Força dos membros inferiores avaliada por dinamometria isocinética e sua associação à composição corporal em adolescentes com obesidade
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Data
2014
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Introdução. A obesidade pediátrica está associada a problemas graves de saúde e
tem vindo a revelar-se a epidemia do século XXI, sendo considerada uma doença
multifactorial. No que diz especificamente respeito ao peak torque, a razão entre
agonista/antagonista fornece informações significativas sobre o equilíbrio muscular,
desempenhando um papel importante na deteção das alterações músculo-esqueléticas, na
definição de medidas preventivas e na implementação de programas de treino específicos.
Os exercícios isocinéticos fornecem valores fidedignos sobre o peak torque produzido e,
consequentemente, sobre a força entre flexores e extensores. Durante a extensão do joelho
em exercícios isocinéticos os adolescentes com obesidade demonstraram ter mais peak
torque nos quadricípedes do que os adolescentes normoponderais.
Objetivo. Analisar a capacidade de produção de peak torque dos membros
inferiores por dinamometria isocinética em adolescentes com obesidade.
Método. Numa primeira fase, foi elaborada uma revisão sistemática da literatura
utilizando como motores de pesquisa a Pubmed e o Sportdiscus de forma a analisar os
índices de fadiga, força e desequilíbrios musculares nos membros inferiores respeitando os
critérios de inclusão e exclusão. Posteriormente foi realizado um estudo transversal em que
participaram 58 adolescentes obesos caucasianos (38 raparigas e 20 rapazes), com idades
compreendidas entre os doze anos e os dezassete anos (16,10±1,33 anos), participantes no
programa TOP (Tratamento da Obesidade Pediátrica). A composição corporal foi avaliada
por densitometria radiológica de dupla energia (Hologic-QDR 4500, Hologic, Inc., Bedford,
MA, USA, modo pencil beam, versão de software 12.5). A aptidão muscular foi avaliada por
dinamometria isocinética (Biodex System 3 - Biodex Corp., Shirley, USA), a 60º/s e 180/s
para determinar o peak torque dos membros inferiores. Para se realizar a comparação entre
géneros e condições do IMC, utilizou-se o teste T para amostras independentes e a análise
das associações entre o IMC e as variáveis da aptidão muscular foi realizada através da
correlação bivariada de Pearson e correlação parcial, com controlo da idade, género e IMC,
uma vez que todas as variáveis tinham uma distribuição normal.
Resultados. Na revisão sistemática de literatura foram encontrados apenas 6
estudos observacionais/transversais, dos quais quatro se concentram na análise do peak
torque e fadiga muscular dos membros inferiores em adolescentes obesos, um avalia a
fadiga muscular em adolescentes normoponderais e um último artigo analisa o equilíbrio
muscular (agonista/antagonista) em jovens atletas de desportos de combate.No estudo transversal verificou-se que os rapazes são mais propícios a lesões no
joelho pois apresentam um maior rácio agonista/antagonista. O peak torque na flexão do
joelho é decisiva para determinar o rácio agonista/antagonista e diminui à medida que a
massa e a percentagem de gordura aumentam nos membros inferiores.
Conclusão. Os rapazes atingem valores de peak torque mais elevados do que as
raparigas. Quanto maior a percentagem de gordura total e gordura nos membros inferiores,
menor será o peak torque na flexão do joelho. Quanto maior a percentagem de gordura total
e gordura nos membros inferiores, menor será o rácio agonista/antagonista. Quanto maior
for o peak torque na flexão do joelho, maior será o rácio agonista/antagonista. Uma vez que
o tema em análise tem sido pouco explorado e a escassa literatura de apoio por vezes data
de há mais de 5 anos, é fundamental a realização de mais estudos para orientar da melhor
forma, detetar e esclarecer a existência de desequilíbrio muscular, os tipos de lesões e o
tipo de trabalho a realizar para contrariar futuros desequilíbrios musculares em adolescentes
com obesidade.
