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      Influência da reabilitação física sobre aspectos funcionais em indivíduos submetidos à artroplastia total de quadril: uma revisão sistemática Translated title: Influence of physical rehabilitation on functional aspects in individuals submitted to total hip arthroplasty: a systematic review

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          Abstract

          Resumo Objetivo: Avaliar, por meio de revisão sistemática, a influência do tratamento fisioterapêutico sobre a funcionalidade, amplitude de movimento articular e força muscular em pacientes submetidos à artroplastia total de quadril devido à osteoartrite. Métodos: A busca sistemática de ensaios clínicos randomizados e não randomizados foi conduzida utilizando os bancos de dados eletrônicos PubMed, Web of Science, PEDro, Cochrane, Clinical Trials e SciELO, com base nas estratégias de pesquisa recomendadas pelos itens de relatórios preferenciais para análises sistemáticas e metanálises (PRISMA). Resultados: Em geral, protocolos supervisionados por fisioterapeutas associados à realização de exercícios ativos da musculatura periarticular do quadril e de extensores de joelho têm propiciado importante prognóstico físico e funcional. Exercícios resistidos (dinâmicos e isométricos) de alta intensidade são mais eficazes para a funcionalidade. Para a força muscular e Amplitude de movimento (ADM), exercícios dinâmicos com 3 a 5 séries de 8 a 12 repetições com baixa e alta intensidade promoveram ganhos mais expressivos em relação a outras modalidades terapêuticas. Conclusões: As técnicas e os protocolos utilizados pela fisioterapia para o tratamento da ATQ são variados e possuem importante eficácia clínica comprovada na literatura.

          Translated abstract

          Abstract Objective: by performing a systematic review, the present study aimed to evaluate the influence of physical rehabilitation on functionality, range of motion and musculoskeletal strength in patients submitted to total hip arthroplasty due to osteoarthritis. Methods: a systematic search for randomized and non-randomized controlled trials was conducted using the PubMed, Web of Science, PEDro, Cochrane, Clinical Trials and SciELO electronic databases, using the search strategies recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: in general, protocols supervised by physiotherapists associated with performing active exercises of the hip periarticular muscles and knee extensors have provided effective functional prognosis. High intensity resistance exercises (dynamic and isometric) are more effective in improving functionality. Dynamic exercises with three to five sets of eight to twelve low and high intensity repetitions promoted more pronounced increases in muscle strength and range of motion than other therapeutic modalities. Conclusions: the techniques and protocols used for physical therapy treatment after THA are wide-ranging and their clinical efficacy is demonstrated in literature.

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          Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse.

          The ability to develop muscle force rapidly may be a very important factor to prevent a fall and to perform other tasks of daily life. However, information is still lacking on the range of training-induced neuromuscular adaptations in elderly humans recovering from a period of disuse. Therefore, the present study examined the effect of three types of training regimes after unilateral prolonged disuse and subsequent hip-replacement surgery on maximal muscle strength, rapid muscle force [rate of force development (RFD)], muscle activation, and muscle size. Thirty-six subjects (60-86 yr) were randomized to a 12-wk rehabilitation program consisting of either 1) strength training (3 times/wk for 12 wk), 2) electrical muscle stimulation (1 h/day for 12 wk), or 3) standard rehabilitation (1 h/day for 12 wk). The nonoperated side did not receive any intervention and thereby served as a within-subject control. Thirty subjects completed the trial. In the strength-training group, significant increases were observed in maximal isometric muscle strength (24%, P < 0.01), contractile RFD (26-45%, P < 0.05), and contractile impulse (27-32%, P < 0.05). No significant changes were seen in the two other training groups or in the nontrained legs of all three groups. Mean electromyogram signal amplitude of vastus lateralis was larger in the strength-training than in the standard-rehabilitation group at 5 and 12 wk (P < 0.05). In contrast to traditional physiotherapy and electrical stimulation, strength training increased muscle mass, maximal isometric strength, RFD, and muscle activation in elderly men and women recovering from long-term muscle disuse and subsequent hip surgery. The improvement in both muscle mass and neural function is likely to have important functional implications for elderly individuals.
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            Osteoarthritis and its management - Epidemiology, nutritional aspects and environmental factors

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              Resistance training induces qualitative changes in muscle morphology, muscle architecture, and muscle function in elderly postoperative patients.

              Although the negative effects of bed rest on muscle strength and muscle mass are well established, it still remains a challenge to identify effective methods to restore physical capacity of elderly patients recovering from hospitalization. The present study compared different training regimes with respect to muscle strength, muscle fiber size, muscle architecture, and stair walking power in elderly postoperative patients. Thirty-six patients (60-86 yr) scheduled for unilateral hip replacement surgery due to hip osteoarthritis were randomized to either 1) resistance training (RT: 3/wk x 12 wk), 2) electrical stimulation (ES: 1 h/day x 12 wk), or 3) standard rehabilitation (SR: 1 h/day x 12 wk). All measurements were performed at baseline, at 5 wk and 12 wk postsurgery. After 12 wk of resistance training, maximal dynamic muscle strength increased by 30% at 60 degrees /s (P < 0.05) and by 29% at 180 degrees /s (P < 0.05); muscle fiber area increased for type I (+17%, P < 0.05), type IIa (+37%, P < 0.05), and type IIx muscle fibers (+51%, P < 0.05); and muscle fiber pennation angle increased by 22% and muscle thickness increased by 15% (P < 0.05). Furthermore, stair walking power increased by 35% (P < 0.05) and was related to the increase in type II fiber area (r = 0.729, P < 0.05). In contrast, there was no increase in any measurement outcomes with electrical stimulation and standard rehabilitation. The present study is the first to demonstrate the effectiveness of resistance training to induce beneficial qualitative changes in muscle fiber morphology and muscle architecture in elderly postoperative patients. In contrast, rehabilitation regimes based on functional exercises and neuromuscular electrical stimulation had no effect. The present data emphasize the importance of resistance training in future rehabilitation programs for elderly individuals.
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                Author and article information

                Journal
                rbgg
                Revista Brasileira de Geriatria e Gerontologia
                Rev. bras. geriatr. gerontol.
                Universidade do Estado do Rio Janeiro (Rio de Janeiro, RJ, Brazil )
                1809-9823
                1981-2256
                2020
                : 23
                : 2
                : e190252
                Affiliations
                [2] Campo Grande Mato Grosso do Sul orgnameUniversidade Federal de Mato Grosso do Sul orgdiv1Laboratório de Estudo do Músculo Estriado (LEME) Brazil
                [1] Campo Grande Mato Grosso do Sul orgnameUniversidade Federal de Mato Grosso do Sul orgdiv1Grupo de Pesquisa “Estudos Avançados em Ciências do Movimento e Reabilitação” Brazil
                Article
                S1809-98232020000200301 S1809-9823(20)02300200301
                10.1590/1981-22562020023.190252
                a6e37b79-ca0f-4f50-8e15-ecf8acdf8d7f

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 05 November 2019
                : 03 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 0
                Product

                SciELO Brazil

                Categories
                Artigo de Revisão

                Envelhecimento,Exercício,Osteoartrite,Artroplastia de Quadril,Aging,Exercise,Osteoarthritis,Hip,Replacement,Arthroplasty

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