Treino Proprioceptivo na Prevenção e Reabilitação de Lesões nos Jovens Atletas

 

Márcio LP Domingues

 

Mestrando FCDEF Coimbra

 

 

RESUMO

O risco de lesão acompanha toda a participação desportiva. A limitação funcional muitas vezes reside da instabilidade provocada por uma lesão articular. A propriocepção é, com efeito, um conjunto de reacções que resultam num input neural cumulativo ao sistema nervoso central (SNC) de mecanoreceptores nas articulações, ligamentos, músculos, tendões e pele.

A reabilitação funcional é uma extensão da terapia física usual. O seu objectivo é proporcionar um regresso rápido do atleta aos elevados padrões motores da vida desportiva. São abordadas lesões de várias articulações tendo em conta o treino proprioceptivo. Existe muita evidência de que o treino proprioceptivo reduz a incidência de algumas lesões, sendo que a reeducação proprioceptiva contribuiu muito para a perda de medo no retorno ao trabalho, bem como às actividades desportivas.

Palavras-Chave: Propriocepção; reabilitação funcional; equilíbrio; lesão

 

 

ABSTRACT

The risk of injury comes with sport participation.  The functional limitation quite often comes from the instability originated from an articular injury. Proprioception is, in fact, a sum of reactions that result on a cumulative neural input into the Central Nervous System (CNS) of mechanoreceptors in the articulations, ligaments, muscles, tendons and skin.

Functional rehabilitation is an extension of normal physical therapy. Its purpose is to allow rapid recovery of the athlete to its high sports motor patterns. We will review injuries form various articulations in respect to proprioceptive training. There is a lot of evidence that proprioceptive training diminishes the incidence of some injuries, and that proprioceptive reeducation contributes a lot to the lost of fear and quick return to work, as well as to sport activities.

Keywords: Proprioception; functional rehabilitation; balance; injury

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

Referências Bibliográficas

 

1. Aalto H, Pyykko I, Ilmarinen R, Kahkonen E, Starck J (1990). Postural stability in shooters. In Journal Otorhinolaryngology Relat Spec. 4: 232-238;        [ Links ]

2. Allegrucci M, Whitney S, Lephart S, Irrgang J, Fu F (1995). Shoulder kinesthesia in healthy unilateral athletes participating in upper extremity sports. In Journal Orthopaedic Sports Physical Therapy. 4: 220-226;

3. Aquino C, Viana S, Fonseca S, Brício S, Vaz D (2004). Mecanismos Neuromusculares de Controle da Estabilidade Muscular in Revista Brasileira da Ciência e Movimento (12) 2: 35-42;

4. Ashton-Miller J, Wojtys E, Huston L, Fry-Welch D (2001). Can Proprioception Really be Improved by Exercise? In Knee Surgery, Sports Traumatology, Arthroscopy. 9: 128-136;

5. Aydin T, Yildiz Y, Yildiz C, Atesalp S, Kalyon T (2002). Proprioception of the ankle: a comparison between female teenaged gymnasts and controls. In Foot Ankle 2:123-129;

6. Becker A, Gaulrapp H, Hess H (2006). Injuries in women soccer - results of a prospective study. In Sportverletz Sportschaden. 20 (4):196-200;

7. Bronner S (1997). Functional Rehabilitaion of the spine: The Lumbopelvis as a Key Point of Control in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 5: 141-190;

8. Brownstein B (1997a). Movement Biomechanics and Control in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 1: 1-42;

9. Brownstein B (1997b). Movement Skills in Sport in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 7: 232-252;

10. Caraffa A, Cerulli G, Projetti M, Aisa G, Rizzo A (1996). Prevention of anterior cruciate ligament injuries in soccer: A prospective controlled study of proprioceptive training. In Knee Surgery, Sports Traumatology, Arthroscopy. 4: 19-21;

11. Chaise F, Morin O, Witvoet J (1985). Results of the surgical treatment of chronic external laxity of the ankle by resetting capsular ligamentous tension. In Journal Chir. (3):159-162;

