Efetividade da estimulação elétrica na reabilitação pós-lesões ligamentares e meniscais
uma revisão sistemática
Palavras-chave:
Terapia por estimulação elétrica, Reabilitação, Articulação do joelho, Traumatismos do joelho, Modalidades de fisioterapiaResumo
CONTEXTO E OBJETIVO: A estimulação elétrica (ES) é amplamente utilizada para fortalecimento muscular após lesões ligamentares ou meniscais do joelho. O objetivo deste estudo foi avaliar a efetividade da ES na reabilitação de lesões de tecidos moles do joelho tratadas de forma cirúrgica ou conservadora. TIPO DE ESTUDO E LOCAL: Revisão sistemática no Centro Cochrane do Brasil. MÉTODOS: Realizamos uma busca no Cochrane Central Register of Controlled Trials (2010, Issue 12), Medline (Medical Analysis and Retrieval System Online) via PubMed (1966 até dezembro 2010), Embase (Excerpta Medica Database, de 1980 até dezembro 2010), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde, de 1982 até dezembro de 2010), and PEDro (Physiotherapy Evidence Database, de 1929 até dezembro de 2010). Os estudos incluídos foram ensaios clínicos randomizados que utilizaram a ES com o objetivo de aumento de força muscular na reabilitação de pacientes com lesões de tecidos moles. Dois autores avaliaram os estudos para inclusão de forma independente e realizaram a extração de dados e avaliação da qualidade metodológica. RESULTADOS: Dezessete estudos incluídos utilizaram a ES após a reconstrução do ligamento cruzado anterior e dois estudos após meniscectomia. Houve melhora estatisticamente significante na força do quadríceps através da ES (diferença média, MD -32.7; 95% intervalo de confiança, IC -39.92 to -25.48; n = 56) e nos desfechos funcionais (MD -7; -12.78 to -1.22; n = 43), seis a oito semanas após cirurgia de reconstrução do ligamento cruzado anterior. CONCLUSÃO: Há evidências de que a ES combinada a exercícios de reabilitação convencional pode ser efetiva na melhora da força muscular e função dois meses após cirurgia.
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Thomson LC, Handoll HH, Cunningham A, Shaw PC. Physiotherapist- led programmes and interventions for rehabilitation of anterior cruciate ligament, medial collateral ligament and meniscal injuries of the knee in adults. Cochrane Database Syst Rev. 2002;(2):CD001354.
Irvine GB, Glasgow MM. The natural history of the meniscus in anterior cruciate insufficiency. Arthroscopic analysis. J Bone Joint Surg Br. 1992;74(3):403-5.
Binfield PM, Maffulli N, Good CJ, King JB. Arthroscopy in sporting and sedentary children and adolescents. Bull Hosp Jt Dis. 2000; 59(3):125-30.
Arvidsson I, Eriksson E, Häggmark T, Johnson RJ. Isokinetic thigh muscle strength after ligament reconstruction in the knee joint: results from a 5-10 year follow-up after reconstructions of the anterior cruciate ligament in the knee joint. Int J Sports Med. 1981;2(1):7-11.
Seto JL, Orofino AS, Morrissey MC, Medeiros JM, Mason WJ. Assessment of quadriceps/hamstring strength, knee ligament stability, functional and sports activity levels five years after anterior cruciate ligament reconstruction. Am J Sports Med. 1988;16(2):170-80.
Tibone JE, Antich TJ. A biomechanical analysis of anterior cruciate ligament reconstruction with the patellar tendon. A two year followup. Am J Sports Med. 1988;16(4):332-5.
Häggmark T, Jansson E, Eriksson E. Fiber type area and metabolic potential of the thigh muscle in man after knee surgery and immobilization. Int J Sports Med. 1981;2(1):12-7.
Halkjaer-Kristensen J, Ingemann-Hansen T. Wasting of the human quadriceps muscle after knee ligament injuries. Scand J Rehabil Med Suppl. 1985;13:5-55.
Morrissey MC, Brewster CE, Shields CL Jr, Brown M. The effects of electrical stimulation on the quadriceps during postoperative knee immobilization. Am J Sports Med. 1985;13(1):40-5
Perry J, Fox JM, Boitano MA, et al. Functional evaluation of the pes anserinus transfer by electromyography and gait analysis. J Bone Joint Surg Am. 1980;62(6):973-80.
Gerber C, Hoppeler H, Claassen H, et al. The lower-extremity musculature in chronic symptomatic instability of the anterior cruciate ligament. J Bone Joint Surg Am. 1985;67(7):1034-43.
Vegso JJ, Genuario SE, Torg JS. Maintenance of hamstring strength following knee surgery. Med Sci Sports Exerc. 1985;17(3):376-9.
Rebai H, Barra V, Laborde A, et al. Effects of two electrical stimulation frequencies in thigh muscle after knee surgery. Int J Sports Med. 2002;23(8):604-9.
Sisk TD, Stralka SW, Deering MB, Griffin JW. Effect of electrical stimulation on quadriceps strength after reconstructive surgery of the anterior cruciate ligament. Am J Sports Med. 1987;15(3):215-20.
Fitzgerald GK, Piva SR, Irrgang JJ. A modified neuromuscular electrical stimulation protocol for quadriceps strength training following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2003;33(9):492-501.
Snyder-Mackler L, Ladin Z, Schepsis AA, Young JC. Electrical stimulation of the thigh muscles after reconstruction of the anterior cruciate ligament. Effects of electrically elicited contraction of the quadriceps femoris and hamstring muscles on gait and on strength of the thigh muscles. J Bone Joint Surg Am. 1991;73(7):1025-36.
