Sintomas osteomusculares e torque/flexibilidade dos membros inferiores de professores do ensino fundamental

Abstract

Resumo: O objetivo do presente estudo foi verificar a relacao entre os sintomas osteomusculares e o pico de torque e flexibilidade dos membros inferiores de professores do ensino fundamental municipal. Foram avaliadas 68 professoras (39,5 }9,1 anos, 65,0 }11,0 kg, 158,4 }5,8 cm) da rede municipal do ensino fundamental de Matinhos-PR. Foram utilizados questionario contendo dados ocupacionais e Questionario Nordico de Sintomas Osteomusculares. Para avaliar o pico de torque dos musculos isquiotibiais (IT) e quadriceps (Q) foi utilizada celula de carga, e para medir a flexibilidade de IT e de flexores de quadril uni e biarticulares, a fotometria. Para a analise dos questionarios foram comparadas as variaveis independentes do questionario de dados ocupacionais com as variaveis dependentes do Questionario Nordico por meio da regressao logistica multivariada (p.0,05), bem como para analise da relacao entre os sintomas osteomusculares e os valores obtidos de pico de torque e flexibilidade. As relacoes entre as variaveis categoricas oram analisadas pelos testes de associacao Qui-Quadrado, com nivel de significancia de p.0,05. Encontrou-se alta prevalencia de sintomas osteomusculares, sendo que 83,5% das professoras relatou sintomas em ao menos uma regiao dos membros inferiores. O local mais atingido pelos sintomas osteomusculares foi a parte inferior das costas (69,1%). Foi encontrado que a idade e o torque de IT foram fatores de risco para ter sintomas osteomusculares na regiao de quadril/coxas nos ultimos 12 meses (p=0,044 e p=0,008, respectivamente), e o torque de Q foi fator de protecao para ter sintomas na mesma regiao (p=0,008). A idade e torque de IT foram encontrados como fatores de risco para presenca de sintomas nos joelhos nos ultimos 12 meses (p=0,009 e p=0,027, respectivamente). A flexibilidade de IT, assim como o encurtamento de lexores de quadril biarticulares, foram associados como fatores de risco para os sintomas nos tornozelos/pes nos ultimos 12 meses (p=0,036 e p=0,030, respectivamente), e o numero total de alunos e IMC (indice de massa corporal) como fatores de protecao para a mesma regiao (p=0,019 e p=0,023, respectivamente). O numero de classes foi fator de risco para ter impedimento para desempenhar as atividades diarias e cupacionais devido aos sintomas na parte inferior das costas e tornozelos/pes (p=0,041 e p=0,005, respectivamente), assim como a flexibilidade de IT para o quadril/coxas (p=0,020). O torque de Q foi encontrado omo fator de protecao para o impedimento devido aos sintomas no quadril/coxas (p=0,013). O numero de alunos foi encontrado como fator de protecao para a consulta devido aos sintomas na parte inferior das costas e quadril/coxas (p=0,026 e p=0,013, respectivamente). A carga horaria semanal tambem foi fator de protecao para a procura a profissional da saude devido aos sintomas no quadril/coxas (p=0,025). O encurtamento musculo-tendineo dos flexores de quadril uniarticulares foi associado, como fator de protecao, a consulta nos ultimos 12 meses devido aos sintomas na regiao de tornozelos/pes (p=0,03). O torque de Q e encurtamento de flexores de quadril uniarticulares foi fatores de protecao para ter sintomas osteomusculares na ultima semana na parte inferior das costas (p=0,027 e p=0,039, respectivamente). O torque de Q tambem foi fator de protecao para ter sintomas na ultima semana em quadril/coxas (p=0,033). O torque de IT, flexibilidade de IT e numero de alunos foram identificados como fatores de protecao para os sintomas nos joelhos nos ultimos 7 dias (p=0,027, p=0,034 e p=0,037). O IMC foi fator de risco para ter sintomas nos tornozelos/pes nos ultimos 7 dias (p=0,028). Os achados do presente estudo demonstram que os rofessores apresentaram alta prevalencia de sintomas e que a regiao mais atingida foi a parte inferior das costas. Tais sintomas podem ser influenciados pela carga horaria semanal, numero de alunos e de classes, bem como pelo torque de Q, de IT, nivel de flexibilidade de IT e encurtamento de flexores de quadril u i e biarticulares.

