Eficácia da Corrente Aussie na Melhora da Força do Quadríceps em Indivíduos Restritos ao Leito
DOI:
https://doi.org/10.17921/1415-6938.2018v22n2p112-118Resumo
O imobilismo acomete diversos sistemas tais como o gastrointestinal, urinário, cardiovascular, respiratório, cutâneo e musculoesquelético
e intervenções precoces são necessárias para reduzir os problemas físicos e psicológicos. Objetivo: analisar a eficácia da corrente Aussie na
melhora da força muscular do quadríceps em indivíduos restritos ao leito. Métodos: Participaram do estudo 12 indivíduos, sendo 7 homens e
5 mulheres, distribuídos aleatoriamente em grupo controle (GC) e grupo tratado (GT). Utilizou-se a dinamometria isométrica (handheld) para
avaliação da força e, também, o ultrassom diagnóstico para avaliar a área de secção transversa do músculo reto femoral. Todos os participantes foram avaliados em dois períodos denominados de pré e pós. Resultados: Verificou-se redução significativa de força no GC coxa direita 2,5 N (p=0,047) e esquerda 3,8 N (p=0,008) nos momentos pré e pós. O GT apresentou ganho de força não significativa na coxa direita 4,9 N (p=0,117) e esquerda 3,2 N (p=0,107). Na ultrassonografia verificou-se no GC, redução não significativa na área da coxa direita 0,04 cm (p=0,283) e significativa na esquerda 0,06 cm (p=0,037). No GT houve redução não significativa coxa direita 0,13 cm (p=0,099) e significativa esquerda 0,22 cm (p=0,002). Conclusão: Pode-se inferir que a associação entre exercícios isométricos e corrente Aussie contribuiu para aumentar a força muscular do quadríceps em indivíduos com imobilidade ao leito.
Palavras-chave: Força Muscular. Resposta de Imobilidade Tônica. Músculo Quadriceps.
Abstract
Immobilism affects several systems such as the gastrointestinal, urinary, cardiovascular, respiratory, cutaneous and musculoskeletal and early
interventions are necessary to reduce physical and psychological problems. Objective: to analyze the effectiveness of the Aussie current in the improvement of quadriceps muscle strength in bed restricted individuals. Methods: Twelve individuals, 7 males and 5 females, were randomly assigned to the control group (CG) and treated group (TG). The use of isometric dynamometry (handheld) for strength evaluation and also the diagnostic ultrasound to evaluate the cross-sectional area of the rectus femoris muscle. All participants were evaluated in two periods called pre and post. Results: There was a significant reduction of strength in the right thigh in CG 2.5 N (p = 0.047) and left 3.8 N (p = 0.008) in the pre and post moments. TG presented a non-significant strength gain in the right thigh 4.9 N (p = 0.117) and left 3.2 N (p = 0.107). Ultrasonography showed no significant reduction in the right thigh area 0.04 cm (p = 0.283) and significant at the left (0.06 cm) (p = 0.037). In the TG there was no significant reduction in the right thigh 0.13 cm (p = 0.099) and significant in the left one 0.22 cm (p = 0.002). Conclusion: It can be inferred that the association between isometric exercises and current Aussie contributed to increase the muscular strength of the quadriceps in individuals with immobility to bed.
Keywords: Muscle Strength. Tonic Immobility Response. Quadriceps Muscle.
Referências
AIHIE SAYER, A. et al. Do all systems age together? Gerontology, v. 45, n. 2, p. 83-6, 1999. ISSN 0304-324X (Print) 0304-324X (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/9933730 >.
BASSEY, E. J.; HARRIES, U. J. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin Sci (Lond), v. 84, n. 3, p. 331-7, Mar 1993. ISSN 0143-5221 (Print) 0143-5221 (Linking). Disponível em: < http://www.ncbi.nlm.nih.gov/pubmed/8384956 >.
BOURJEILY-HABR, G. et al. Randomised controlled trial of transcutaneous electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease. Thorax, v. 57, n. 12, p. 1045-9, Dec 2002. ISSN 0040-6376 (Print) 0040-6376 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/12454299 >.
DITTMER D.K., TEASELL R. Complications of immobilization and bed rest. Part1: Musculoskeletal and cardiovascular complications. Can. F. Physician. v.39, p. 1428-1437, 1993.
