Efeitos do treino neuromuscular e fortalecimento da musculatura do tronco e membro inferior em mulheres com Disfunção Femoropatelar: Um ensaio clínico controlado, randomizado e cego.

Abstract

Patellofemoral Pain (DFP) is a common musculoskeletal condition, characterized by pain in the patella region, which is exacerbated during activities that increase joint overload. It often affects young women, and its etiology is multifactorial and poorly understood. The intervention is primarily conservative, and has been focused on correcting the deficits that this population often presents, such as muscle weakness and poor motor control. The aim of this study was to evaluate the additional effects of neuromuscular training in a conservative treatment to strengthen the trunk, hip and knee muscles in the pain, function and kinematics of the trunk, pelvis and lower limbs in women with DFP. This is a blind randomized controlled clinical trial. Seventy-one active women were recruited and randomly distributed into two groups. Both were submitted to a 12-week intervention protocol: Strengthening Group (SG) performed strengthening exercises for the trunk, hip and knee muscles; while Neuromuscular Training Group (NMTG) received the same treatment, including neuromuscular training exercises in the 4th week. The primary outcomes were pain intensity (Visual Analogue Scale: in the last month, squat 90º and 26 cm step for 1 minute), functional capacity (Anterior Knee Pain Scale and Activities of Daily Living Scale) and 2D kinematics of the trunk, pelvis and lower limb during unilateral squat. The secondary outcome was isometric muscle strength of the lower limb, and the level of satisfaction. Treatment effects were calculated using ANOVA two-way repeated measures, and then Bonferroni's post-hoc. All outcomes were assessed after 12 weeks of treatment. Both groups improved clinically and significantly the intensity of pain and function after 12 weeks of intervention. But there was no significant difference between groups in all outcomes. Therefore, we conclude that the addition of neuromuscular training does not produce superior improvements in pain, function, kinematics and muscle strength when compared to the group that performed isolated strengthening