus. The purpose of this review is to verify how comprehensive the description of participants in randomized controlled trials involving individuals with patellar tendinopathy is. A literature review was carried out in (PubMed/MEDLINE, Scopus, PEDro, SciELO and LILACS) by two independent reviewers, seeking to identify randomized controlled trials involving individuals with patellar tendinopathy. To assess the quality of studies regarding the description of the participants, a scale was developed based on the score of the International Tendinopathy Consensus (eCONT). Pearson's correlation test was used to verify the existence of a relationship between year of publication of the trials and the quality of data presentation. Thirty-four clinical trials were included in the review. The studies involved a total of 1,262 individuals (996 men and 266 women), with an average age of 28.25 ± 4.10 years. The average score of studies in the eCONT was 9.88 ± 2.07 points, ranging from 6 to 13 points out of a total of 16 possible on the score. The inclusion criteria of the different studies were substantially heterogeneous. Most often incomplete information included medication use and the presence of comorbidities. There was no correlation between year of publication and score on the quality of data presentation scale (P=0.372). In conclusion, clinical trials involving individuals with patellar tendinopathy present heterogeneous and, in many cases, incomplete information about the included participants. The possibility that individuals with different conditions that cause anterior knee pain may have been recruited for these studies under the diagnosis of patellar tendinopathy is also of note. This could lead to confusion among the scientific community and clinicians as to which treatments are in fact effective for the rehabilitation of individuals with patellar tendinopathy.Master Thesis Efeitos imediatos de instruções verbais na qualidade de movimento durante o teste do degrau lateral e correlação da avaliação visual com dados de cinemática, força e flexibilidade do membro inferior(2019-11-18) Silva, Rômulo Lemos e; Silva, Rodrigo Scattone da; ; ; Serrão, Fábio Viadanna; ; Vieira, Wouber Hérickson de Brito;Introduction: Abnormal lower limb movement patterns during closed kinetic chain activities seem to contribute to the occurrence of knee injuries. The Lateral Step-Down test (LSD) is a simple test for the assessment of lower limb movement patterns. Verbal instructions may result in immediate improvements in movement patterns in certain functional activities; however, it remains unknown whether these instructions can cause these same improvements during the LSD. Objectives: the purposes of this dissertation were: 1) to conduct a narrative review regarding the assessment of quality of movement during the LSD, 2) to determine the immediate effects of a verbal instructions intervention in the quality of movement and trunk, pelvis and lower limb kinematics in healthy females during the LSD, 3) to verify possible associations between lower limb muscle strength and flexibility and the results of quality of movement and 3D kinematics during the LSD. Methods: For the first study, two independent reviewers conducted a literature review in different databases. For the experimental study, thirtyfour healthy females performed the LSD and were assessed both visually and using a 3D kinematics analysis before and after receiving verbal instructions for movement correction. Participants were divided into Good Movement Group (GG) and Poor Movement Group (PG) according to their scores. Lower limb flexibility was measured using the Lunge Test and the assessment of passive hip stiffness. Muscle strength was measured using a handheld dynamometer. Verbal intervention included instructions aimed at improving the alignment of the trunk, pelvis, hip and knee during the LSD. Results: The narrative review identified a few confounding factors in the included studies that may interfere with the LSD results, such as step height and instructions given prior to the test. It was also found that the LSD is considered a simple test for clinical use, with moderate reliability (κ=0.59–0.81). Results from the experimental study showed that quality of movement during the LSD was positively correlated with kinematic measures of hip adduction, hip flexion and pelvic drop. Verbal instructions improved quality of movement of the volunteers in general, with the GG showing greater improvement in quality of movement after the instructions than the PG. In group comparisons, the PG presented greater pelvic drop, greater hip adduction and decreased hip flexion when compared to GG. Conclusions: The LSD has adequate reliability and should be standardized in order to minimize possible confounding factors. In the experimental investigation, the visual assessment of the LSD presented a significant association with pelvic drop and hip adduction during the 3D analysis in healthy females. Factors such as decreased ankle flexibility and increased hip flexibility are related to greater hip movements during the LSD. Verbal instructions caused an immediate improvement in lower limb quality of movement in healthy women during the LSD.