Exercícios terapêuticos no tratamento das tendinopatias do membro inferior

• Ano de defesa: 2019
• Autor(a) principal: Franco, Yuri Rafael dos Santos
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa Pós-Graduação Mestrado e Doutorado em Fisioterapia; UNICID
• Palavras-chave em Português: Tendinopatia; Tendões; Extremidade inferior; Terapia por exercício; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2766

This doctoral thesis aimed to investigate the effectiveness of different exercises in the treatment of tendinopathies of the lower limb. The specific objectives were: (1) to systematically review studies that evaluated the effectiveness of different types of physical exercises in the treatment of patients with the main tendinopathies of the lower limb; and (2) investigating the feasibility of a randomized controlled trial comparing a traditional protocol against a newer protocol for patients with patellar tendinopathy. In the systematic review included 31 randomized controlled trials. Most of the studies were about tendonopathy of the calcaneus tendon, with 21 studies, 18 of which were related to non-insertional tendinopathy and three were related to insertional tendinopathy, nine studies investigated patients with patellar tendinopathy and one study assessed gluteal tendinopathy. Five meta-analyzes were possible. The first four meta-analyzes were for tendinopathy of the non-insertional calcaneal tendon: two of them showed no difference between eccentric exercises and use of orthoses; when comparing eccentric exercises with orthosis-related exercises, the effect was favorable to the isolated exercise; Finally, the fourth meta-analysis showed that eccentric exercises are better than control without intervention. The fifth meta-analysis was for patellar tendinopathy and showed that eccentric exercises performed on inclined surfaces have a better effect than on flat surfaces. In general, it was possible to perceive that studies with tendinopathy of the non-insertional calcaneal tendon are more evolved, on the use of the exercise technique, and that the most used therapy to treat patients with tendinopathy are the eccentric exercises, performed in about 87 % of studies. The results of the feasibility study indicate that there is difficulty in recruiting patients with patellar tendinopathy because the recruitment rate is 4.3 patients / month and a velocity rate of 0.8 patients / month. However, adherence and follow-up rates of 77% were observed. Regarding the scientific feasibility, it was not possible to observe a difference between the two protocols for pain and function.