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Mini-dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Purpose: Patellofemoral Pain Syndrome is a common condition in all age groups, with a multifactorial etiology. This study aimed to investigate the association between the Quadriceps femoris muscle group, Hamstring muscle group and Adductor muscle group, and to establish the relationship between myofascial trigger points (MFTP’s) in these muscle groups and patellofemoral pain syndrome (PFPS). Methods: A cross-sectional, observational, quantitative non-intervention clinical assessment study was conducted at the Chiropractic Day Clinic at Durban University of Technology (DUT), to determine the extent of the PFPS, the MFTPs and thus the relationship between the two. The study included eighty patients with PFPS, who were recruited by convenience sampling. The results were captured using Microsoft excel and SPSS version 15.0 was used to analyze the data. Results: Quadriceps femoris muscle group MFTPs were noted in 92.5% of the patients (most prevalent being Vastus medialis TP1 (63.8%), Vastus lateralis TP1 (33.8%) and Vastus intermedius at 27,5%). Least common was Vastus lateralis TP2 only presenting in 2,5% of the patients. Hamstring muscle group MFTPs were found overall in 86.3% of patients (most prevalent being in Biceps femoris muscle (66%), and least prevalent being in Semitendinosus muscle (11,3%)). MFTPs were present in 64% overall of the Adductor muscle group (Adductor magnus muscle being the most common). Significant associations were made between the presence of MFTPs in the Vastus lateralis TP2 (p=0.00), Vastus medialis TP1 (p=0.046; 0.005; 0.004), the NRS and the PPSS. Also significant was the relationship between the NRS, PPSS and the Semimembranosus and Adductor magnus muscles indicated that these muscles were the most likely causes of pain even though they had fewer MFTPs than other comparable muscles. Conclusion: The outcomes of this study supports previous research indicating that an extensor dysfunction of the Quadriceps femoris muscle group may be of MFTP origin and indicates that other muscles in the thigh require further research indicating their role in the development of PFPS.

Made available in DSpace on 2016-06-02T20:19:24Z (GMT). No. of bitstreams: 1 DissKGS.pdf: 2103991 bytes, checksum: 61e70ed2d6d68cd4b555a73add3e4835 (MD5) Previous issue date: 2005-02-18 / Financiadora de Estudos e Projetos / The purpose of this study was to evaluate the electrical activity of the Vastus Medialis Obliquus (VMO), Vastus Lateralis Obliquus (VLO) and Vastus Lateralis Longus (VLL) in the isometric wall slide squat exercise at 45 and 60º knee flexion associated in a neutral position (NP), 45º of lateral rotation (LR 45), 15º of medial rotation (MR 15) and 30º hip medial rotation (MR 30) only in the 45o angle. The electrical activity of the VMO, VLO and VLL of 15 healthy subjects control group (21,13 ± 2,17 years) and 12 subjects with Patellofemoral pain syndrome (PFPS) PFPS group (21,08 ± 2,31 years), female, was picked up using simple active differential surface electrode, the electromyography system of 8 channels and software Aqdados 7.2.6. The data were normalized by the percentage of the squatting exercise at 75º flexion and hip in neutral position RMS (µV). The volunteers executed the exercise on the Squat Platform that permitted the standing on the hip rotation desirable and the electrogoniometer indicated the amplitude of knee flexion. The ANOVA with repeated measures was used to analyze the data as well as the Duncan pos hoc (p≤0,05). The results of this study revealed no significant interaction between any knee angulation and hip position and every muscles showed significantly higher electrical activity at 60º squatting compared with 45º, on both groups. For the control group, intramuscles analysis, there was no statistical difference for hip position and intermuscles analysis, at 45º squatting as well as 60º, the VLL muscle showed greater electrical activity than VMO (p=0,00036 - 45º; p=0,02 - 60º) and VLO muscle (p=0,00013 - 45º; p=0,0048 - 60º), whereas there was no significant difference between the VMO and VLO muscle (p=0,68 - 45º; p=0,51 - 60º). For the PFPS group, in intramuscles analysis, just VLO muscle showed significantly difference to hip position (p=0,019), that this electrical activity greater in 60º LR (p=0,00); on the analysis between muscles it was revealed that, in 45º