12. Cups E, Verhagen E, Meeusen R (2007). Efficacy of a Sports Specific Programme on the Incidence of Ankle Sprains in basketball. In Journal of Sports Science and Medicine. 6: 212 – 219;

13. Danion F, Boyadjian A, Marin L (2000). Control of locomotion in expert gymnasts in the absence of vision. In Journal Sports Science. 10 :809-814;

14. Decicco P, Fisher M (2005). The effects of proprioceptive neuromuscular facilitation stretching on shoulder range of motion in overhand athletes in The Journal of Sports Medicine and Physical Fitness. (45) 2: 183 - 187;

15. d'Hemecourt P, Gerbino P, Micheli L (2000). Back injuries in the young athlete. In Clinical Sports Medicine. 4:663- 679;

16. Einhorn A, Mandas M, Sawyer M, Brownstein B (1997). Evaluation and Treatment of the Shoulder in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 4: 89-140;

17. Ferretti A, Papandrea P, Poggini L, Falez F (1991). Third-degree lesions of the external compartment of the ankle: Results of conservative treatment. Italian Journal Orthopaedic Traumatology. (1): 41-53;

18. Forkin D, Koczur C, Battle R, Newton R (1996). Evaluation of kinesthetic deficits indicative of balance control in gymnasts with unilateral chronic ankle sprains. In Journal Orthopaedic Sports Physical Therapy. 4: 245-250;

19. Fremerey R, Bosch U, Lobenhoffer P, Stalp M, Wippermann B (2005). Capacity for sport and the sensorimotor system after stabilization of the shoulder in overhead athletes. In Sportverletz Sportschaden. (2): 72-76;

20.  Funk D, Swank A, Mikla B, Fagan T, Farr B (2003). Impact of prior exercise on hamstring flexibility: a comparison of proprioceptive neuromuscular facilitation and static stretching. Journal Strength Conditioning Resistance. Aug;17 (3):489-492;

21. Graziano M (1999). Where is my Arm? The Relative Role of Vision and Proprioception in the Neuronal Representation of Limb Position. In Proc. Natural. Academy. Science. 96: 10418 – 10421;

22. Guillou E, Dupui P, Golomer E (2007). Dynamic balance sensory motor control and symmetrical or asymmetrical equilibrium training. In Clinical Neurophysioly. 118 (2): 317-24;

23. Guillot A, Collet C (2004). Field dependence-independence in complex motor skills.In Perceptual Motor Skills. 2:575-583;

24. Halseth T, McChesney J, DeBeliso M, Vaughn R, Lien J (2004). The Effects of Kinesio Taping on Proprioception at the Ankle. In Journal of Sports Science and Medicine. 3: 1 – 7;

25. Hernandez, A (2006). Perspectivas da Traumatologia Esportiva no Esporte de Alto Rendimento. In Revista Brasileira de Educação Física e Esporte. (20) 5: 181 – 183;

26. Hilberg T, Herbsleb M, Puta C, Gabriel H, Schramm W (2003).Physical training increases isometric muscular strength and proprioceptive performance in haemophilic subjects. In Haemophilia. 9(1): 86-93;

27. Hotz A (2003a). Tudo passa pela coordenação in Seminário Internacional Treino De Jovens “Ensinar bem para treinar melhor”. IDP, Instituto Desporto Portugal. Pp: 85-93;

28. Hotz A (2003b). A Coordenação como Modelo Filosófico in Seminário Internacional Treino De Jovens “Ensinar bem para treinar melhor”. IDP, Instituto Desporto Portugal. Pp: 101-107;

29. Jenkins W, Bronner S, Mangine R (1997). Functional Evaluation and Treatment of the Lower Extremity in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 6: 191 - 230;

30. Jerosch J, Thorwesten L, Teigelkotter T (1997).  Proprioception of the shoulder joint in young tennis players. In Sportverletz Sportschaden. 11: 1-9;

31.  Jobe F, Bradley J (1988). Rotator cuff injuries in baseball. Prevention and rehabilitation. In Journal of Sports Medicine. 6: 378-387;

32. Karlsson J, Eriksson B, Sward L (1996). Early functional treatment for acute ligament injuries of the ankle joint. Scandinavian Journal Medicine Science Sports. (6): 341-345;

33. Knobloch K, Jagodzinski M, Haasper C, Zeichen J, Krettek C (2006). Gymnastic school sport injuries--aspects of preventive measures. In Sportverletz Sportschaden. 20 (2): 81-85;

34. Knobloch K, Rossner D, Jagodzinski M, Zeichen J, Gossling T, Martin-Schmitt S, Richter M, Krettek C (2005). Prevention of school sport injuries--an analysis of ballsports with 2234 injuries. In Sportverletz Sportschaden. (2):82-88.

