Instabilidade Translacional (atraumática)
Autor: Cassio Ferreira | Publicado: 2013-09-10T06:27:00-07:00

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É a inabilidade de se controlar
os movimentos osteocinematicos e artrocinemáticos de uma articulação por meio
da ativação muscular coordenada conforme a articulação se move ao longo da
amplitude de movimento (ADM). O fim da ADM é usualmente normal e os tecidos
muscular e inertes possuem um comprimento normal e a avaliação musculoesquelética
pode ser negativa.



O que o paciente relata?



O paciente sente que a
articulação não está se movendo corretamente.

O paciente sente um agarre ou uma
falha&nbsp; em algum ponto da ADM

Não tem dor local apesar da área
estar mais sensível à palpação, se presente a dor vem com o movimento , mas
desaparece com o repouso



Sinais e sintomas



Estes só aparecem quando se
executa um movimento com velocidade e cargas funcionais ou em posições
articulares específicas.

Fadiga precoce com perda da
qualidade do movimento

Dificuldade em aquecer-se para
atividade



Causas&nbsp;



Ocorre&nbsp; em razão da falência dos estabilizadores&nbsp; contrateis em suportar a estrutura de base
(escapula, pelve) ou da perda do controle do movimento em razão de uma
disfunção muscular ou nervosa;

Rigidez articular combinada com
uma ação &nbsp;conjugada anormal (músculos de
força trabalhando com&nbsp; músculos
estabilizadores e motores)

Inicialmente os tecidos inertes
são normais , mas com o tempo se tornam patológicos.

Normalmente a instabilidade é
bilateral mesmo quando o paciente se queixa apenas de um lado. A instabilidade
pode ocorrer em qualquer lugar na ADM

É comum a instabilidade em uma
direção e a hipomobilidade na direção oposta.



Sinal de alerta



A instabilidade ocorre a
principio em altas velocidades ou cargas durante movimentos funcionais
particulares ou em algumas posições.

A instabilidade atraumática é, a princípio
um problema de tecido contrátil

Obs: pessoas que não conseguem
estabilizar escapula e pelve na realização das atividades e realizam padrões de
movimentos anormais , geralmente não apresentam nenhum sintoma quando a
sobrecarga , a velocidade de movimento e o nível de exigência do movimento são
baixos, mas quando cargas mais elevadas e movimentos mais rápido e ou complexos
são exigidos , os sintomas aparecem. 

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  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
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   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
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   UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
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   UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
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  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
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   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
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   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
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   UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
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   UnhideWhenUsed="false" Name="Dark List Accent 3"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
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   UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
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   UnhideWhenUsed="false" Name="Light List Accent 4"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
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   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
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   UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
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   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
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   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
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   UnhideWhenUsed="false" Name="Dark List Accent 4"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 5"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 5"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 6"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 6"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="19" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
  <w:LsdException Locked="false" Priority="21" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
  <w:LsdException Locked="false" Priority="31" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
  <w:LsdException Locked="false" Priority="32" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
  <w:LsdException Locked="false" Priority="33" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
  
  
 
<![endif]--><!--[if gte mso 10]>

 /* Style Definitions */
 table.MsoNormalTable
 {mso-style-name:"Tabela normal";
 mso-tstyle-rowband-size:0;
 mso-tstyle-colband-size:0;
 mso-style-noshow:yes;
 mso-style-priority:99;
 mso-style-parent:"";
 mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
 mso-para-margin-top:0cm;
 mso-para-margin-right:0cm;
 mso-para-margin-bottom:8.0pt;
 mso-para-margin-left:0cm;
 line-height:107%;
 mso-pagination:widow-orphan;
 font-size:11.0pt;
 font-family:"Calibri","sans-serif";
 mso-ascii-font-family:Calibri;
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<![endif]-->





Sinais de fadiga e perda de controle



·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Movimento errado

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Movimentos espasmódicos

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Movimentos compensatórios

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Perda de controle de pelve e escápula

·&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Movimentos aberrantes

Fonte:Magee D, Zachazewski J, Quilen W, Pratica da Reabilitação Musculoesquelética: Princípios e Fundamentos Científicos, 1edição.ed Manole,São Paulo,2013.