Efeito imediato do exercício resistido em cadeia cinética aberta e fechada sobre a temperatura cutânea de indivíduos com e sem osteoartrite de joelho : um ensaio clínico cruzado

Abstract

Introduction: Knee osteoarthritis (KOA) is a joint degeneration with an underlying inflammatory process resulting in pain, joint stiffness and loss of functionality in affected individuals. Among the phlogistic signs of the inflammatory process, one can observe an increase in the temperature of the skin in the region, which can be assessed using Infrared Thermography (IT). The main treatment guidelines indicate primary management through physical exercise, to maintain the functionality and quality of life of these individuals. Objective: to investigate the main thermographic changes in the knees of individuals affected by KOA, submitted to two types of exercise: open kinetic chain (CCA) and closed kinetic chain (CCF). Methodology: This is a crossover study, with individuals with KOA (GO; n=16) and without KOA (GSO; n=16), who performed the exercises in CCA and CCF with a one-week interval between interventions. The volunteers responded to the WOMAC questionnaire and visual analogue pain scale (VAS), and underwent thermographic evaluation of the thigh and knee region during the execution of the exercise protocols at 7 different moments: T1 – initial rest time; immediately after the 1st series (T2) 2nd series (T3) 3rd series (T4) and 1 min (T5), 2 min (T6) and 3 min (T7) after the last series, respectively. Friedman's ANOVA was performed to analyze the temperature of the region of interest (ROI) on the thigh (ROI1), Patellar Tendon (ROI 2) Knee (ROI3) during the intervention, for each group over time, and the Wilcoxon test to find the differences from T1 to T7 for each ROI. The Mann Whitney test was performed for intergroup analysis. Results: The GO group showed a difference in WOMAC with a mean of 36.3±22.2 compared to 6.5±14 in the GSO group (p=0.001). The temperature of ROI 1 and 3 during CCA showed a significant alteration only for the GO group (p=0.001 and 0.03). In ROI 2, both the GO (p=0.002) and GSO (p=0.04) groups obtained temperature differences during the CCA evaluation, and in CCF, the groups did not show any difference in temperature. In intergroup comparison, there was no significant difference between them in any ROIs or times. Conclusion: both exercises promoted an increase in temperature, with CCF having a greater influence on the change in skin temperature of the knee and thigh in individuals from both groups, and CCA showing greater influence in the same areas only in the group with OAJ.