Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro
The overall purpose of this doctorate thesis were to present information on the clinical aspects that involve the presence of myofascial trigger points (MTP) in shoulder and neck muscles, to verify the relationship between MTP and the clinical variables of pain, psychological aspects, mobility an...
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Dor no ombro Limiar de dor Sensibilização Síndrome da dor miofascial Amplitude de movimento Força |
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Dor no ombro Limiar de dor Sensibilização Síndrome da dor miofascial Amplitude de movimento Força Nascimento, José Diego Sales do Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
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The overall purpose of this doctorate thesis were to present information on the clinical
aspects that involve the presence of myofascial trigger points (MTP) in shoulder and neck
muscles, to verify the relationship between MTP and the clinical variables of pain,
psychological aspects, mobility and strength and the effects of a physical therapy
approach on these aspects in individuals with non-traumatic shoulder pain. To this end,
three studies were carried out: Study 1 - Myofascial pain and trigger points in the shoulder
and neck region: from concept to physical therapy management; Study 2 - Relationship
and predictive capacity between active myofascial trigger points and physical, clinical
and psychological characteristics in individuals with shoulder pain; Study 3 - Immediate
effects of ischemic compression on myofacial trigger points on pain, mobility and
strength in individuals with subacromial impact syndrome: a single arm study. The study
1 is a literature review on MTPs in the shoulder and neck region that addresses definitions,
assessment reliability, sensitization phenomena, differential diagnosis, the relationship of
MTP with clinical variables and therapeutic management. Study 2 is a cross-sectional and
observational study. A total of 58 individuals (36 men and 22 women, aged between 31
± 10.91 years and BMI of 25.01 ± 3.42 kg/m²) participated in the study. All individuals
were assessed for physical and demographic characteristics, depression symptoms, pain
and shoulder function, presence of MTPs, ROM and pain during ROM and force. Pointbiserial (rpb) and Spearman (rs) correlation tests and multiple linear regression were used
to assess the relationship between the presence and quantity of MTPs and the study
variables, adopting a significance value of p<0.05. The presence and quantity of MTPs
generally correlated between weak to moderate with depression symptoms, pain during
sagittal flexion ROM and internal and external rotation, pain during sagittal lifting force,
self-reported shoulder function and external rotation force. The presence of MTPs in the
infraspinatus has been shown to influence depression symptoms; MTPs in the upper and
lower trapezius influenced pain during the internal rotation ROM; MTPs in the upper
trapezius influenced pain during internal rotation force; and MTPs in the supraspinatus
influenced pain during external rotation ROM. There is a weak to moderate correlation
between the presence and quantity of active MTPs and depression symptoms, pain during
shoulder ROM and force, ROM, force, and self-reported function. Study 3 is a single-arm
study. A total of 15 individuals (6 women and 9 men, 34.4 ± 10.43 years and 24.20 ± 2.18
kg/m2) with clinical symptoms of unilateral SIS. All individuals were assessed for the
amount of MTPs in the shoulder muscles; pressure pain threshold (PPT) in shoulder
muscles; range of motion of the shoulder; isometric strength of shoulder muscles; and
pain in performing ROM and isometric strength contraction. The evaluations took place
48 hours before the ICT, immediately before, and after the ICT. There was a reduction in
the total amount of MTPs and an increase in the PPT in the middle deltoid muscle in the
comparisons between pre and post treatment, while there was no difference in ROMs and
strength measures; however, the pain was less during the sagittal elevation ROM and
internal rotation, and during the performance of strength in arm elevation and external
rotation. There was generally no difference in the variables assessed between baseline
and pre-treatment. The ICT immediately reduced the amount of MTPs and pain during
mobility and strength, but did not change the PPT, ROM or strength variables. The present
study will support clinical practice in the management of shoulder and neck myofascial
