Masticatory Myoelectric Side Modular Ratio Asymmetry during Maximal Biting in Women with and without Temporomandibular Disorders.

There is no consensus on the role of electromyographic analysis in detecting and characterizing the asymmetries of jaw muscle excitation in patients with temporomandibular disorders (TMD). To analyze the TMD patients (n = 72) in comparison with the healthy controls (n = 30), the surface electromyography (sEMG) of the temporalis anterior muscle (TA) and masseter muscle (M) was recorded while a maximal biting task was performed. The differences in the asymmetry of the relationship between the masseter muscles were assessed in a module to determine the sensitivity (Sn) of binomial logistic models, based on the dominance of the TA or the M muscle, in accurately predicting the presence of TMD. All assumptions were met, and comparisons between the groups showed significant differences for the TA muscle ratio (p = 0.007), but not for the M muscle ratio (p = 0.13). The left side was predominant over the right side in the TMD group for both the TA (p = 0.02) and M muscles (p = 0.001), while the non-TMD group had a higher frequency of the right side. Binary logistic regression showed a significant model (χ2 = 9.53; p = 0.002) for the TA muscle with Sn = 0.843. The model for the M muscle also showed significance (χ2 = 8.03; p = 0.005) with Sn = 0.837. The TMD patients showed an increased TA muscle ratio and asymmetry of left dominance, compared to the healthy subjects. Both of the binomial logistic models, based on muscle dominance TA or M, were moderately sensitive for predicting the presence of TMD.

Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study.

This study aimed to characterize the risk of falling in low-, moderate- and high-risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69% and female: 61.87%), with no differences between men and women. Moreover, no differences were found between North vs. South Americans, nor between male and female groups compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years' normative age-range. The prevalence of low falls risk was~61-65%; the prevalence of moderate to high risk was~16-19%. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.

Pressure pain threshold mappings of the infraspinatus muscle in chronic unilateral shoulder pain patients do not reflect generalized hypersensitivity.

OBJECTIVES: Increased mechanical sensitivity has been observed on the unaffected side in chronic pain conditions, suggesting generalized or widespread hypersensitivity. However, this cannot be considered as a universal response since this hypersensitivity is inconsistent across muscle pain pathologies. The aim of this study was to assess generalized hypersensitivity in chronic unilateral shoulder pain, using pressure pain threshold (PPT) mappings of the infraspinatus muscle. The proposed evaluation is based on the assessment of PPT on a limited subset of sites, reducing potential habituation or sensitization effects. METHODS: Twenty-nine patients with unilateral shoulder pain (USP) and twenty-seven healthy volunteers were recruited. PPT was assessed using a manual pressure algometer. Six sites distributed over the infraspinatus muscle were assessed, and three repetitions were performed at each site. Mappings were derived using two-dimensional interpolation. RESULTS: Lower PPT values were found in the symptomatic side in comparison with the asymptomatic side at all assessment sites (estimated difference: 1.42 ±â€¯0.10 kgf/cm2, p < 0.001), but there were no differences among the asymptomatic side of USP patients and any of the sides in healthy volunteers (largest estimated difference: 0.17 ±â€¯0.28 kgf/cm2, p = 0.927). Furthermore, the medial region of the infraspinatus muscle showed higher mechanical sensitivity in both healthy volunteers and USP patients. CONCLUSIONS: These results suggest that USP does not induce generalized hypersensitivity, in contrast with previously reported findings. Physiotherapists could take these results into account for the assessment and treatment of patients with USP.

Test-Retest of a Novel Wii Board-Based Device to Assess Eccentric Knee Flexor Strength During the Nordic Hamstring Exercise.

This study aimed to assess the test-retest reliability of a Wii board-based device to assess the eccentric knee strength. Healthy participants (n = 20, 22.7 [3.4] y, 1.71 [0.09] m, 69 [13] kg) performed 2 assessments-days 1 and 2-of the Nordic hamstring exercise (3 trials per day, 3 min of rest between trials, and 48 h between trials) on a padded board with an attached Wii Balance Board (WBB). A ratchet inelastic strap made the contact between the participant's distal aspect of both legs and the inverted upper surface of the WBB. The means among 3 trials were used to extract the absolute strength and the left and the right limb strengths. No between-session differences were found (P range = .691-.981). The intraclass correlation coefficient range showed excellent results (.905-.926), as the Cronbach α test (above .94). The correlation was high (r > .91; .820 < r2 < .862). The Bland-Altman analysis returned high levels of agreement. The standard error of measurement ranged from 5.56 to 11.07 N and the minimal detectable change from 15.42 to 30.68 N. The percentage of standard error of measurement values were 2.95%, 3.74%, 2.88%, respectively, for absolute strength, right limb strength, and left limb strength. The adapted system showed an excellent cost-benefit relationship with optimal test-retest reliability. The findings suggest that the adapted system, using the WBB, is a reliable method for measuring the eccentric knee strength.