squatting, the VLL muscle showed significantly greater electrical activity than the VMO (p=0,005) and the VLO muscles (p=0,000), whereas, the VMO muscle showed greater electrical activity than VLO (p=0,0001). On the other hand, at 60º squatting, the electrical activity of VLL and VMO were greater than VLO muscle (p=0,000 VLL; p=0,0001 - VMO). However, there was no significative difference between VMO and VLL (p=0,72). The analysis between the groups revealed that just the VMO muscle of the PFPS groups showed greater electrical activity than VMO from the control group in 60º squatting with hip rotation analyzed, except in LR (p=0,00036). The results of this research, obtained under the experimental conditions, indicated that the squatting exercise at the 60º angle, in any hip position (except in the lateral rotation) is indicated for the PFPS treatment since it presents a higher stability of the medial and lateral components of the muscle (VMO and VLL). On the other hand, the squatting exercise at the 45º, in any hip position, should avoid in the subjects with PFPS because the electrical activity of VLL is higher than VMO. / A proposta desse trabalho foi analisar a atividade elétrica dos músculos Vasto Medial Oblíquo (VMO), Vasto Lateral Oblíquo (VLO) e Vasto Lateral Longo (VLL) no exercício de agachamento isométrico "wall slide" a 45º e 60º de flexão do joelho associado à posição neutra (PN), à rotação lateral de 45º (RL 45), a rotação medial à 15º (RM15) e a 30º de rotação medial do quadril (RM30) apenas no ângulo de 45º. A atividade elétrica dos músculos VMO, VLO e VLL de 15 indivíduos clinicamente normais grupo controle (21,13 ± 2,17 anos) e 12 indivíduos portadores de Síndrome da Dor Femoropatelar (SDFP) grupo SDFP (21,08 ± 2,31 anos), sexo feminino, foi captada por eletrodos ativos diferenciais simples de superfície, um eletromiógrafo de 8 canais e programa AqDados 7.2.6. Os dados foram normalizados pela porcentagem do exercício de agachamento a 75º com o quadril em posição neutra (%RMS-µV). Os exercícios foram realizados na Plataforma de Agachamento ajustável a cada posição do quadril e o ângulo de flexão do joelho foi obtido por meio de um eletrogoniômetro. Os dados foram analisados pela ANOVA com medidas repetidas e o teste de Duncan (p≤0,05). Não houve interação entre a angulação do joelho e as posições do quadril, nos dois grupos estudados. A atividade elétrica de todos os músculos foi significativamente maior no agachamento a 60º do que a 45º, em qualquer posição do quadril, nos dois grupos. No grupo Controle, na análise intramúsculos, não houve diferença significativa entre as posições do quadril. Na análise intermúsculos, tanto no agachamento a 45º quanto a 60º, o músculo VLL apresentou atividade elétrica significativamente maior do que a do VMO (p=0,00036 a 45º; p=0,02 a 60º) e do que a do VLO (p=0,00013 a 45º; p=0,0048 a 60º). No entanto, não houve diferença significativa entre o VMO e o VLO (p=0,68 a 45º; p=0,51 a 60º). No grupo SDFP, na análise intramúsculos, apenas o VLO apresentou diferença significativa no posicionamento do quadril (p=0,019), sendo a atividade elétrica maior na Rotação Lateral a 60º (p=0,00). Na análise intermúsculos, no agachamento a 45º, em todas as posições do quadril, o músculo VLL apresentou atividade elétrica maior do que a do VMO (p=0,005) e do que a do VLO (p=0,000). No entanto, a atividade elétrica do VMO foi significativamente maior do que a do VLO (p=0,0001). Por outro lado, no agachamento a 60º, em todas as posições do quadril, os músculos VLL e VMO apresentaram atividade elétrica maior que a do VLO (p=0,000; p=0,0001, respectivamente). Entretanto, não houve diferença significativa entre o VMO e VLL (p=0,72). Na análise entre os grupos, no agachamento a 60º e, em todas as posições do quadril analisadas (p=0,00036), exceto na Rotação Lateral, a atividade elétrica do VMO do grupo SDFP foi significativamente maior do que a do VMO do grupo Controle. Os dados dessa pesquisa, nas condições experimentais utilizadas, sugerem que o exercício de agachamento wall-slide à 60º associado a qualquer posição do quadril, exceto na rotação lateral, está indicado no tratamento da SDFP por apresentar uma maior estabilidade dos componentes medial e lateral (longo e oblíquo) da patela. Por outro lado, o exercício de agachamento wallslide a 45º associado a qualquer posição do quadril deveria ser evitado nos indivíduos com SDFP pela atividade elétrica do VLL ser maior do que a do VMO.