pain in the presence of MTPs. |
| author2 |
Sousa, Catarina de Oliveira |
| author_facet |
Sousa, Catarina de Oliveira Nascimento, José Diego Sales do |
| format |
doctoralThesis |
| author |
Nascimento, José Diego Sales do |
| author_sort |
Nascimento, José Diego Sales do |
| title |
Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| title_short |
Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| title_full |
Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| title_fullStr |
Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| title_full_unstemmed |
Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| title_sort |
aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2021 |
| url |
https://repositorio.ufrn.br/handle/123456789/32504 |
| work_keys_str_mv |
AT nascimentojosediegosalesdo aspectosclinicosefuncionaisdasindromedolorosamiofascialemindividuoscomdornoombro |
| _version_ |
1773963041349566464 |
| spelling |
ri-123456789-325042021-05-12T17:28:51Z Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro Nascimento, José Diego Sales do Sousa, Catarina de Oliveira http://lattes.cnpq.br/4398504440980866 http://lattes.cnpq.br/5522647106933904 Ferreira, José Jamacy de Almeida http://lattes.cnpq.br/7942403520160630 Guilherme, Melina Nevoeiro Haik http://lattes.cnpq.br/8240155487619947 Guirro, Rinaldo Roberto de Jesus http://lattes.cnpq.br/4966448047381105 Silva, Rodrigo Scattone da http://lattes.cnpq.br/9953273388451412 Dor no ombro Limiar de dor Sensibilização Síndrome da dor miofascial Amplitude de movimento Força The overall purpose of this doctorate thesis were to present information on the clinical aspects that involve the presence of myofascial trigger points (MTP) in shoulder and neck muscles, to verify the relationship between MTP and the clinical variables of pain, psychological aspects, mobility and strength and the effects of a physical therapy approach on these aspects in individuals with non-traumatic shoulder pain. To this end, three studies were carried out: Study 1 - Myofascial pain and trigger points in the shoulder and neck region: from concept to physical therapy management; Study 2 - Relationship and predictive capacity between active myofascial trigger points and physical, clinical and psychological characteristics in individuals with shoulder pain; Study 3 - Immediate effects of ischemic compression on myofacial trigger points on pain, mobility and strength in individuals with subacromial impact syndrome: a single arm study. The study 1 is a literature review on MTPs in the shoulder and neck region that addresses definitions, assessment reliability, sensitization phenomena, differential diagnosis, the relationship of MTP with clinical variables and therapeutic management. Study 2 is a cross-sectional and observational study. A total of 58 individuals (36 men and 22 women, aged between 31 ± 10.91 years and BMI of 25.01 ± 3.42 kg/m²) participated in the study. All individuals were assessed for physical and demographic characteristics, depression symptoms, pain and shoulder function, presence of MTPs, ROM and pain during ROM and force. Pointbiserial (rpb) and Spearman (rs) correlation tests and multiple linear regression were used to assess the relationship between the presence and quantity of MTPs and the study variables, adopting a significance value of p<0.05. The presence and quantity of MTPs generally correlated between weak to moderate with depression symptoms, pain during sagittal flexion ROM and internal and external rotation, pain during sagittal lifting force, self-reported shoulder function and external rotation force. The presence of MTPs in the infraspinatus has been shown to influence depression symptoms; MTPs in the upper and lower trapezius influenced pain during the internal rotation ROM; MTPs in the upper trapezius influenced pain during internal rotation force; and MTPs in the supraspinatus influenced pain during external rotation ROM. There is a weak to moderate correlation between the presence and quantity of active MTPs and depression symptoms, pain during shoulder ROM and force, ROM, force, and self-reported function. Study 3 is a single-arm study. A total of 15 individuals (6 women and 9 men, 34.4 ± 10.43 years and 24.20 ± 2.18 kg/m2) with clinical symptoms of unilateral SIS. All individuals were assessed for the amount of MTPs in the shoulder muscles; pressure pain threshold (PPT) in shoulder muscles; range of motion of the shoulder; isometric strength of shoulder muscles; and pain in performing ROM and isometric strength contraction. The evaluations