Supine scapular punch: An exercise for early phases of shoulder rehabilitation?

BACKGROUND: Serratus anterior strengthening generally appears in shoulder rehabilitation protocols. This study's aim was to measure electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles during the Supine Scapular Punch exercise in healthy volunteers and those with unilateral shoulder pain. METHODS: Fifty-four participants were included and grouped as without (n = 34, age = 25.8 years) or with unilateral shoulder pain (n = 20, age = 26.3 years, visual analogue scale = 4.15 cm). Electromyographic activity of the serratus anterior, upper trapezius, and infraspinatus muscles was assessed during Supine Scapular Punch (four phases: P1 = press up concentric, P2 = Supine Scapular Punch concentric, P3 = Supine Scapular Punch eccentric, P4 = press up eccentric) performed under two conditions, with and without additional load. FINDINGS: Overall muscle activity during P1 and P4 was negligible (< 10% maximal voluntary isometric contractions). During P2 and P3, no statistically significant differences in serratus anterior and upper trapezius muscle activity were found between groups, with moderate to high serratus anterior activity (28.94% to 44.3%) and very low upper trapezius activity (< 6%). Upper trapezius/serratus anterior activity ratios ranged from 0.09 to 0.18. Overall infraspinatus muscle activity was always very low (< 10%). INTERPRETATION: The Supine Scapular Punch induces moderate to high serratus anterior muscle activity with very low upper trapezius and infraspinatus activation. Based on these results, the Supine Scapular Punch is a safe exercise that can be used in the early phases of shoulder rehabilitation.

Validity and Test-Retest Reliability of a Novel Push Low-Cost Hand-Held Dynamometer for Knee Strength Assessment during Different Force Ranges.

The objective was to assess the instrumental validity and the test-retest reliability of a low-cost hand-held push dynamometer adapted from a load-cell based hanging scale (tHHD) to collect compressive forces in different ranges of compressive forces. Three independent raters applied 50 pre-established compressions each on the tHHD centered on a force platform in three distinct ranges: ~70 N, ~160 N, ~250 N. Knee isometric strength was also assessed on 19 subjects in two sessions (48 h apart) using the tHHD anchored by an inelastic adjustable strap. Knee extension and flexion were assessed with the participant seated on a chair with the feet resting on the floor, knees, and hips flexed at 90°. The isometric force peaks were recorded and compared. The ICC and the Cronbach's α showed excellent consistency and agreement for both instrumental validity and test-retest reliability (range: 0.89-0.99), as the correlation and determination coefficients (range: 0.80-0.99). The SEM and the MDC analysis returned adequate low values with a coefficient of variation less than 5%. The Bland-Altman results showed consistency and high levels of agreement. The tHHD is a valid method to assess the knee isometric strength, showing portability, cost-effectiveness, and user-friendly interface to provide an effective form to assess the knee isometric strength.

Overhead Shoulder Position Versus Scapular Retraction Position to Normalize the Electromyographic Signal of the Lower Trapezius Muscle.

This study aimed to compare electromyographic response of the lower trapezius muscle during maximal voluntary isometric contractions under two conditions: overhead shoulder position versus scapular position, rating the pain after each condition. Twenty-six participants with shoulder pain (SP; n = 15; Shoulder Pain and Disability Index-Pain = 34 [range 6-66]) and without shoulder pain (nSP; n = 11; Shoulder Pain and Disability Index-Pain = 0 [range 0-14]) performed maximal voluntary isometric contractions in those 2 conditions while the lower trapezius was monitored using surface electromyography. Pain was rated using the visual analog scale. The nSP group experienced no pain, whereas the SP group reported pain in both conditions with higher pain during the overhead movement. No differences were observed for muscle excitation between conditions, but higher levels were observed for the nSP group compared with the SP group. The overhead condition was more painful for the SP group (visual analog scale: SP = 4 vs nSP = 1.09, P = .036). Scapular position showed the same levels of LT excitation than overhead position. The scapular position is preferable, compared with overhead positioning, to normalize the lower trapezius instead of overhead positioning.