35. Krogsgaard MR (2002).The anterior cruciate ligament. In Ugeskr Laeger. 9:1208-1114;

36. Kuni B, Schmitt H (2004). Peak torque and proprioception at the ankle of dancers in professional training. In Sportverletz Sportschaden. 18(1): 15-21;

37. Laskowski E, Newcomer-Aney K, Smith J (1997). Refining Rehabilitation with Proprioception Training: Expediting Return to Play. In The Physician and Sports medicine. (25), 10;

38. Lephart S, Henry T (1995). Functional rehabilitation for the upper and lower extremity. In Orthopaedic Clinical North America. 3: 579-592;

39. Lephart S, Giraldo J, Borsa P, Fu F (1996). Knee joint proprioception: a comparison between female intercollegiate gymnasts and controls. In Knee Surgery Sports Traumatolgy Arthroscopy. 2:121-124;

40. Lephart S, Perrin D, Fu F (1992). Relationship between selected physical characteristics and functional capacity in the anterior cruciate ligament – insufficient athlete. Journal. Orthopaedic Sports Physical Therapy. 16: 174 – 181;

41. Liederbach M (1997). Movement and Function in Dance in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 8: 253 - 310;

42.  Louw Q, Grimmer K, Vaughan C (2006). Knee movement patterns of injured and uninjured adolescent basketball players when landing from a jump: a case-control study. InBMC Musculoskeletal Disorders. 7: 22;

43. Lutz G, Stuart M, Sim F, Scott S (1990). Rehabilitative techniques for athletes after reconstruction of the anterior cruciate ligament. In Mayo Clinical Procedures. 10:1322-1329;

44. Mandelbaum B, Silvers H, Watanabe D, Knarr J, Thomas S, Griffin L, Kirkendall D, Garrett W (2005). Effectiveness of a Neuromuscular and Proprioceptive Training Program in Preventing Anterior Cruciate Ligament Injuries in Female Athletes. In The American Journal of Sports Medicine. (33) 7: 1003 - 1010;

45. Mesure S, Amblard B, Cremieux J (1997). Effect of physical training on head-hip co-ordinated movements during unperturbed stance. In Neuroreport. 8 (16):3507-3512;

46. Nelson K, Cornelius W (1991). The relationship between isometric contraction durations and improvement in shoulder joint range of motion. Journal Sports Medicine Physical Fitness. (3): 385-388;

47. Nitz A, Nyland J, Brosky Jr. T, Caborn D (1997). Neurosciences in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 2: 43 - 72;

48. Noronha M, Refshauge K, Herbert R, Kilbreath S (2006). Do Voluntary Strength, Proprioception, Range of Motion, or Postural Sway Predict Occurrence of Lateral Ankle Sprain? In British Journal of Sports Medicine.  40: 824 – 828;

49. Olsen O, Myklebust G, Engebretsen L, Holme I, Bahr R (2005). Exercises to Prevent Lower Limb Injuries in Youth Sports: cluster randomised controlled trial in BMJ.com;

50. Paine R, Brownstein B, Macha D (1997). Functional Outcomes and Measuring Function in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 3: 73-88;

51. Pearce P (2006). Prehabilitation: Preparing Youth Athletes for Sports. In Current Sports Medicine Reports;

52. Pinheiro J (1988). Estimulação Proprioceptiva. In Medicina de Reabilitação em Traumatologia do Desporto. 10: 149-161;

