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

• Ano de defesa: 2019
• Autor(a) principal: Silva, Rômulo Lemos e
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA REABILITAÇÃO
• Palavras-chave em Português: Extremidade inferior; Joelho; Patelofemoral; Dor; Reabilitação; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://repositorio.ufrn.br/jspui/handle/123456789/29282

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.