Validity of a portable hanging scale to assess the isometric muscle strength during knee movement.

Inexpensive and practical equipment to assess muscle strength can disseminate objective measures, which can provide valid information to implement effective treatment and exercise training. The purpose of the study was to examine the instrumental validity of the hanging scale (HS) to assess the muscle strength during knee flexion and extension by comparing the peak force values to a standard equipment (laboratory-grade load cell [LLC]). Knee isometric strength was assessed on thirty-two subjects (16 women and 16 men, 22 [5] years, 171 [9] cm, 69 [15] kg, 23 [4] kg/m2). The knee flexion was tested by placing the volunteer's body in prone with the knee flexed at 90°. Knee extension was assessed with the volunteer seated on a chair with the feet resting on the floor, knees, and hips flexed at 90°. No differences were observed comparing the isometric peak forces between a laboratory-grade load cell and a HS (p > 0.05). The intraclass correlation coefficient (ICC)1,1 returned values above 0.90. The Cronbach's α test also returned values above 0.90 for all comparisons. Bland-Altman results showed high levels of agreement with low risk of bias. The HS appears to be a valid method to assess the knee isometric strength. The portability, the cost-effectiveness and the simple user-friendly system provides an effective way to assess the knee isometric strength.

Scapular Retraction under Adduction Load: An Alternative to Overhead Exercises to Activate Infraspinatus, Upper, and Lower Trapezius in Subjects with and without Shoulder Pain.

Exercises for lower trapezius (LT) often use overhead positions, causing compressive forces to the subacromial space. Scapular retraction would be an alternative to activate LT muscle. The present study aimed to assess the excitation levels of infraspinatus, upper trapezius, and lower trapezius muscles during a scapular retraction exercise under progressive adduction loads in subjects with and without painful shoulder. Electromyography of infraspinatus (IS), upper trapezius (UT), and LT was recorded during scapular retraction under progressive adduction loads of 42 participants, divided into two groups: with (SP, n = 26) and without shoulder pain (nSP, n = 16). The adduction loads of 20%, 30%, 40%, and 50% of the maximal voluntary contraction (MVC) were applied using a load cell. Normalized electromyography and the ratio between UT and LT (UT:LT) were used for statistical analysis. No differences were observed between groups, but a condition effect occurred for all muscles: UT showed higher values at 50% vs. 20% of MVC (p = 0.004); LT showed higher values on 40% and 50% of MVC (p = 0.001; 0.006). Higher values for IS were noted at 40% of MVC (vs. 20% of MVC; p = 0.04) and at 50% of MVC (vs. 20% of MVC; p = 0.001, vs. 30% of MVC, p = 0.001; vs. 40% of MVC; p = 0.001). UT:LT showed lower values at 50% of MVC (vs. 20% of MVC; p = 0.001 and vs. 30% of MVC; p = 0.016). Scapular retraction with adduction loads at 40-50% is an alternative to overhead exercises aiming to activate the LT and the IS muscles. The exercise ensures higher levels of LT and IS excitation without increasing UT excitation.

Acceleration Profiles and the Isoinertial Squatting Exercise: Is There a Direct Effect on Concentric-Eccentric Force, Power, and Neuromuscular Efficiency?

OBJECTIVE: To examine the selective influences of distinct acceleration profiles on the neuromuscular efficiency, force, and power during concentric and eccentric phases of isoinertial squatting exercise. DESIGN: Cross-sectional study. SETTING: Biomechanics laboratory of the university. PARTICIPANTS: A total of 38 active adults were divided according to their acceleration profiles: higher (n = 17; >2.5 m/s2) and lower acceleration group (n = 21; <2.5 m/s2). INTERVENTION: All subjects performed squats until failure attached to an isoinertial conic pulley device monitored by surface electromyography of rectus femoris, vastus medialis, vastus lateralis, biceps femoris, and semitendinosus. MAIN OUTCOME MEASURES: An incremental optical encoder was used to assess maximal and mean power and force during concentric and eccentric phases. The neuromuscular efficiency was calculated using the mean force and the electromyographic linear envelope. RESULTS: Between-group differences were observed for the maximal and mean force (Prange = .001-.005), power (P = .001), and neuromuscular efficiency (Prange = .001-.03) with higher significant values for the higher acceleration group in both concentric and eccentric phases. CONCLUSION: Distinct acceleration profiles affect the neuromuscular efficiency, force, and power during concentric and eccentric phases of isoinertial squatting exercise. To ensure immediate higher levels of power and force output without depriving the neuromuscular system, acceleration profiles higher than 2.5 m/s2 are preferable. The acceleration profiles could be an alternative to evolve the isoinertial exercise.