DITTMER, D. K.; TEASELL, R. Complications of immobilization and bed rest. Part 1: Musculoskeletal and cardiovascular complications. Can Fam Physician, v. 39, p. 1428-32, 1435-7, Jun 1993. ISSN 0008-350X (Print) 0008-350X (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/8324411 >.
DROUIN, J. M. et al. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol, v. 91, n. 1, p. 22-9, Jan 2004. ISSN 1439-6319 (Print) 1439-6319 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/14508689 >.
ESFORMES, J. I.; NARICI, M. V.; MAGANARIS, C. N. Measurement of human muscle volume using ultrasonography. Eur J Appl Physiol, v. 87, n. 1, p. 90-2, May 2002. ISSN 1439-6319 (Print) 1439-6319 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/12012082 >.
FERNANDES, F. Atuação Fisioterapêutica em imobilismo ao leito prolongado. Rev. Intellectus., v.25, p.161-176, 2011.
GEROVASILI, V. et al. Electrical muscle stimulation preserves the muscle mass of critically ill patients: a randomized study. Crit Care, v. 13, n. 5, p. R161, 2009. ISSN 1466-609X (Electronic) 1364-8535 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/19814793 >.
GILDEMEISTER M. Zur Theorie des elektrischen Reizes. V. Polarisation durch Wechselströme. Ber Sachs Ges Wiss. v.81, p.303-313, 1930.
GRUTHER, W. et al. Effects of neuromuscular electrical stimulation on muscle layer thickness of knee extensor muscles in intensive care unit patients: a pilot study. J Rehabil Med, v. 42, n. 6, p. 593-7, Jun 2010. ISSN 1651-2081 (Electronic) 1650-1977 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/20549166 >.
GURALNIK, J. M. et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med, v. 332, n. 9, p. 556-61, Mar 02 1995. ISSN 0028-4793 (Print) 0028-4793 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/7838189 >.
HALAR E.M., BELL K.R. Contraturas e Outros Efeitos Deletérios da Imobilidade. In: Delisa, JA. Medicina de Reabilitação: princípios e prática. São Paulo: Editora Manole, 1992.
HUGHES, S. et al. Predictors of decline in manual performance in older adults. J Am Geriatr Soc, v. 45, n. 8, p. 905-10, Aug 1997. ISSN 0002-8614 (Print) 0002-8614 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/9256839 >.
HUGHES, V. A. et al. Muscle strength and body composition: associations with bone density in older subjects. Med Sci Sports Exerc, v. 27, n. 7, p. 967-74, Jul 1995. ISSN 0195-9131 (Print) 0195-9131 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/7564983 >.
ISHIDA, Y. et al. Reliability of B-mode ultrasound for the measurement of body fat and muscle thickness. Am J Hum Biol, v. 4, n. 4, p. 511-520, 1992. ISSN 1520-6300 (Electronic) 1042-0533 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/28524394 >.
KENDALL PF, McCREARY EK, PROVANCE P: Lower-extremity strength tests; in Peterson Kendall F, Provance P, McCreary EK (eds): Muscles: Testing and Function. Philadelphia, Lippincott Williams & Wilkins. 1993.
KUH, D. et al. Birth weight, childhood size, and muscle strength in adult life: evidence from a birth cohort study. Am J Epidemiol, v. 156, n. 7, p. 627-33, Oct 01 2002. ISSN 0002-9262 (Print) 0002-9262 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/12244031 >.
LAUKKANEN, P.; HEIKKINEN, E.; KAUPPINEN, M. Muscle strength and mobility as predictors of survival in 75-84-year-old people. Age Ageing, v. 24, n. 6, p. 468-73, Nov 1995. ISSN 0002-0729 (Print) 0002-0729 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/8588534 >.
LIMA K.M.M., OLIVEIRA L.F. Confiabilidade das medidas de arquitetura do músculo Vasto Lateral pela ultrassonografia. Motriz: rev. educ. fis. v.19, n.1, p.217-223, 2013.
MATHIOWETZ, V. Comparison of Rolyan and Jamar dynamometers for measuring grip strength. Occup Ther Int, v. 9, n. 3, p. 201-9, 2002. ISSN 0966-7903 (Print) 0966-7903 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/12374997 >.
MATHIOWETZ, V. et al. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am, v. 9, n. 2, p. 222-6, Mar 1984. ISSN 0363-5023 (Print) 0363-5023 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/6715829 >.