Introduction. The pediatric obesity is associated to serious health problems and has proved itself to be the epidemic of the 21st century, being considered as a multifactorial disease. In what specifically concerns the peak torque, the rate between agonist/antagonist offers significant information on the muscular balance and reveals itself important for the detection of muscular-skeletal alterations, the setting of preventive measures and the implementation of specific training programs. The isokinetic exercises provide faithful data on the peak torque and, therefore, on the strength between flexors and extensors. During the knee extension through isokinetics exercises, adolescents with obesity reach higher peak torque values on their quadriceps than normalweight adolescents. Objective. To examine the capacity of lower limbs in terms of peak torque production through isokinetic dynamometry in adolescents with obesity. Method. In a first stage, the literature was systematically reviewed using Pubmed and Sportdiscus as search engines in order to analyse the indexes of fatigue, strength and muscular imbalances in lower limbs taking into account the inclusion and exclusion criteria. In a second stage, a cross-sectional study was conducted involving 58 caucasian obese adolescents (38 girls and 20 boys) aged between 12 and 17 years (16,10+/-1,33 years) that were participating in the TOP (Pediatric Obesity Treatment). The body composition was evaluated by dual-energy x-ray absorptiometry (Hologic-QDR 4500, Hologic, Inc., Bedford, MA, USA, modo pencil beam, software version 12.5). The muscle peak torque was estimated by isokinetic dynamometry (Biodex System 3 - Biodex Corp, Shirley, USA) on 60º/s and 180º/s to determine the peak torque of the lower limbs. The T test was used to compare genders and BMI values by examining independent samples. The link between the BMI and the variables related to muscular fitness was evaluated by a bivariate correlation established by Pearson and by a partial correlation controlling age, gender and BMI variables, as they presented a normal distribution. Results. Following the systematic review of the available literature only 6 observational/cross-sectional studies were found, of which four focus their research on peak torque and muscular fatigue of the lower limbs in adolescents with obesity, one researches muscular fatigue in normalweight adolescents and one last article examines the muscular balance (agonist/antagonist) in young athletes in combat sports. The cross-sectional study showed that boys are more often subject to knee injuries as they have a higher agonist/antagonist rate. The peak torque values during knee bending is decisive to establish the agonist/antagonist rate and it decreases as the mass and the fat rate increase in lower limbs. Conclusion. Boys reach higher peak torque values than girls. The higher the total fat and fat rate in lower limbs, the lower the peak torque values during knee bending. The higher the peak torque values during knee bending, the higher the agonist/antagonist rate. Given the fact that this subject has not been sufficiently explored and the support literature is very scarce and was prepared more than 5 years ago, it is crucial to conduct more studies in order to better guide, understand and clarify the existence of muscular imbalances, the types of injuries and the actions to be taken in order to address future muscular imbalances in adolescents with obesity.
Introduction. The pediatric obesity is associated to serious health problems and has proved itself to be the epidemic of the 21st century, being considered as a multifactorial disease. In what specifically concerns the peak torque, the rate between agonist/antagonist offers significant information on the muscular balance and reveals itself important for the detection of muscular-skeletal alterations, the setting of preventive measures and the implementation of specific training programs. The isokinetic exercises provide faithful data on the peak torque and, therefore, on the strength between flexors and extensors. During the knee extension through isokinetics exercises, adolescents with obesity reach higher peak torque values on their quadriceps than normalweight adolescents. Objective. To examine the capacity of lower limbs in terms of peak torque production through isokinetic dynamometry in adolescents with obesity. Method. In a first stage, the literature was systematically reviewed using Pubmed and Sportdiscus as search engines in order to analyse the indexes of fatigue, strength and muscular imbalances in lower limbs taking into account the inclusion and exclusion criteria. In a second stage, a cross-sectional study was conducted involving 58 caucasian obese adolescents (38 girls and 20 boys) aged between 12 and 17 years (16,10+/-1,33 years) that were participating in the TOP (Pediatric Obesity Treatment). The body composition was evaluated by dual-energy x-ray absorptiometry (Hologic-QDR 4500, Hologic, Inc., Bedford, MA, USA, modo pencil beam, software version 12.5). The muscle peak torque was estimated by isokinetic dynamometry (Biodex System 3 - Biodex Corp, Shirley, USA) on 60º/s and 180º/s to determine the peak torque of the lower limbs. The T test was used to compare genders and BMI values by examining independent samples. The link between the BMI and the variables related to muscular fitness was evaluated by a bivariate correlation established by Pearson and by a partial correlation controlling age, gender and BMI variables, as they presented a normal distribution. Results. Following the systematic review of the available literature only 6 observational/cross-sectional studies were found, of which four focus their research on peak torque and muscular fatigue of the lower limbs in adolescents with obesity, one researches muscular fatigue in normalweight adolescents and one last article examines the muscular balance (agonist/antagonist) in young athletes in combat sports. The cross-sectional study showed that boys are more often subject to knee injuries as they have a higher agonist/antagonist rate. The peak torque values during knee bending is decisive to establish the agonist/antagonist rate and it decreases as the mass and the fat rate increase in lower limbs. Conclusion. Boys reach higher peak torque values than girls. The higher the total fat and fat rate in lower limbs, the lower the peak torque values during knee bending. The higher the peak torque values during knee bending, the higher the agonist/antagonist rate. Given the fact that this subject has not been sufficiently explored and the support literature is very scarce and was prepared more than 5 years ago, it is crucial to conduct more studies in order to better guide, understand and clarify the existence of muscular imbalances, the types of injuries and the actions to be taken in order to address future muscular imbalances in adolescents with obesity.
Descrição
Orientação: Sandra Martins
Palavras-chave
DESPORTO, COMPOSIÇÃO CORPORAL, ADOLESCENTES, OBESIDADE, OBESIDADE INFANTIL, FORÇA MUSCULAR, AVALIAÇÃO ISOCINÉTICA, MEMBROS INFERIORES, MESTRADO EM EXERCÍCIO E BEM-ESTAR, SPORT, BODY COMPOSITION, ADOLESCENTS, OBESITY, CHILD OBESITY, MUSCULAR STRENGTH, ISOKINETIC EVALUATION, LOWER LIMBS