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Tratamento da Lombalgia Crônica Influenciada pela Discrepância dos Membros Inferiores: Um Estudo de Caso

DOI: http://dx.doi.org/10.15602/1983-9480/cmbs.v13n27p9-17

https://www.metodista.br/revistas/revistas-ipa/index.php/EUM/index 

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Nélio S. Souza1, Glória M. M. V. Rosa2, Glauco A. Gaban3, Dionis Machado4, Ana C. G. Martins5 & Victor H. Bastos6

 

Resumo: A coluna vertebral é sede de diversas doenças, sendo a lombalgia, a principal e mais frequente causa de absenteísmo. Diversos autores consideram a discrepância dos membros inferiores (DCMI) uma das causas de dor lombar, sendo a obliquidade pélvica a alteração mais comum. O objetivo deste estudo foi analisar e tratar a influência da discrepância dos membros inferiores no desenvolvimento de um quadro de lombalgia crônica. Para a descrição do paciente foram utilizados o índice de incapacidade de Oswestry e uma ficha de avaliação funcional da lombar, onde se observou desordens funcionais incluindo a obliqui¬dade pélvica. Para o resgate funcional deste indivíduo foram empregadas diversas abordagens terapêuti¬cas, bem como o nivelamento pélvico. Aproximadamente 40 a 70% da população apresenta obliquidade pélvica, contudo suas relações com a lombalgia, a discrepância dos membros inferiores e as desordens musculoesqueléticos são discutíveis. Deste modo, são necessários novos estudos a fim de desenvolver diagnósticos mais criteriosos.

Palavras-chave: Dor lombar – DCMI - Obliquidade pélvica e Fisioterapia

 

Abstract: The spine is headquarters of several diseases, narrow road the low back pain is the main and more frequent privations cause. Many authors consider the difference of length of the inferior member (DLIM) one of the causes low back pain, being the pelvic inclination the most common alteration. The objective of this study was to analyze and treat it influences of the difference of the length of the inferior members in the development of a picture of chronic low back pain. For the patient’s description they were used the index of inability of Oswestry and a record of functional evaluation of the lumbar, where it was observed functional disorders including the pelvic bias. For this individual’s functional ransom therapeutic several treatments was used as well as the pelvic equality. Approximately 40 to 70% of the population presents pelvic bias, however their relationships with the low back pain, the discrepancy of the inferior members and the disorders muscleskeleticon are debatable. This way, it is made new necessary studies in order to develop more discerning diagnoses.

Key words: Low Back Pain – DLIM - Pelvic Bias and Physiotherapy

 

1 Fisioterapeuta, UNIFESO; Mestrando em Ciências da Reabilitação, UNISUAM.
2 Fisioterapeuta, Mestre em Morfologia, UERJ e docente UGF, IBMR e UNIFESO - Teresópolis/RJ.
3 Fisioterapeuta, UGF; Mestre em Ciências Biológicas, UFRJ.
4 Professora Assistente do Departamento de Fisioterapia da Universidade Federal do Piauí (UFPI/Parnaíba).
5 Fisioterapeuta, UNIFESO; Mestranda em Atenção Integrada a Saúde da Mulher e da Criança, UFF.
6 Professor Adjunto do Departamento de Fisioterapia da Universidade Federal do Piauí (UFPI/Parnaíba).

 

Literatura Citada

BANDY, Willian; SANDERS, Barbara. Exercício Terapêutico: Técnicas para Intervenção. Rio de Janeiro: Guanabara Koogan, 2003. 252-280 p.

BEAUDOIN, L ; ZABJEK, KF ; LEROUX, MA. Acute Systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects. Europe Spine Journal, v. 8, p.40-5. 1999. http://dx.doi.org/10.1007/s005860050125

BIGOS, S; BOWER, O. Acute low back problems in adults. Clinical Practice Guideline nº 14. AHCPR. Publication nº 95: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services, Rockville, MD, December: 1994.

BLAKE, RL; FERGUSON, HJ. Correlation between limb length discrepancy and asymmetrical rearfoot position. Journal of the American Podiatric Medical Association, v. 83, p.625-33. 1993. doi

BLAKE, RL; FERGUSON, HJ. Limb Length Discrepancies. Journal of the American Podiatric Medical Association, v. 82, n. 1, p.33-8. 1992. doi

BRICOT, Bernard. Posturologia Clínica. 1º ed. São Paulo: Cies Brasil, 2010. p. 183-185.

