Padrão de movimento e o risco de lesões musculoesqueléticas

Abstract

The purpose of this study was to evaluate the association between musculoskeletal injuries and movement patterns. Musculoskeletal injuries are common in several types of physical exercises and may cause temporary or permanent withdrawal from sports or work functions. Injury prevention programs can act against modifiable risk factors (RF), which motivated the first study, a systematic review, which pointed out several RF, but age, previous injury, body mass index and running test performance were the most important. However, certain movement patterns were identified as potential RF, which motivated the second study, a systematic review that assessed whether movement patterns can be used to predict injuries. There was an absence of studies with Dynamic Movement Assessment (DMA). On the other hand, Functional Movement Screening (FMS) seems to be a method for predicting injuries, but it was not possible to achieve a quantitative result. Thus, the third study was carried out, which assessed whether the FMS score is associated with a higher incidence of injuries. Athletes or military individuals at high risk had a 51% higher risk of developing injuries. However, there was a high inconsistency between the studies, possibly due to the different definitions of injuries adopted. Subsequently, to assess whether a single functional test can be considered a predictor of injuries, cohort studies were analyzed to investigate the association between the tests of DMA and FMS tests with injuries, but only studies with the deep squat (DS) were found, which gave rise to the fourth study, a systematic review that assessed the association between TAP and musculoskeletal injuries. TAP seems to be associated with a higher risk of injuries, but the studies included had several methodological limitations. As the movement patterns that have been identified as potential risk factors for injuries are detected mainly in tests with unilateral support (jumping and squatting), it was decided to evaluate the agreement and the association between DMA and the risk of injuries, giving the fifth and sixth study, respectively. It was found that the DMA score in points has a good intra and inter-rater reliability, good and excellent respectively, however when assessing the risk classification (high, moderate, medium or minimum), the agreement was moderate. In the sixth study, a prospective cohort study evaluated the association between different RF and musculoskeletal injuries in military personnel in the first week of the military career. A logistic regression analysis has found that high school origin (civil or military high school) and history of musculoskeletal pain or discomfort increase the chance of injury. Individuals with the worst scores in the evaluation of the movement pattern showed no difference in the chance of injuries. Finally, considering the impact of physical conditioning on injury risk, the seventh and final study investigated the effects of prevention programs on injury risk. Previous studies with athletes have shown that some prevention programs reduce the risk of injury to athletes. However, a meta-analysis of 14 experimental studies showed that prevention programs investigated do not reduce the risk of injury in military personnel.