Avaliação da força muscular pós-AVE pela dinamometria portátil: uma
						revisão da literatura

Martins, Júlia Caetano; Teixeira-Salmela, Luci Fuscaldi; Aguiar, Larissa Tavares; Souza, Lucas Araújo Castro e; Lara, Eliza Maria; Faria, Christina Danielli Coelho de Morais

doi:10.1590/0103-5150.028.001.AR02

Acessibilidade / Reportar erro

Brasil

Fisioterapia em Movimento

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review articles • Fisioter. mov. 28 (1) • Mar 2015 • https://doi.org/10.1590/0103-5150.028.001.AR02 copiar

Avaliação da força muscular pós-AVE pela dinamometria portátil: uma revisão da literatura

Autoria SCIMAGO INSTITUTIONS RANKINGS

Introdução

A mensuração da força muscular em indivíduos acometidos pelo Acidente Vascular Encefálico (AVE) é comumente realizada na clínica, sendo os dinamômetros portáteis os instrumentos mais utilizados para tanto.

Objetivo

Verificar se há uma padronização dos métodos utilizados para avaliação da força muscular de tronco e membros superiores (MMSS) com o uso de dinamômetros portáteis em indivíduos pós-AVE, bem como verificar quais propriedades de medida já foram investigadas.

Materiais e métodos

As buscas foram realizadas nas bases de dados MEDLINE, SciELO, LILACS e PEDro com combinação de termos específicos, seguidas de busca manual ativa. A seleção dos estudos e a extração das informações foram realizadas por dois examinadores independentes.

Resultados e discussão

Foram incluídos 58 estudos (três de tronco e 55 de MMSS, incluindo preensão manual e pinça). Os grupos musculares mais avaliados foram preensão manual, flexores de cotovelo, extensores de punho, extensores de cotovelo e pinça lateral. Nove estudos reportaram confiabilidade adequada do método. A maioria dos estudos que avaliaram os músculos de tronco, de preensão manual e de pinça utilizou a postura sentada, enquanto o decúbito dorsal foi mais utilizado na avaliação dos demais músculos. O número de repetições mais utilizado foi três, já o tempo de contração e o período de repouso variaram entre os estudos.

Considerações finais

A maioria dos estudos relatou o posicionamento e/ou o protocolo de coleta, porém não houve uma padronização. A única propriedade de medida investigada foi a confiabilidade. Poucos estudos avaliaram os músculos de tronco e as outras propriedades de medida.

Dinamômetro; Tronco; Membros superiors; Confiabilidade; Validade

Study	Muscular group	Subject positioning	Protocol
Bohannon (23)	Lateral flexors	Sitting and trunk stabilization	NI
Bohannon (14)	Anterior and lateral flexors	Sitting, stabilization by the examiner in the proximal thigh	One trial, maximal isometric contractions over 5s
Bohannon et al. (42)	Anterior and lateral flexors	Sitting, stabilization by the examiner in the proximal thigh	One trial, maximal isometric contractions over 3 to 4s

Study	Subject position	Protocol
Sunderland et al. (12)	Sitting, hand on the thigh	Three alternate trials
Jones et al. (60)	Upper limb extended next to the body	Three trials
Van Deusen et al. (61)	NI	Three trials
Robinson et al. (62)	Sitting, elbow extended	Two trials, contraction of 6s
Bohannon (63)	Sitting, upper limb extended next to the body, elbow flexed to 90°	NI
Marque et al. (64)	Upper limb down and away from the body	Three trials, rest interval of 5min
Boissy et al. (9)	Sitting, shoulder abducted to 30° and flexed to 0º, elbow flexed to 90°	Three trials, rest interval of 2min
Bhakta et al. (65)	Sitting, elbow flexed to 90° and elbow extended	Three trials, contraction of 10s
Merians et al.(66)	NI	One trial
Pandyan et al. (67)	Elbow flexed to 90°, minimum elevation of the shoulder	Three trials, rest interval of 15s
Hammer et al. (28)	Sitting, feet resting, hand and forearm stabilized, elbow flexed to 90° shoulder flexed to 10º and abducted to 10º	Three trials, contraction of 10s, rest interval ≥ 30s
Dijkerman et al. (68)	Elbow flexed to 90°	Three alternate trials
Broeren et al. (69)	NI	Contraction of 10s
Bohannon (70)	Sitting, shoulder adducted, elbow flexed to 90°, wrist extended between 0° to 30°, ulnar deviation between 0° to 15°	One trial
Suputtitada et al. (71)	NI	Three trials
Kamper et al. (4)	NI	Two trials
Wolf et al. (72)	Sitting, elbow flexed to 90°	Three trials, contraction of 3s
Restemeyer et al. (73)	NI	Three trials
Ploughman et al. (31)	Sitting, elbow flexed to 90°, without trunk support	Three trials
Gosselin et al. (74)	NI	Two alternate trials
Kang et al. (75)	NI	Three trials
Beebe et al. (76)	Sitting, upper limb next to the body, elbow flexed to 90°, wrist slightly extended	Three trials
Bohannon (77)	Sitting, shoulder adduced, elbow flexed to 90°	One trial
Burdea et al. (78)	NI	Three trials