Abstract: The aim of this study was to investigate the relationship between musculoskeletal symptoms and the peak of torque and flexibility of the lower limbs of municipal school teachers. It was evaluated 68 teachers (39.5 } 9.1 years, 65.0 } 11.0 kg, 158.4 } 5.8 cm) from municipal elementary school of Matinhos-PR. Was used a questionnaire with occupational data and the Nordic Questionnaire of Musculoskeletal Symptoms. To evaluate the hamstrings and quadriceps peak of torque was used a load cell, and to measure the flexibility of hamstring and muscle-tendon lengths of the uni and biarticular hip flexors, the photometry was used. For the questionnaires analysis were compared the independent variables of the questionnaire occupational data with the dependent variables of the Nordic Questionnaire by multivariate logistic regression (p.0.05) as well as analyzing the relationship between musculoskeletal symptoms and the values obtained of peak of torque and flexibility and muscle-tendon length. Relations between categorical variables were analyzed by tests of association chi-square, with a significance level of p . 0.05. Was found a high prevalence of musculoskeletal symptoms, and 83.5% of teachers reported symptoms in at least one region of the lower limbs. The most affected area by musculoskeletal disorders (MD) was the lower back (69.1%). It was found that age and torque of hamstrings were risk factors to have musculoskeletal symptoms in the region of hip/thigh in the last 12 months (p=0.044 and p=0.008, respectively), and torque of quadriceps was a factor of protection to have symptoms in the same region (p=0.008). The age and the torque of hamstrings were found as risk factors for symptoms in the knees over the past 12 months (p=0.009 and p=0.027, respectively). The flexibility of hamstrings, as well as length of bi-articular hip flexors, have been associated as risk factors for symptoms in the ankle/feet in the last 12 months (p=0.036 and p=0.030, respectively), and the total number of students and body mass index (BMI) as protective factors for the same region (p=0.019 and p=0.023, respectively). The number of classes was a risk factor to be unable to perform daily activities and occupational activities due to symptoms in the lower back and ankle/feet (p=0.041 and p=0.005, respectively), as well as flexibility of hamstrings for the hip/thigh (p=0.020). The torque of quadriceps was found as a protective factor in preventing symptoms due to the hip/thigh (p=0.013). The number of students was found as a protective factor for consultation because of symptoms in the lower back and hips/thigh (p=0.026 and p=0.013, respectively). The weekly schedule was also a protective factor for demand in the health care provider due to symptoms in the hips/thigh (p=0.025). The muscle-tendon length of the single joint hip flexors was associated as a protective factor to query in the last 12 months due o symptoms in the region of the ankle/feet (p=0.03). The torque of quadriceps and muscle-tendon length of the single joint hip flexors were protective factors to have musculoskeletal symptoms in the last week in the lower back (p=0.027 and p=0.039, respectively). The torque of quadriceps was also a protective factor against having symptoms in the last week in the hip/thigh (p=0.033). Torque of hamstrings, hamstrings flexibility and number of students were identified as protective factors for symptoms in the knees over the past 7 days (p=0.027, p=0.034 and p=0.037). BMI was a risk factor for having symptoms of the ankle/feet in he last days (p=0.028). The findings of this study demonstrate that teachers had high prevalence of symptoms and that the region most affected was the lower back. These symptoms may be influenced by the eekly workload, number of students and classes as well as by the torque of quadriceps, torque of hamstrings, hamstrings level of flexibility and muscle-tendon length of hip flexors uni and bi-articular.