Muscle excitation, force response, and efficiency during explosive force production after diacutaneous fibrolysis on lateral gastrocnemius of recreational athletes.

OBJECTIVE: Fibrous adhesions impair normal muscle mechanics. The present study aimed to assess lateral gastrocnemius muscle excitation, isometric force response, and neuromuscular efficiency during explosive force in plantarflexion before and after diacutaneous fibrolysis. METHODS: Thirty-five recreational athletes were allocated in the intervention group (n = 20) treated with diacutaneous fibrolysis, while the sham group (n = 15) was treated with placebo diacutaneous fibrolysis. Force response synchronized with surface electromyography during a plantarflexion task was collected. RESULTS: Differences between Pre- and Post-diacutaneous fibrolysis were observed for all variables, except for the placebo group. CONCLUSIONS: Diacutaneous fibrolysis was effective to increase force, muscle excitation, and neuromuscular efficiency on lateral gastrocnemius.

Instrumental validity and intra/inter-rater reliability of a novel low-cost digital pressure algometer.

BACKGROUND: Pain assessment is a key measure that accompanies treatments in a wide range of clinical settings. A low-cost valid and reliable pressure algometer would allow objective assessment of pressure pain to assist a variety of health professionals. However, the pressure algometer is often expensive, which limits its daily use in both clinical and research settings. OBJECTIVES: This study aimed to assess the instrumental validity, and the intra- and inter-rater reliability of an inexpensive digital adapted pressure algometer. METHODS: A single rater applied 60 random compressions on a force platform. The pressure pain thresholds of 20 volunteers were collected twice (3 days apart) by two raters. The main outcome measurements were as follows: the maximal peak force (in kPa) and the pressure pain threshold (adapted pressure algometer vs. force platform). Cronbach's α test was used to assess internal consistency. The standard error of measurement provided estimates of measurement error, and the measurement bias was estimated with the Bland-Altman method, with lower and upper limits of agreement. RESULTS: No differences were observed when comparing the compression results (P = 0.51). The validity and internal intra-rater consistencies ranged from 0.84 to 0.99, and the standard error of measurement from 0.005 to 0.04 kPa. Very strong (r = 0.73-0.74) to near-perfect (r = 0.99) correlations were found, with a low risk of bias for all measurements. The results demonstrated the validity and intra-rater reliability of the digitally adapted pressure algometer. Inter-rater reliability results were moderate (r = 0.55-0.60; Cronbach's α = 0.71-0.75). CONCLUSION: The adapted pressure algometer provide valid and reliable measurements of pressure pain threshold. The results support more widespread use of the pressure pain threshold method among clinicians.

Validity of an Inexpensive Hanging Scale During Isometric Shoulder Movements.

CONTEXT: Strength assessment is essential to prescribe exercise in sports and rehabilitation. Low-cost valid equipment may allow continuous monitoring of training. OBJECTIVE: To examine the validity of a very low-cost hanging scale by comparing differences in the measures of peak force to a laboratory grade load cell during shoulder abduction, flexion, extension, and internal and external rotations. DESIGN: Analytical study. PARTICIPANTS: Thirty-two healthy subjects (18 women, age 26 [10] y, height 172 [8] cm, mass 69 [13] kg, body mass index 23 [4] kg/m2). MAIN OUTCOME MEASURES: The dependent variable was the maximal peak force (in kilogram-force). The independent variable was the instrument (laboratory grade load cell and hanging scale). RESULTS: No differences were observed while comparing the results. The intraclass correlation coefficients1,1 ranged from .96 to .99, showing excellent results. The Cronbach alpha test also returned >.99 for all comparisons. The SEM ranged from 0.02 to 0.04 kgf, with an averaged SD from 0.24 to 0.38 kgf. The correlation was classified as high for all tested movements (r > .99; P < .001), with excellent adjusted coefficients of determination (.96 < r2 < .99). Bland-Altman results showed high levels of agreement with bias ranging from 0.27 to 0.48. CONCLUSIONS: Hanging scale provides valid measures of isometric strength with similar output measures as laboratory grade load cell.

Effects of 8 weeks of masticatory muscles focused endurance exercises on women with oro-facial pain and temporomandibular disorders: A placebo randomised controlled trial.