Study	Pinch type	Subjects’ position	Protocol
Van Deusen et al. (61)	Lateral and palmar	NI	Three trials
Conforto et al. (29)	Lateral	Sitting, shoulder adducted, elbow flexed to 90°, wrist extended between 0° to 30°, ulnar deviation between 0° to 15°	Five trials
Byl et al. (47)	Lateral and palmar	NI	NI
Suputtitada et al. (71)	Pinch strength	NI	Three trials
Hummel et al. (30)	Lateral	Sitting, shoulder adducted, elbow flexed to 90°, wrist extended between 0° to 30°, ulnar deviation between 0° to 15°	Nine trials, contraction between 1 and 3s
Lomarev et al. (79)	Pinch strength	NI	Five trials, rest interval of 10s
McDonnell et al. (80)	Pulp-to-Pulp	NI	Three trials, rest interval of 30s
Lang et al. (54)	Palmar	NI	NI
Ploughman et al. (31)	Lateral	Sitting, elbow flexed to 90°, without trunk support	Three trials
Beebe et al. (55)	Palmar	NI	NI
Klaiput et al. (81)	Lateral and pulp-to-pulp	NI	Three trials, rest interval of 15s
Beebe et al. (76)	Palmar	Sitting, upper limb next to the body, elbow flexed to 90°, wrist slightly extended	Three trials
Connelly et al. (57)	Lateral and palmar	NI	NI
Burdea et al. (78)	Pulp-to-pulp, lateral and palmar	NI	Three trials
Triandafilou et al. (58)	Lateral	NI	NI

Study	Muscular group	Subjects’ position	Protocol
Bohannon (24)	Wrist and elbow flexors/extensors; shoulder internal/external rotators, abductors/adductors	Supine, wrist and elbow flexion/extension, shoulder internal/external rotation: upper limb next to the body and elbow flexed at 90°; shoulder abduction/adduction: elbow extended and shoulder abducted at 45°. Manual stabilization next to the evaluated segment	Three trials, contractions of 4 to 5s, rest intervals between 10 and 30s
Bohannon et al. (82)	Wrist and elbow flexors/extensors; shoulder internal/external rotators, abductors/adductors, flexors/extensors	Supine, tested segment without the interference of gravity and in the middle of range of motion	Same as above
Bohannon et al. (25)	Wrist extensors; elbow flexors/extensors; shoulder internal/ external rotators, abductors, and flexors/extensors	Supine, tested segment without the interference of gravity and in the middle of range of motion	Same as above
Bohannon et al. (26)	Wrist extensors; elbow flexors, and shoulder external rotators	Supine, tested segment without the interference of gravity and the middle of range of motion, described by Bohannon (24)	One trial, contractions of 4 to 5s
Riddle et al. (83)	Wrist and elbow flexors/extensors; shoulder internal/external rotators	Supine (24)	Three trials, contractions of 4 to 6s, rest intervals of 10 to 30s
Bohannon et al. (84)	Elbow flexors	Supine, upper limb extended, 90° of elbow flexion, 30° of shoulder abduction, forearm at supine position	Four trials, contractions of 4 to 5s, rest intervals of 10s
Bohannon et al. (85)	Elbow flexors	Supine, elbow flexed at 90°, shoulder stabilization	Two trials, contractions of 4 to 5s
Bohannon (63)	Elbow flexors and shoulder abductors	Supine, elbow flexed at 90° and shoulder at 45°	NI
Bohannon et al. (86)	Wrist extensors, elbow flexors, and shoulder abductors	Supine, tested segment without the interference of gravity and in the middle of the range of motion, wrist extension: shoulder in neutral, elbow flexed at 90°, wrist in neutral and fingers relaxed. Stabilization: distal forearm; elbow flexion: shoulder in neutral, elbow flexed at 90°, forearm in supine. Stabilization: upper arm or shoulder; shoulder abduction: shoulder abducted at 45° and elbow extended. Stabilization: top of shoulder	NI
Andrews et al. (27)	Wrist extensors, elbow flexors, and shoulder abductors	Supine, tested segment without the interference of gravity, wrist extensors: shoulder in neutral, elbow flexed at 90°, and fingers relaxed. Stabilization: distal forearm, elbow flexors: elbow flexed at 90°, forearm in supine. Stabilization: upper arm or shoulder; elbow extensors: elbow flexed at 90°. Stabilization: anterior part of the shoulder or arm; shoulder abductors: shoulder abducted at 45° and elbow extended. Stabilization: shoulder	Two trials, contractions of 3 to 4s, rest intervals of 1 to 2min
Byl et al. (47)	Wrist extensors, elbow flexors, and shoulder flexors	Supine or sitting; wrist extensors: arm on the table, forearm in prone, and wrist in neutral. Stabilization: distal forearm; elbow flexors: elbow flexed at about 90°, forearm in supine. Stabilization: under the elbow, shoulder flexors: shoulder flexed and internally rotated, elbow flexed and forearm in supine. Stabilization at the trunk	NI
Bohannon (70)	Elbow flexors and shoulder abductors	Supine: elbow flexors: elbow flexed at 90° and forearm in supine; shoulder abuctors: shoulder abducted at 45° and elbow extended	One trial, contractions of 4 to 5s, rest intervals of 1min
Beebe et al. (55)	Index finger, wrist, elbow, and shoulder flexors and extensors	Supine, tested segment without the interference of gravity; forefinger flexors/extensors: NI; wrist flexors: NI; wrist extensors: shoulder in neutral, elbow flexed at 90°, and fingers relaxed. Stabilization: distal forearm; elbow flexors: elbow flexed at 90°, forearm in supine. Stabilization: anterior part of the shoulder or arm; shoulder flexors: shoulder flexed at 90° and elbow extended. Stabilization: axillary region, shoulder extensors: shoulder flexed at 90°, elbow flexed. Stabilization: shoulder	NI
Beebe et al. (76)	Index finger, wrist, elbow, and shoulder flexors and extensors	Same as above	NI