Robinson AJ, Snyder-Mackler L. Clinical electrophysiology: electrotherapy and electrophysiologic testing. 2nd ed. Baltimore: Lippincott Williams & Wilkins; 1995.
Verhagen AP, de Vet HC, de Bie RA, et al. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol. 1998;51(12):1235-41.
FrankeJ,UllmannP,SchleicherW.WirksamkeitderElektromyostimulation (EMS) nach Operationen am Kapsel-Band-Apparat des Kniegelenkes bei Sportlern [The effectiveness of electromyostimulation following operations of the capsule-ligament system of the knee joint in athletes]. Sportverletz Sportschaden. 1989;3(2):62-6.
Hörster G, Kedziora O. Kraftverlust und -regeneration der Kniestreckmuskulatur nach Operationen am Kniebandapparat. EMG-Untersuchungen zum Einfluss von Verletzungsmuster, Operationsverfahren und Nachbehandlung unter besonderer Berücksichtigung der EMS [Loss of strength and regeneration of knee extensor musculature after operations of the knee ligaments. EMG studies of the effect of the injury pattern, surgical procedure and after-care with special reference to electromyostimulation]. Aktuelle Traumatol. 1993;23(5):244-54.
Paternostro-Sluga T, Fialka C, Alacamliogliu Y, Saradeth T, Fialka- Moser V. Neuromuscular electrical stimulation after anterior cruciate ligament surgery. Clin Orthop Relat Res. 1999;(368):166-75.
Wigerstad-Lossing I, Grimby G, Jonsson T, et al. Effects of electrical muscle stimulation combined with voluntary contractions after knee ligament surgery. Med Sci Sports Exerc. 1988;20(1):93-8.
Delitto A, Rose SJ, McKowen JM, et al. Electrical stimulation versus voluntary exercise in strengthening thigh musculature after anterior cruciate ligament surgery. Phys Ther. 1988;68(5):660-3.
Snyder-Mackler L, Delitto A, Bailey SL, Stralka SW. Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation. J Bone Joint Surg Am. 1995;77(8):1166-73.
Lieber RL, Silva PD, Daniel DM. Equal effectiveness of electrical and volitional strength training for quadriceps femoris muscles after anterior cruciate ligament surgery. J Orthop Res. 1996;14(1):131-8.
Buhmann HW, SchleicherW, Urbach D, SchultzW. Elektromyostimulation und isokinetisches Training in der Rehabilitation nach Operationen des vorderen Kreuzbandes - eine randomisierte, prospektive Studie [Electromyostimulation and isokinetic training in rehabilitation after anterior cruciate surgery]. Physikalische Medizin Rehabilitationsmedizin Kurortmedizin. 1998;8(1):13-6. Available from: https://www.thieme-connect.com/ejournals/abstract/physmed/doi/10.1055/s-2008-1061813. Accessed in 2011 (Apr 26).
Staub A, Ullmann P, Winker KH. Die Elektromyostimulation bei frühfunktioneller Rehabilitation nach vorderer Kreuzbandersatzplastik [Electromyostimulation under Early Rehabilitation after Replacement of the Anterior Cruciate Ligament}. Sporttraumatologie Akt Traumatol. 2002;32(2):65-72. Available from: https://www.thieme-connect.com/ejournals/abstract/trauma/doi/10.1055/s-2002-25750. Accessed in 2011 (Apr 26).
Anderson AF, Lipscomb AB. Analysis of rehabilitation techniques after anterior cruciate reconstruction. Am J Sports Med. 1989;17(2):154-60.
Ross M. The effect of neuromuscular electrical stimulation during closed kinetic chain exercise on lower extremity performance following anterior cruciate ligament reconstruction. Research in Sports Medicine: An International Journal. 2000;9(4):239-51. Available from: http://www.informaworld.com/smpp/content~db=all~content=a913026809. Accessed in 2011 (Apr 26).
Eriksson E, Häggmark T. Comparison of isometric muscle training and electrical stimulation supplementing isometric muscle training in the recovery after major knee ligament surgery. A preliminary report. Am J Sports Med. 1979;7(3):169-71.
Siebert WE, Kohn D, Wirth CJ. Influence of electrical muscle stimulation on postoperative muscle atrophy after major knee ligament surgery. International Journal of Sports Medicine. 1988;5(9):376. [abstract].
Draper V, Ballard L. Electrical stimulation versus electromyographic biofeedback in the recovery of quadriceps femoris muscle function following anterior cruciate ligament surgery. Phys Ther. 1991;71(6):455-61; discussion 461-4.
Currier DP, Ray JM, Nyland J, et al. Effects of electrical and electromagnetic stimulation after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1993;17(4):177-84.
Williams RA, Morrissey MC, Brewster CE. The effect of electrical stimulation on quadriceps strength and thigh circumference in menisectomy patients. J Orthop Sports Phys Ther. 1986;8(3):143-6.
Lainey CG, Walmsley RP, Andrew GM. Effectiveness of exercise alone versus exercise plus electrical stimulation in strengthening the quadriceps muscle. Physiotherapy Canada. 1983;35(1):5-11.
Atallah AN, Castro AA. Uniform requirements for manuscripts, CONSORT statement and more informative abstracts: three fundamental papers for improving the quality of medical publications. Sao Paulo Med J. 1999;117(1):3-4.
Bax L, Staes F, Verhagen A. Does neuromuscular electrical stimulation strengthen the quadriceps femoris? A systematic review of randomised controlled trials. Sports Med. 2005;35(3):191-212.
Kim KM, Croy T, Hertel J, Saliba S. Effects of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction on quadriceps strength, function, and patient-oriented outcomes: a systematic review. J Orthop Sports Phys Ther. 2010;40(7):383-91.
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