MIYATANI, M. et al. Validity of ultrasonograph muscle thickness measurements for estimating muscle volume of knee extensors in humans. Eur J Appl Physiol, v. 86, n. 3, p. 203-8, Jan 2002. ISSN 1439-6319 (Print) 1439-6319 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/11990727 >.
MIYATANI, M.; KANEHISA, H.; FUKUNAGA, T. Validity of bioelectrical impedance and ultrasonographic methods for estimating the muscle volume of the upper arm. Eur J Appl Physiol, v. 82, n. 5-6, p. 391-6, Aug 2000. ISSN 1439-6319 (Print) 1439-6319 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/10985592 >.
NEDER, J. A. et al. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax, v. 57, n. 4, p. 333-7, Apr 2002. ISSN 0040-6376 (Print) 0040-6376 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/11923552 >.
NUHR, M. J. et al. Beneficial effects of chronic low-frequency stimulation of thigh muscles in patients with advanced chronic heart failure. Eur Heart J, v. 25, n. 2, p. 136-43, Jan 2004. ISSN 0195-668X (Print) 0195-668X (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/14720530 >.
POULSEN, J. B. et al. Effect of transcutaneous electrical muscle stimulation on muscle volume in patients with septic shock. Crit Care Med, v. 39, n. 3, p. 456-61, Mar 2011. ISSN 1530-0293 (Electronic) 0090-3493 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/21150583 >.
RANTANEN, T. et al. Midlife hand grip strength as a predictor of old age disability. JAMA, v. 281, n. 6, p. 558-60, Feb 10 1999. ISSN 0098-7484 (Print) 0098-7484 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/10022113 >.
RANTANEN, T. et al. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci, v. 55, n. 3, p. M168-73, Mar 2000. ISSN 1079-5006 (Print) 1079-5006 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/10795731 >.
REID, C. L. et al. Quantification of lean and fat tissue repletion following critical illness: a case report. Crit Care, v. 12, n. 3, p. R79, 2008. ISSN 1466-609X (Electronic) 1364-8535 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/18559097 >.
SILVA, A.P.F.; MAYNARD, K.; CRUZ, M.R. Efeitos da fisioterapia motora em pacientes críticos: revisão de literatura. Rev. bras. ter. intensiva, São Paulo , v. 22, n. 1, p. 85-91, Mar. 2010.
STARKEY, D. B. et al. Effect of resistance training volume on strength and muscle thickness. Med Sci Sports Exerc, v. 28, n. 10, p. 1311-20, Oct 1996. ISSN 0195-9131 (Print) 0195-9131 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/8897390 >.
TAVARES DMS, PEREIRA GA, IWAMOTO HH, MIRANZZI SSC, RODRIGUES LR et al. Incapacidade funcional entre idosos residentes em um município do interior de Minas Gerais. Enferm. v.16, n.1, p.32-39, 2007.
TEASELL, R.; DITTMER, D. K. Complications of immobilization and bed rest. Part 2: Other complications. Can Fam Physician, v. 39, p. 1440-2, 1445-6, Jun 1993. ISSN 0008-350X (Print) 0008-350X (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/8324412 >.
VIVODTZEV, I. et al. Improvement in quadriceps strength and dyspnea in daily tasks after 1 month of electrical stimulation in severely deconditioned and malnourished COPD. Chest, v. 129, n. 6, p. 1540-8, Jun 2006. ISSN 0012-3692 (Print) 0012-3692 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/16778272 >.
WARD AR, TOUMBOUROU SL, McCARTHY B. A comparison of the analgesic efficacy of medium-frequency alternating current and TENS. Phys. v.95, p.280-288, 2009.
WHIPPLE, R. H.; WOLFSON, L. I.; AMERMAN, P. M. The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study. J Am Geriatr Soc, v. 35, n. 1, p. 13-20, Jan 1987. ISSN 0002-8614 (Print) 0002-8614 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/3794141 >.
ZANOTTI, E. et al. Peripheral muscle strength training in bed-bound patients with COPD receiving mechanical ventilation: effect of electrical stimulation. Chest, v. 124, n. 1, p. 292-6, Jul 2003. ISSN 0012-3692 (Print) 0012-3692 (Linking). Disponível em: < https://www.ncbi.nlm.nih.gov/pubmed/12853536 >.