53. Plona R, Brownstein B (1997). Function in Older Individuals – Orthopaedic Geriatrics in Evaluation treatment and outcomes Functional Movement in Orthopaedic and Sports Physical Therapy (Eds B. Brownstein, S. Bronner) Churchill Livingstone. 9: 311-347;

54. Rieser J, Hill E, Talor C, Bradfield A, Rosen S (1992). Visual experience, visual field size, and the development of nonvisual sensitivity to the spatial structure of outdoor neighborhoods explored by walking. Journal Experiment Psychology Genetics. (2): 210-221;

55. Roberts D, Ageberg E, Andersson G, Friden T (2004). Effects of short-term cycling on knee joint proprioception in ACL-deficient patients. In Knee Surgery Sports Traumatology Arthroscopy. 5:357-363;

56. Roberts D, Andersson G, Fridén T (2007). Knee Joint Proprioception in ACL-Deficient Knees is related to Cartilage Injury, Laxity and Age in Acta Orthopaedica. (75), 1: 78 – 83;

57. Safran M, Borsa P, Lephart S, Fu F, Warner J (2001). Shoulder proprioception in baseball pitchers. In Journal Shoulder Elbow Surgery. 5:438-444.;

58. Sampaio T, Souza J (1994). Reeducação Proprioceptiva nas Lesões do Ligamento Cruzado Anterior do Joelho. In Revista Brasileira Ortopedia. (29), 5: 303-309;

59. Schmitt H, Kuni B, Sabo D (2005). Influence of professional dance training on peak torque and proprioception at the ankle. In Clinical Journal Sports Medicine. 5:331-339.

60. Sheth P, Yu B, Laskowski E, An K (1997). Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain.

61. American Journal Sports Medicine. 25(4): 538-43;

62. Silva C, Rodrigues C (2005). Prevenção de Lesões Articulares no Desporto in Revista Treino Desportivo. IDP, Instituto do Desporto de Portugal. Nº 29: 52-55;

63.  Starkes J, Gabriele L, Young L (1989). Performance of the vertical position in synchronized swimming as a function of skill, proprioceptive and visual feedback. InPerceptual Motor Skills. 1: 225-226;

64. Strobel MJ, Castillo RJ, Weiler A (2001). Reflex extension loss after anterior cruciate ligament reconstruction due to femoral "high noon" graft placement. In Arthroscopy. 4: 408-411;

65. Theoret D, Lamontagne M (2006). Study on three-dimensional kinematics and electromyography of ACL deficient knee participants wearing a functional knee brace during running. In Knee Surgery Sports Traumatology Arthroscopy. 14(6): 555-563;

66. Verhagen E, van Mechelen W, de Vente W (2000). The Effect of Preventive Measures on the Incidence of Ankle Sprains. In Clinical Journal of Sports Medicine. 10: 291 - 296;

67. Verhagen E, van der Beek A, van Mechelen W (2001). The Effect of Tape, Braces and Shoes on Ankle Range of Motion.  In Sports Medicine. (31) 9: 667 – 677;

68. Verhagen E, van der Beek A, Twisk J, Bouter L, Bahr R, van Mechelen W (2004). The Effect of a Proprioceptive Balance Board Training Program for the Prevention of Ankle Sprains. In The American Journal of Sports Medicine. (32) 6: 1385 - 1392;

69. Verhagen E, van Tulder M, van der Beek A, Bouter L, van Mechelen W (2004). An economic evaluation of a proprioceptivo balance board training programme for the prevention of ankle sprains in volleyball. In British Journal of Sports Medicine. 39: 111 - 115;

70. Williams G, Chmielewski T, Rudolph K, Buchanan T, Snyder-Mackler L. (2001). Dynamic Knee Stability: current theory and implications for clinicians and scientists in J. Orthopaedic Sports Physical Therapy. (31)10: 546 – 56.

71. Zazulak B, Hewett T, Reeves N, Goldberg B, Cholewicki J (2007). The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. American Journal Sports Medicine. 3(3): 368-73;

 

 

Correspondência:

Márcio LP Domingues

Rua Nova, Horta-Velha Borralha

3750-862, Borralha

E-mail: tecomarciano@hotmail.com