took place 48 hours before the ICT, immediately before, and after the ICT. There was a reduction in the total amount of MTPs and an increase in the PPT in the middle deltoid muscle in the comparisons between pre and post treatment, while there was no difference in ROMs and strength measures; however, the pain was less during the sagittal elevation ROM and internal rotation, and during the performance of strength in arm elevation and external rotation. There was generally no difference in the variables assessed between baseline and pre-treatment. The ICT immediately reduced the amount of MTPs and pain during mobility and strength, but did not change the PPT, ROM or strength variables. The present study will support clinical practice in the management of shoulder and neck myofascial pain in the presence of MTPs. Os objetivos gerais desta Tese de Doutorado foram apresentar informações sobre os aspectos clínicos que envolvem a presença de pontos-gatilho miofasciais (PGMs) em músculos do ombro e pescoço, verificar a relação entre PGMs e as variáveis clínicas de dor, aspectos psicológicos, mobilidade e força e os efeitos de uma abordagem fisioterapêutica nesses aspectos em indivíduos com dor no ombro não traumático. Para tanto, foram realizados três estudos: Estudo 1 - Dor miofascial e pontos-gatilho na região do ombro e pescoço: do conceito ao manejo fisioterapêutico; Estudo 2 - Relação e capacidade preditiva entre pontos-gatilho miofasciais ativos e características físicas, clínicas e psicológicas em indivíduos com dor no ombro; Estudo 3 - Efeitos imediatos da compressão isquêmica em pontos-gatilhos miofaciais na dor, mobilidade e força em indivíduos com síndrome do impacto subacromial: estudo de braço único. O estudo 1 é uma revisão narrativa sobre PGMs a região do ombro e pescoço que aborda definições, confiabilidade da avaliação, fenômenos de sensibilização, diagnóstico diferencial, relação dos PGMs com variáveis clínicas e manejo fisioterapêutico. O estudo 2 trata-se de uma pesquisa do tipo transversal, que avaliou 58 indivíduos com diagnóstico clínico de síndrome do impacto subacromial (36 homens e 22 mulheres, idade entre de 31±10,91 anos e IMC de 25,01±3,42 kg/m²). Os indivíduos foram avaliados quanto a características físicas e demográficas, sintomas de depressão, dor e função do ombro, presença de PGMs, amplitude de movimento (ADM), força isométrica e dor durante a ADM e a força. Foram realizados testes de correlação, ponto-bisseral e Spearman, e regressão linear múltipla para a avaliação das relações entre a presença e a quantidade de PGMs e as variáveis do estudo, adotando um valor de significância de p<0,05. De maneira geral, houve correlação de fraca a moderada entre a presença e a quantidade PGMs ativos e sintomas de depressão, dor durante ADM e força do ombro, ADM, força, autorrelato de função. Os PGMs são preditores para sintomas de depressão, dor durante movimento de rotação interna e externa e dor durante força de rotação interna. O estudo 3 foi um estudo clínico de braço único, com quinze indivíduos (6 mulheres e 9 homens, 34.4±10.43 anos e 24.20±2.18 kg/m2 ) com sintomas clínicos de síndrome do impacto subacromial (SIS) unilateral. Os indivíduos foram avaliados quanto à quantidade de PGMs nos músculos do ombro; limiar de dor a pressão (LDP) nos músculos do ombro; ADM do ombro; força isométrica de músculos do ombro; e dor durante a execução da ADM e da força. As avaliações ocorreram 48 horas antes da terapia de compressão isquêmica (TCI), imediatamente antes, e após a TCI. Nas comparações entre pré e pós-tratamento, houve redução na quantidade total de PGMs e aumento no LDP do músculo deltóide médio com tamanho de efeito pobre; não houve diferença nas ADMs e nas medidas de força, entretanto, a dor foi menor durante a ADM de elevação sagital e rotação interna e durante a força de elevação escapular e rotação externa. A TCI reduziu imediatamente a quantidade de PGMs e dor durante a mobilidade e força, mas não melhorou as variáveis de LDP, ADM e força. O presente estudo subsidiará a prática clínica no manejo da dor miofascial no ombro e pescoço na presença de PGMs. 2021-05-12T17:27:58Z 2021-05-12T17:27:58Z 2021-02-22 doctoralThesis NASCIMENTO, José Diego Sales do. Aspectos clínicos e funcionais da síndrome dolorosa miofascial em indivíduos com dor no ombro. 2021. 90f. Tese (Doutorado em Fisioterapia) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2021. https://repositorio.ufrn.br/handle/123456789/32504 pt_BR Acesso Aberto application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM FISIOTERAPIA |