Characterization of biomechanical parameters during stair ascent

Author(s)

Heloyse Uliam Kuriki

• Document type: Doctoral Thesis
• Press: São Carlos.
• Institution: Universidade de São Paulo (USP). Escola de Engenharia de São Carlos (EESC/SBD)
• Defense date: 2013-04-18

Examining board members

Neri Alves; Vilmar Baldissera; Luis Mochizuki; Arlindo Neto Montagnoli; Fábio Viadanna Serrão

• Advisor: Neri Alves

Abstract

Go up and down stairs are functional activities very habitual and reported as complaint for patients with orthopedic alterations as patellofemoral pain syndrome because it is a movement that carries unilateral weight bearing and thus cause an increase in pain and for patients with neurological disorders due to the difficulty in carrying out this gesture. Moreover, the ascent and descent of stairs is usually used as a therapeutic technique in the rehabilitation of these patients, but few studies have been conducted in order to characterize this gesture and, these studies conclude that the high variability of the data does not confirm the results. Studies on patients with patellofemoral pain usually assess these subjects with surface electromyography and suggest that there is a balance deficit in the patella stabilizer muscles and that this is the cause of pain in these patients, but there is also a great variability in the results, that does not allow to confirm this hypothesis. In this context, this study aimed to determine which parameters of electromyographic signals showed good reproducibility and low variability and are, therefore, more appropriate to characterize the proposed gesture and can be used to compare groups of individuals with and without patellofemoral pain. For this, we used electromyography to evaluate the activity of the vastus lateralis and vastus medialis of the quadriceps during stair climbing in 39 clinically healthy individuals and 23 individuals with patellofemoral pain. The results showed that the parameters with good reproducibility between the two days of evaluation were: onset, duration of muscle contraction, median time of contraction, intensity of activation, muscular co-activation and median frequency. Among these parameters, those that could differentiate the groups were the median time of activation, which occurred later in subjects with pain and muscle co-activation, which showed a lower percentage of combined activation in individuals with joint pain. These data indicate a change in neuromotor control during stair climbing, suggesting that the clinical approach should undergo training of balance, coordination and proprioception, in order to improve joint stability while performing dynamic activities. (AU)

• FAPESP's process: 10/06833-6 - Characterization of biomechanical parameters during stair climbing
• Grantee: Heloyse Uliam Kuriki
• Support Opportunities: Scholarships in Brazil - Doctorate