BUTLER, David. Mobilização do Sistema Nervoso, São Paulo: Manole, 2003. 127-139p.

CLARKE, GR. Unequal leg length: an accurate method of detection and some clinical results. Rheumatology Physical Medicine, v. 11, p.385-90. 1972. http://dx.doi.org/10.1093/rheumatology/11.8.385

CLAUS, Andrew et al. Is ‘ideal’ sitting posture real? Measurement of spinal curves in four sitting posture. Manual therapy, Australia, March, v. 14, p. 404-408. 2009.

DAHL, MT. Limb length discrepancy. Pediatric Clinics of North America, v. 43, p. 849-65. 1996. doi

DEFRIN, R; BENUAMIN, SB; ALDUBI, D; PICKE, CG. Censervative Correction of Leg-Length Discrepancies of 10mm or Less for the Relief of Chronic Low Back Pain. Archives of Physical Medicine and Rehabilitation, v. 86, p.2075-79. 2005. doi

DEMOULIN, C. et al. Lumbar functional instability: A critical appraisal of the literature. Revue Annles réadaptation medicine physique. Belgium. 2007 May; 50: 677-684.

ECKARD, VR; BATINITZKY, S; ABRAMS, BM; ECKARD, DA. Radiology and the diagnosis and management of pain. In: Raj PP, editor. Practical management of pain. 3ed. St. Louis: Mosby, 2000. p. 338-407.

FAIRBANK, JCT; DAVIES, JB. The Oswestry low back pain disability questionnaire. Physiotherapy, v. 66, p. 271-73. 1980.

FRIBERG, O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine, v.8, p.643-51. 1981. doi

FRITZ, JM; SHANNOM, NC. Low Back Pain in Adolescents: A Comparison of Clinical Outcomes in Sports Participants and Nonparticipants. Journal of Athletic Training, v. 45, n. 1, p.61–66. 2010. doi

GIBSON, PH; PAPAIOANNOU, T; KENWRIGHT, J. The influence on the spine of leg-length inequality after femoral fracture. Journal of Bone and Joint Surgery, v. 65-B, p.584-7. 1983.

GILES, LGF; TAYLOR, JR. Low-back pain associated with leg length inequality. Spine, v. 6, p.510-521. 1981a. doi

GILES, LGF. Lumbosacral facetal joint angles associated with leg length inequality. Rheumatology Rehabilitation, v. 20, p. 233-8. 1981b. doi

GOFTON, JP. Persistent low back pain and leg length disparity. Journal Rheumatology, v. 12, p. 747-50. 1985.

GREENMAN, PE. Lift therapy: use and abuse. Journal of the American Podiatric Medical Association, v. 79: p. 238-50. 1979.

GURNEY, B. Leg length discrepancy. Gait and Posture, v. 15, p. 195-206. 2002. doi

HALL, Carrie; BRODY, Lori Thein. Exercício terapêutico na busca da função. Rio de Janeiro: Guanabara Koogan, 2007. p. 355-401

HART, LG; DEYO, RA; CHERKIN, DC. Physician office visits for low back pain. Spine, v. 20, p. 11-19. 1995.

HARTVIGSEN, J; MORSØ, L; BENDIX, T; MANNICHE, C. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: A single blind randomized clinical trial. BMC Musculoskeletal Disorders, v. 11, n. 30, p. 2-9. 2010. http://dx.doi.org/10.1186/1471-2474-11-30

HEBERT, J; KOPPENHAVER, HDC; MAGEL, JS; FRITZ, JM. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: A Cross-Sectional Study. Archives of Physical Medicine and Rehabilitation, v. 91, p. 78-85, Jan. 2010. http://dx.doi.org/10.1016/j.apmr.2009.08.146

HOIKKA, vV; YLIKOSKI, M; TALLROTH, K. Leg-length inequality has poor correlation with lumbar scoliosis. A radiographical study on 100 patients with low-back pain. Archives Orthopedic Traumatology Surgery, v. 108, p. 173-5. 1989. http://dx.doi.org/10.1007/BF00934262

IRVIN, RE. Reduction of lumbar scoliosis by use of a heel lift to level the sacral base. Journal American Osteopathatic Association, v. 91, n. 34, p. 37-44. 1991.