Submitted by Livia Mello (liviacmello@yahoo.com.br) on 2016-10-03T14:14:11Z No. of bitstreams: 1 DissCTM.pdf: 1497226 bytes, checksum: e33fe63139fc98a7e56c4936a60ee50c (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T19:42:38Z (GMT) No. of bitstreams: 1 DissCTM.pdf: 1497226 bytes, checksum: e33fe63139fc98a7e56c4936a60ee50c (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T19:42:49Z (GMT) No. of bitstreams: 1 DissCTM.pdf: 1497226 bytes, checksum: e33fe63139fc98a7e56c4936a60ee50c (MD5) / Made available in DSpace on 2016-10-10T19:42:59Z (GMT). No. of bitstreams: 1 DissCTM.pdf: 1497226 bytes, checksum: e33fe63139fc98a7e56c4936a60ee50c (MD5) Previous issue date: 2016-04-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Menopause, permanent discontinuation phase of ovarian follicular activity, triggers tissue and molecular changes in the body of women. The obesity and sarcopenia are two important deleterious effects, affect the functional independence and therefore the quality of life of the same. Resistance training (RT), caloric restriction (CR) are interventions that can minimize and slow down these degenerative processes related to menopause. The objective of this study was evaluate the effects of TR and RC on the biogenesis markers and mitochondrial dynamics on the quadríceps mucle of ovariectomized rats. Ratas Holtzman were divided into 8 groups (n = 10) Sham sedentary, trained, caloric and association training restriction with caloric restriction (SHAM SED, SHAM TR, SHAM RC AND SHAM TR-RC), ovariectomized sedentary, trained, caloric restriction and association training with caloric restriction (OVX SED, OVX TR, OVX and OVX RC TR-RC). The ovariectomy surgery (OVX) and pseudo-ovariectomy (Sham) was conducted when the rats reached 250g body weight. Two days after surgery, began the control of food intake and after 10 days of recovery from surgery, began the TR which consisted of 13 weeks of climbing training vertical ladder, with 72 hours between training sessions. The intensity of TR was 65, 85, 95 and 100% of the predetermined maximum load for each load proportion. After the fourth climbing, it was added 30g to determine the new maximum filler loading. Euthanasia of the animals after 13 weeks was TR and 48 hours after the last training session. The quadriceps muscle of the right hind foot was excised and stored at -80°C for analysis of gene expression and protein mediators of biogenesis and mitochondrial dynamics. The ovariectomy in rats altered mitochondrial biogenesis and dynamics as well as body weight and food consumption. The proposed interventions have been effective in minimized the body mass gains and reverse the molecular changes found in ovariectomy, especially in relation to mitochondrial biogenesis and dynamics. / A menopausa, fase de interrupção permanente da atividade folicular ovariana, desencadeia alterações teciduais e moleculares no organismo das mulheres. O ganho de massa corporal e a sarcopenia são dois importantes efeitos deletérios que ao longo do tempo, afetam a independência funcional e consequente qualidade de vida das mesmas. O treinamento resistido (TR), a restrição calórica (RC) são intervenções que podem amenizar e retardar esses processos degenerativos relacionados à menopausa. O objetivo deste trabalho foi avaliar os efeitos do TR e RC sobre os marcadores de biogênese e dinâmica mitocondrial sobre o quadríceps de ratas ovariectomizadas. Ratas Holtzman foram alocadas em 8 grupos (n=10) Sham sedentárias, treinadas, restrição calórica e associação treinamento com restrição calórica (SHAM SED, SHAM TR, SHAM RC E SHAM TR-RC), ovariectomizadas sedentárias, treinadas, restrição calórica e associação treinamento com restrição calórica (OVX SED, OVX TR, OVX RC e OVX TR-RC). As cirurgias ovariectomia (OVX) e pseudo-ovariectomia (SHAM) foram realizadas quando as ratas alcançaram 250g de massa corporal. Dois dias após as cirurgias, iniciou-se o controle do consumo alimentar e após 10 dias de recuperação das cirurgias, iniciou o TR que consistiu em 13 semanas de treinamento de escalada em escada vertical, com 72 horas de intervalo entre as sessões de treinamento. A intensidade do TR foi de 65, 85, 95 e 100% da carga máxima de carregamento previamente determinada para cada rata. Após a quarta escalada, acrescentou-se 30g para determinar a nova carga máxima de carregamento. A eutanásia dos animais ocorreu após 13 semanas de TR e 48 horas após a última sessão de treino. O músculo quadríceps da pata traseira direita foi excisado e armazenado a -80°C para as análises da expressão gênica e proteica dos mediadores da biogênese e dinâmica mitocondrial. A ovariectomia em ratas alterou a biogênese e dinâmica mitocondrial, bem como a massa corporal e o consumo alimentar. As intervenções propostas foram eficazes em amenizar os ganhos da massa corporal e reverter as alterações moleculares encontradas na ovariectomia, principalmente em relação à biogênese e dinâmica mitocondrial.