Coordenação entre tronco e pelve e ativação muscular em indivíduos com dor lombar: uma revisão da literatura

Abstract

Introduction: Individuals with LBP exhibit an abnormal gait pattern, characterized by lower variability of trunk movements, reduced stride length, increased step width and TPC deficient, which can compromise the range of motion (ROM) of the gait. The changes in the coordination of gait can reduce the ability to handle unexpected disruptions, resulting in instability of the spine. There is evidence of activity behind the deep muscles of the trunk in association with movements of the trunk and upper limbs in people with LBP. Delayed activityof the deep muscles of the trunk indicates a deficit of motor control and the chance to result in inefficient muscular stabilization of the spine. Objective: Conduct a literature review to investigate factors involved in changes in the TPC, as well as changes in muscle activation of these components. Method: We conducted a review of the literature in Medline (Pubmed), Scielo and Lilacs. There were no restrictions regarding the date of publication of articles, age and sex of study participants. We selected only articles containing changes in TPC and activity of the lower back muscles as main purpose. Results: We found 45 studies. Studies not focused on changes related to the LBP muscle were excluded. At the end, 16 studies related to TPC and muscle recruitment, and three on the concept and epidemiology of pain were used in the review. Conclusion: Individuals with LBP tend to stay in standard in-phase of trunk and pelvis with increasing walking speed, and in healthy individuals, this pattern is modified to antiphase, thus improving body mechanics. The deep trunk muscle activation and pelvis to perform body movements is important to gain stability of the lumbar spine, avoiding a pattern of misuse of the trunk muscles.