BACKGROUND: Exercises are used to treat temporomandibular disorders (TMD), but they are often assessed with other therapies. Local endurance exercises may alter the resistance to fatigue and pain. OBJECTIVE: To assess the effects of an 8-week protocol of local endurance exercises of masticatory muscles on muscle excitation, force response, perceived pain and over muscle efficiency. DESIGN: Randomised controlled trial. SETTING: Ambulatory care. SUBJECTS: In a placebo randomised controlled trial, 46 women with TMD and oro-facial pain were randomised into intervention group and placebo group. The intervention group received a protocol of biting endurance exercises, controlled by biofeedback. The placebo group received a placebo (simulated laser therapy). MAIN OUTCOME MEASURES: The primary outcomes were collected at baseline, 4 weeks and 8 weeks. Pain was assessed through visual analogue scale (VAS) and pressure pain thresholds (PPT). Bite force was collected by a load cell synchronised with surface electromyography of masticatory muscles, bilaterally. RESULTS: Pain scores decreased for both groups, but the intervention group showed lower values at 8 weeks. No differences were noted between groups for PPT, but the results increased for both overtime. Time until fatigue and muscle efficiency were higher in the intervention group vs placebo group in both within- and between-subject analysis. Force increased from 4 to 8 weeks in the PG, without differences between groups. Temporal muscle excitation was higher on 8 weeks compared with baseline for the intervention group, without differences between groups. CONCLUSION: Eight-week exercise protocol of muscle endurance alleviates the pain and improves the resistance to fatigue and muscle efficiency in TMD subjects.

Pain, balance, grip strength and gait parameters of older adults with and without post-chikungunya chronic arthralgia.

OBJECTIVE: To compare the levels of pain, grip strength, balance and gait in older adults with and without post-Chikungunya chronic arthralgia (PCCA). METHODS: Sixty-two older adults, 30 with and 32 without PCCA participated in the study. Pain level was assessed using a Visual Analogue Scale (VAS). Gait during a 10-m walk was assessed using inertial sensors. Semi-static balance was assessed during an eyes-closed bipedal balance test on a force platform, and grip strength was assessed using a hand dynamometer. RESULTS: Participants with PCCA presented severe levels of pain (VAS > 7.5), poorer balance, lower grip strength, walked slower, with lower cadence and stride length and higher stride time and stride length variability than participants without PCCA (P < 0.001 for all variables). CONCLUSIONS: Older adults with PCCA had high levels of pain, impaired balance and gait and lower grip strength compared to older adults without PCCA.

Pilates experience vs. muscle activation during abdominal drawing-in maneuver.

The purpose of this study was to compare the activation of deep abdominal and spine stabilizer muscles of subjects with and without Pilates experience. Twenty-three subjects were divided into a no-experience group (n = 13) and an experienced group (n = 10). The subjects performed three 12-s drawing-in maneuver trials at 50% TrA/IO maximal voluntary contraction (MVC). The experienced group presented greater activation of both muscles than the no-experience group (62% vs. 32% MVC for the TrA/IO, and 52% vs. 12% MVC for the LD, p < 0.001). The no-experience group had higher variability among trials and did not reach 50% MVC for the TrA/IO, while the experienced group was able to reach and keep the TrA/IO activation at or above 50% MVC. Pilates experience and muscle activation were strongly associated. Pilates trained subjects were able to sustain concomitant abdominal and low back muscle contraction during the drawing-in maneuver, while subjects with no Pilates experience were not able to reach the same levels of abdominal activation and did not present significant low back muscle co-activation.

Increased Activation Amplitude Levels of Gluteus Medius in Women During Isometric and Dynamic Conditions Following a 4-week Protocol of Low-load Eccentric Exercises.

BACKGROUND: The dysfunction of gluteus medius (GMed) has been implicated in other musculoskeletal disorders including low back pain and lower limb injuries. The purpose of this study was to use a protocol involving low-load eccentric exercises to observe the effects on the three subdivisions of GMed activation through surface electromyography (sEMG) and digital dynamometry. METHODS: Eleven female subjects having femoral instability participated in a 4-week protocol (three sessions per week/non-consecutive days). At each session, two low-load eccentric exercises (12% of maximal isometric voluntary contraction [MVIC]) in abduction, extension and external rotation were applied to the hip joint. The sEMG of the GMed subdivisions (anterior, mid and posterior) during a squat and MVIC were assessed. The digital dynamometry was also assessed during MVIC. Parametric paired t-test was used to compare the results before and after treatment with α = 0.05. RESULTS: The results showed an increased sEMG activity of GMed (middle and posterior portions) during isometric voluntary contraction and squat after the protocol. No difference was noted to the anterior subdivision of GMed. Another finding was the significant difference to the dynamometry results, showing improvements to generate strength to the GMed as a whole muscle in abduction. CONCLUSION: The 4-week exercise protocol was effective to increase the activation of the GMed middle and posterior subdivisions, improving also the capacity to generate strength as a whole muscle during the proposed tasks. Copyright © 2015 John Wiley & Sons, Ltd.

