O comportamento das variáveis cinemáticas para diferenciar mulheres com dor femoropatelar durante tarefas funcionais

Abstract

Introduction: Little is known about how the variables of the body segments can contribute or misrepresent the data extracted in the kinematic analysis, thus identifying possible influences that may guide the acquisition and interpretation of kinematic data, as well as contribute to clinical decision making. The aim of this study was to identify and interpret the behavior of the kinematic variables on the MDP, in 7 tests and functional tasks, aiming to identify the variables capable of contributing to the differentiation of the individual with PFP. Methods: Retrospective study of 35 women with patellofemoral pain (PFD) and 35 asymptomatic patients (age: 24.93 ± 5.94 years, height: 161.51 ± 2.77 cm, mass: 56.97 ± 8.54 kg). A kinematic analysis of 7 tests and tasks such as gait, anterior step down, lateral step down, stair climbing and descent, single leg hop test preparation and landing phase using the PIG and OFM models were performed. The frontal, sagittal and transverse planes of the trunk, hip and frontal, frontal and sagittal planes of the knee, ankle flexion, foot angle of advancement and hindfoot eversion were analyzed by means of the deviance index (MDP). As variables were then eliminated systematically, covering 105 combinations of effects of 13 and 12 variations on the MDP. The total Z score of the control group and the DFP group were calculated using 14 variables for each task and the confidence interval (95% CI). Subsequently the calculation of the other Z-scores for complete data combinations. A variability of the z-score of the combinations was considered within the CI (95%). Results: The z-score values of the 105 combinations of variables are within the 95% confidence interval in all the analyzed tasks, therefore, they did not present difference when compared to the z-total. The oscillations of z-score values greater or less influence positively or negatively the differentiation between groups. Discussion: In SDL, the variables that most influenced positively were flexion and extension of the trunk, pelvic obliquity, and inversion and eversion of the hindfoot. In SDA, trunk flexion and extension, pelvic obliquity, hip abduction and abduction, and dorsiflexion and plantar flexion. In the preparation of the SLHT, the trunk flexion and extension, and the inversion and eversion of the hindfoot. On SLHT landing on inclination and flexion and extension of the trunk, hip rotation and dorsiflexion and plantar flexion. In descending slope inclination and flexion and extension of trunk, hip rotation, flexion and extension and valgus / varus of the knee. In the climb of stairs, the inclination of the trunk, obliquity of the pelvis and adduction and abduction of the hip. During the march all variables. It deals with a new methodology, making use of the MDP index, to assist in locating deviations from the combination curve 1never before used in functional tasks.