Study	Sample	Muscular group	Measurement property	Results
Bohannon (24)	n = 16, aged between 17 and 82 years	Wrist and elbow flexors/extensors, shoulder internal/external rotators and abductors/adductors	Test-retest reliability	0.95 ≤ r ≤ 0.99
Bohannon et al. (25)	n = 42, male and female, ages between 22 e 84 years, time since the onset of stroke between 9 and 233 days	Wrist extensors; elbow flexors/extensors; shoulder internal/external rotators, adductors, and flexors/extensors	Test-retest reliability	r² ≥ 0.88
Bohannon et al. (26)	n = 21, male and female	Wrist extensors, elbow flexors, and shoulder external rotators	Inter-rater reliability	0.88 ≤ r ≤ 0.94
Riddle et al. (83)	n = 31, mean age of 54.6 ± 18.1 years, time since the onset of stroke between 5 and 150 days	Wrist flexors and extensors, elbow flexors and extensors, and shoulder internal and external rotators	Test-retest and inter-rater reliabilities	Test-retest 0.91 ≤ r ≤ 0.99; ICC: 0.93-0.98 Inter-rater 0.92 ≤ r ≤ 0.98; ICC: 0.90-0.98
Bohannon et al. (85)	n = 23	Elbow flexors	Inter-rater reliability	ICC = 0.99
Bohannon (63)	n = 10, male and female, ages between 46 and 81 years, time since the onset of stroke between 2 and 10 days	Elbow flexors, shoulder abductors, and grip strength	Test-retest reliability	0.95 ≤ r_s ≤ 0.96
Bohannon et al. (42)	n = 11 male and female, mean age of 67.4 ± 10.2 years, time since the onset of stroke of 14.2 ± 11.5 days	Anterior and lateral trunk flexors	Inter-rater reliability	ICC = 0.80-0.82
Boissy et al. (9)	n = 15, male and female, ages between 29 and 65 years	Grip	Test-retest reliability	ICC = 0.91
Hammer et al. (28)	n = 18, male and female, ages between 38 and 63 years, time since the onset of stroke between 2 and 25 weeks	Grip	Test-retest reliability	C_R = 48.2 N

Pontifícia Universidade Católica do Paraná Rua Imaculada Conceição, 1155 - Prado-Velho -, Curitiba - PR - CEP 80215-901, Telefone: (41) 3271-1608 - Curitiba - PR - Brazil
E-mail: revista.fisioterapia@pucpr.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * JCM: MSc, e-mail: julia_caetano@yahoo.com.br LFTS: Ph.D, e-mail: lfts@ufmg.br LTA: Grad., e-mail: larissatavaresaguiar@gmail.com LACS: MSc, e-mail: lucas.araujo.ufmg@gmail.com EML: Grad., e-mail: izamlara@yahoo.com.br CDCMF: PhD, e-mail: cdcmf@ufmg.br