Manipulation and selective exercises decrease pelvic anteversion and low-back pain: a pilot study.

OBJECTIVES: To study the effect of a protocol involving joint manipulation and specific exercises for pelvic stability to influence proprioceptive input to the spinal tissues and to observe the effects on sensorimotor function. METHODS: Seven patients with pelvic anteversion and low back pain participated in an eight-week protocol (three sessions per week/nonconsecutive days). At each session, a high-velocity, low-amplitude manipulative thrust was applied to the sacroiliac joint, followed by quadriceps eccentric and hamstring concentric contractions. The perceived pain symptoms, pelvic anteversion as determined by photogrammetry analysis, and the electromyographic activity of the rectus femoris and lateral and medial hamstrings during flexion and extension exercises were assessed before and after treatment. Non-parametric tests were used to compare the groups before and after treatment with α=0.05. RESULTS: Perceived pain symptoms decreased after treatment (p=0.0007). The differences in the pelvis angles (p=0.0130) suggested significant differences between the assessments, and the electromyographic activities of all the muscles during isometric voluntary contraction increased. CONCLUSION: The eight-week manipulation/exercise protocol was effective for these subjects' needs. Further research should include a greater sample size to confirm the results and to determine the lead factors of pelvic stability.

Efetividade de protocolo cinesioterapêutico-proprioceptivo em pacientes com assimetrias torcionais pélvicas em anteversão / Effectiveness of kinesiotherapeutic-proprioceptive protocol in patients with anteversion torsional pelvic asymmetries

Os distúrbios assimétricos da articulação sacroilíaca podem desencadear perda da funcionalidade e limitações das atividades de vida diária, representando cerca de 40% das dores lombossacrais. O objetivo foi analisar a efetividade de protocolo cinesioterapêutico-proprioceptivo para redução angular e de dor em pacientes que apresentam assimetrias torcionais pélvicas em voluntárias com idade entre 20 a 35 anos, apresentando anteversão. Dividiu-se a pesquisa em três etapas: (1) avaliação inicial da angulação pélvica e de dor percebida das voluntárias (escala visual analógica), (2) intervenção fisioterapêutica através de exercícios concêntricos para músculos isquiotibiais e exercícios excêntricos para músculo quadríceps durante 45 dias (três sessões semanais com três séries de dez repetições), e (3) reavaliação da dor e da angulação pélvica. Esta foi realizada por meio da biofotogrametria computadorizada, na qual mensuramos o ângulo de anteversão ilíaco. Para o protocolo foram adotados exercícios a 20% de carga submáxima. Na avaliação biofotogramétrica inicial observamos 18,69º de anteversão e posteriormente 12,05º. A avaliação subjetiva de dor apresentou média de 5,65 pontos iniciais e 4,49 pontos na avaliação final. Ambos os dados com diferenças significantes entre os momentos. O protocolo mostrou-se efetivo para correção de assimetrias em anteversão para as voluntárias estudas, com diminuição do quadro álgico.

The sacroiliac joint assymmetries may cause loss of functionality and daily life activities limitations, representingabout 40% of low-back pains. The purpouse of this study was to analyze the effectiveness of kinesiotherapeutic proprioceptive protocol in patient s who have torsional pelvic anteversion asymmetry aged 20 to 35 years-old. Theresearch was divided into three stages: (1) initial evaluation of volunteers pelvic angle and pain level (visual analogue scale), (2) physical therapy intervention through concentric exercises to hamstrings muscles and concentric exercise to quadriceps muscle for 45 days (three sessions/week, three series of ten repetitions), and (3) revaluation of painand pelvic angle. This was performed by biophotogrammetry, measuring the pelvic angle. The protocol included 20%sub-maximum exercises levels. Initial biophotogrammetric evaluation showed 18,69º and the fi nal, 12,05º of pelvicanteversion. Pain subjective evaluation showed initial mean of 5,65 points and 4,49 points on fi nal evaluation, bothdatas demonstrate signifi cant differences between the moments. The protocol demonstrates effectiveness to treat anteversion asymmetries on the studied group, with pain decrease.