Saavedra MP, Coronado ZR, Diez GMP, León HR, Jaimes CR, Granados RR, Ballesteros RF, Chávez D

Idioma: Español
Referencias bibliográficas: 58
Paginas: 110-116
Archivo PDF: 60.53 Kb.

RESUMEN

Introducción: El esguince de tobillo ocurre en la vida diaria y en la práctica deportiva hasta en un 75% de frecuencia. La inestabilidad crónica y la debilidad muscular coexisten; el tratamiento debe encaminarse a tratar dichas alteraciones. Objetivo: Comparar efectos del ejercicio excéntrico isocinético e isotónico en la fuerza muscular de pacientes con esguince de tobillo y determinar efectividad en tratamiento conservador. Material y métodos: Estudiamos 20 pacientes con esguince de tobillo grado I-II, subagudo, sedentarios. Rango de edad 20-58 años. Aleatoriazados, sometidos a programa de entrenamiento excéntrico: isocinético e isotónico en 4 fases, de ocho semanas, 3 sesiones por semana. Grupo isocinético a 60°, 90° y 120° por segundo. Grupo isotónico, con resistencia progresiva. Efectuando evaluación inicial y final isocinéticas en equipo Biodex a 60°, 90° y 120° por segundo, en flexión plantar, dorsiflexión, inversión y eversión. Análisis estadístico: X² y prueba t de Student para muestras independientes (software SPSS 10.0). Resultados: Se encontró diferencia estadísticamente significativa (p = 0 0.001) en la flexión plantar, eversión en todas las velocidades estudiadas en el grupo isocinético. En la inversión existe ganancia no significativa. Dorsiflexión con decremento en la fuerza no significativo. Grupo isotónico con diferencia significativa para los movimientos estudiados, excepto en dorsiflexión a 120°. Comparación ambos grupos con diferencia significativa para flexión plantar a 60° a favor del isocinético, resto sin diferencia significativa Conclusión: Ambos tratamientos son efectivos para mejorar fuerza muscular, con leve diferencia a favor del ejercicio isotónico.

REFERENCIAS (EN ESTE ARTÍCULO)

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30. Hintermann B. Biomechanics of the unstable ankle joint and clinical implications. Medicine Science in Sport Exercise 1999; 31: S459-S469.

31. Safran M. Benedetti R et al. Lateral ankle sprains: a comprehensive review part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Medicine & Science in sports & Exercise 1997; 31: S429-437.

32. Liu S, Jaso W. Lateral ankle sprains and instability problems. Clinics in Sports medicine 1994; 13: 793-809.

33. Safran M. Benedetti R et al. Lateral ankle sprains: a comprehensive review part 2: etiology, pathoanatomy, histopathogenesis, and diagnosis. Medicine & Science in sports & Exercise 1997; 31: S429-437.

34. Trevino S et al. Management of acute and chronic lateral ligament injuries of the ankle. Orthopedic clinics of North America. 1994; 25: 1-15.

35. Mascaro T et al. Rehabilitation of foot and Ankle. Orthopedic clinics of North America 1994; 25: 147-159.

36. Diamond J. Rehabilitation of ankle Sprains. Clinics in Sports Medicine 1989; 8: 877-889.

37. Konradsen L et al. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. The American Journal of Sports Medicine 1998; 26: 72-77

38. Wright I et al. The effects of ankle compliance and flexibility on ankle sprains. Medicine & Science in Sport& Exercise 2000; 32: 260-265.

39. Hertel J et al. Talocrural and Subtalar Joint Instability After Lateral Ankle Sprain. Medicine & Science in sports & Exercise 1999; 31: 1501-1508.

40. Guirao L y col. Lesiones ligamentosas de tobillo: orientación diagnóstica y terapéutica. Rehabilitación 1997; 31: 304-310.

41. Kellis E, Batzopoulos V. Muscle activation differences between eccentric and concentric isokinetic exercise. Medicine & Science in Sport & Excersise 1998; 30: 1616-1623.

42. Esselman P. Lacerte: Principles of Isokinetic Exercise: Physical medicine and rehabilitation. Clinics North America 1994; 5: 255-265.

43. Clifford et al. Ankle injury: third degree sprain of lateral collateral ligaments. In: Biodex clinical Application Manual. Biodex Corps, Shirley, NY 1988.

44. Nardone Schieppanti. Shift of activity from slow to fast muscle during voluntary lengthening contractions of the triceps surae muscles in humans. Journal Physiology 1989; 409: 451.

45. Bennett et al. Evaluation and treatment of anterior knee pain using eccentric exercise. Medicine Science Sports Medicine 1986; 18: 526.

46. Urrialde M. El trabajo isocinético excéntrico. Fisioterapia l998; 20: 81-90.

47. Hartsell H, Sapaulding S. Eccentric/concentric ratios at selected velocities for the invertor and evertor muscles of the chronically unstable ankle. Bristh J Sport Medicine 1999; 33: 255-258.

48. Hubbley C, Earl E. Coactivation of the ankle musculature during maximal isokinetic dorsiflexión at different angular velocities. Euro J Appl Physiology 2000; 82: 289-296.

49. Ledunois, Percheron. Workshop: Metrology. Evaluation of muscular strength using an isokinetic ergometer. Institut de Miologie París.

50. Fisiocenter Rehabilitación y acondicionamiento. Biodex.

51. Morrisey MC, Harman EA, Johnson MJ. Resistance training modes: specificity and effectiveness. Med Science Sport Exercise 1994; 27: 548-660.

52. Valdés M, Molins J, Acebes O. El ejercicio isocinético: valoración y método de tratamiento. Rehabilitación 1996; 30: 429-435.

53. Davies GJ. A compendium of isokinetics in clinical usage. 1992 4th edition. Hardcover.

54. Rowinski MJ. The role of eccentric exercise. Bide Evaluation & Management.

55. Urrialde JA. Los isocinéticos y sus conceptos principales. Physiotherapies 1998; 20: 2-7.

56. Andel M. Prerequisites and limitations to isokinetic measurements in humans. Euro Appl Physiology 1996; 73: 225-230.

57. Conelly, Carnahan, Heather; Vandervoot. Motor skill learning of concentric and eccentric Isokinetic Movements in Older Adults. Experimental Aging Research 2000; 26: 209-220.

58. Dean E. Physiology and therapeutic implications of negative work. A review. Physical Therapy 1988; 68: 233.