JANSE, J. Clinical biomechanics of the sacroiliac mechanism. ACA Journal Chiropractic, v. 82, p. 33-8. 1987.

KOLTYN, KF. Analgesia following exercise: a review. Sports Medicine. v. 29, n. 2, p.85-98. 2000. doi

MAITLAND, GD; HENGWELD, E; BAMES, K; ENGLISH, K. Manipulação Vertebral de Maitland. 6 ed. Rio de Janeiro: Medsi, 2003. 480p.

MAITLAND, Geoff D. Peripheral Manipulation. 2ed. Butterworth: London, 1997. 462p.

MANNELLO, DO. Leg length inequality. Journal Manipulative Physical Therapy, v. 15, p. 576-90. 1992.

MCCAW, ST; BATES, BT. Biomechanical implications of mild leg length inequality. British journal of sports, v. 25, p. 10-3. 1991.

MORSCHER, E. Etiology and pathophysiology of leg length discrepancies. Prog. Orthop, v. 1, p. 9-19. 1977. http://dx.doi.org/10.1007/978-3-642-66549-3_2

MULLIGAN, Brain. Manual therapy ‘‘Nags’’, ‘‘Snags’’, ‘‘MWMs’’ etc. 5ed. Wellington, New Zealand: Plane View Services, 2004. 15-24p.

PAPAIOANNOU, T; STOKES, I; KENWRIGHT, J. Scoliosis associated with limb-length inequality. Journal of Bone and Joint Surgery American, v. 64, p. 59-62. 1982.

PRAEMER, A; FURNES, S; RICE, DP. Musculoskeletal conditions in the United States. Rosemont AAUS, p.1-99. 1992.

SABHARWAL, S. What’s New in Limb Lengthening and Deformity Correction. Journal of Bone and Joint Surgery American. v. 93, p. 213-221. 2011. doi

SHACKLOCK, Michael. Neurodinâmica clínica: uma nova abordagem da dor e da disfunção músculo-esqueléticas. São Paulo: Elsevier, 2007. 211-256 p.

SHUIT, D; MCPOIL, TG; MULESA, P. Incidence of sacroiliac joint malalignment in leg length discrepancies. Journal American Osteopathatic Association, v. 798, p. 380-3. 1989.

SICURANZA, BJ; RICHARDS, J; TISDALL, LH. The short leg syndrome in obstetrics and gynecology. American Journal Obstetric Gynecology, v. 107, p. 217-9. 1970. http://dx.doi.org/10.1016/0002-9378(70)90588-0

SOUZA, Nélio Silva et al. A influência da estabilização segmentar vertebral no tratamento da lombalgia por disfunção postural em flexão. Fisioterapia Ser, v. 5, n. 3, 2010.

SPECHT, DL ; DE BOER, KF. Anatomical leg length inequality scoliosis and lordotic curve in unselected clinic patients. Journal Manipulative Physiology Therapy, v. 14, p. 368-75. 1991.

STEVENS, VK et al. The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises. Manual therapy. Australia. v. 12, p. 271-279, July. 2007.

SUBOTNICK, SI. The short leg syndrome. Physician Sports medicine, v. 3, n. 6, p. 61-3. 1975.

VANTI, C et al. La Rieducazione Posturale Globale nelle patologie muscolo-scheletriche: evidenze scientifiche e indicazioni cliniche. Reumatismo, v. 59, n. 3, p. 192-20, 2007.

VICENZINO, Bill et al. Mobilization with movement: the art and the science. 1º ed. Australia: Elselvier, 2011.

WALSH, M et al. Leg length discrepancy – an experimental study of compensatory changes in three dimensions using gait analysis. Elselvier. v. 12, p. 156-161. 2000. http://dx.doi.org/10.1016/s0966-6362(00)00067-9

WEARMAN, AL; BINDER-MACLEOD, AS. Leg length discrepancy assessment: accuracy and precision in five cli¬nical methods of evaluation. Journal of Orthopaedic and Sports Physical Therapy, v. 5, p. 230-238. 1984. doi