Banca de DEFESA: Tatiane Morelati Rosa de Camargo

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : Tatiane Morelati Rosa de Camargo
DATE: 12/12/2023
TIME: 09:00
LOCAL: Ambiente virtual Teams
TITLE:

Deficit in strength, pain, functionality and quality of life in individuals with greater trochanter pain syndrome: Education and effects of a physical exercise program.

KEY WORDS:

Gluteal region, hip injuries, tendinopathy, pain, exercise

PAGES: 81
BIG AREA: Ciências da Saúde
AREA: Educação Física
SUMMARY:

Physical exercise has been considered an important strategy in approaching the rehabilitation of individuals with greater trochanter pain syndrome (GTPS) and hip abductor strength deficits have been associated with this pathology. The objective of this study was to investigate the correlation between hip abductor strength deficits and SDGT, as well as the effects of a physical exercise program with different training modes combined with educational guidelines for the treatment of individuals diagnosed with this musculoskeletal condition. With the aim of offering theoretical foundations for the physical exercise program to be established, a systematic review was carried out, registered in PROSPERO (CRD42020216803), in which the databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), Pubmed, Embase, CINAHL, evidence database (PEDro) Physiotherapy. The descriptors used were gluteal region, hip injuries, tendinopathy, pain and exercise. Five randomized clinical trials were included, which used physical exercise as an intervention in the treatment of SDGT. Excluded cohort studies, case controls, systematic reviews and clinical trials with other diagnoses. The articles presented high methodological quality according to the PEDro scale and a low risk of bias, according to Rob 2.0. In total there were 637 patients, 591 of whom were female, with a mean age of 57.9 (9.52). Significant differences were observed in the sample number and a variation in the types of scales used to assess pain, functionality and quality of life outcomes, limiting a meta-analysis due to heterogeneity. The five studies used daily resistance physical exercise programs with progressive mechanical load and reported a reduction in pain, improvement in motor control and hip functionality in the long term, in addition to presenting rare and mild adverse events. Despite the limitations, this systematic review offers a summary of the current evidence on the effects of physical exercise and the findings of this study were consistent with previous studies that recommend that daily resistance physical exercise programs with progressive mechanical load promote the reduction of pain, improvement of functionality and muscle strength. An observational cross-sectional study was carried out to describe and analyze the correlation between the strength deficit of the hip abductor muscles and SDGT and assist in planning the physical exercise program and load progression to be established during the clinical trial. The assessment of maximum isometric contraction was used in the analysis of flexion, extension, adduction, abduction, internal rotation and external rotation movements of the hip, using a manual dynamometer. Adult individuals diagnosed with greater trochanter pain syndrome with persistent pain in the lateral region of the hip above 3 on the visual analogue pain scale (VAS) for more than 3 months were included. Participants with hip joint pathologies and spinal disorders were excluded. 46 participants were admitted, 31 with a unilateral diagnosis and 15 bilaterally affected, totaling 92 hips evaluated. A positive, significant and medium strength relationship (spearman: 0.542, p < 0.001) was observed between the strength of the hip abductor muscles and the functional capacity of individuals diagnosed with SDGT, as individuals who presented greater strength obtained a significantly higher score on the VISA-G questionnaire (z: 109, p<0.001) and a lower score on the visual analogue pain scale. Furthermore, it was also observed that sedentary individuals with SDGT had lower hip muscle strength, worse functional capacity and greater pain, with a positive and significant correlation being observed between the hip muscle strength deficit and a worse clinical condition of the participants. of the study, reinforcing the current recommendation in the literature that physical exercise is an important strategy in the rehabilitation of this musculoskeletal condition. A prospective, parallel, two-arm, randomized, blind study was developed to verify the effects of physical exercise on the rehabilitation of individuals with SDGT. Adults diagnosed with greater trochanter pain syndrome with persistent pain in the lateral region of the hip above 3 on the analogue pain scale (VAS) for more than 3 months were admitted. Participants diagnosed with hip joint pathologies and spinal disorders were excluded. Educational Guidelines and a program with different training modes for the hip muscles, abdominal core and lower limbs for twelve weeks was conducted and compared with an exercise program with different training modes for the hip muscles. The outcomes assessed were pain (VAS scale, pressure algometer), functionality (VISA-G questionnaire), quality of life (EuroQol) and isometric strength of the hip muscles (manual dynamometry). 62 participants were included, 56 (90.3%) female and 6 (9.7%) male, with a mean age of 57.3 ±13.9 and BMI of 26.8 ±3.3. Participants were randomized into two groups and completed 12 weeks of treatment and 24 weeks of follow-up. A significant improvement was observed in the reduction of pain (z: 6.87, df:61, p<0.001), in the gain in functionality (z: 6.87, df: 61, p<0.001) in the increase in muscle strength (t: 27.15, df: 61, p<0.001) and improved quality of life (z: 6.85, df: 61, p<0.001) with 12 and 24 weeks of follow-up of the participants, but there was no difference significant between groups (x2: 0.86, p:0.353). These findings may suggest that the specific mode of contraction and number of muscle groups worked may not be the most relevant element, but the individualization of the load, progressive physical exercise and the work of different characteristics of the neuromuscular system. In short, this dissertation demonstrated a positive and significant correlation between the regular practice of physical exercises, greater strength of the hip abductors and a better clinical condition in individuals with greater trochanter pain syndrome, reinforcing the importance of developing health programs for combat a sedentary lifestyle and prevent the development of chronic and debilitating injuries. Furthermore, it suggests that progressive physical exercise, individualization of the load and the work of different characteristics of the neuromuscular system to alleviate pain, improve motor control and incorporate strength gains in functional movement are essential strategies in the treatment of individuals with this debilitating condition musculoskeletal.

COMMITTEE MEMBERS:
Presidente - 1017867 - PAULO JOSE BARBOSA GUTIERRES FILHO
Interna - 1998953 - LIDIA MARA AGUIAR BEZERRA DE MELO
Externa à Instituição - ANDREIA PELEGRINI - UDESC
Externo à Instituição - FRANCISCO XAVIER DE ARAÚJO - UFPel