Tendinopatia de Aquiles sob dupla perspectiva: desvendando desfechos clínicos e explorando os impactos em pacientes com diabetes tipo I

Abstract

We conducted research on the inclusion of the biopsychosocial model in questionnaires used with patients with Achilles tendinopathy and the impact of type 1 diabetes mellitus on the physical-functional capacity of the plantar flexor musculature, as well as its repercussions on tendon symptoms. To this end, we conducted two studies: (1) Systematic review and (2) Cross- sectional study. In the systematic review, our objective was to analyze the inclusion of domains of the biopsychosocial model in questionnaires and instruments used in intervention studies with patients with Achilles tendinopathy. We performed the search strategy in the following databases: (1) Ovid/MEDLINE, (2) Embase, and (3) Web of Science. In total, we found 219 records, of which 51 studies were included, and 27 instruments were analyzed. The study indicates that the instruments are composed mostly of domains related to activity and participation and body functions. Thus, the model of human functionality advocated by the World Health Organization (WHO) has not been adequately incorporated into the context of Achilles tendinopathy. Our study provides a database that can assist in the development of frameworks for the implementation of the biopsychosocial model in research and clinical practice with this population. In the cross-sectional study, we aimed to investigate the influence of type 1 diabetes mellitus on the strength and endurance of the plantar flexor musculature, ankle range of motion, functional capacity, and symptoms in the Achilles tendon. Forty-four participants were analyzed, 21 of whom were diabetic and 23 were non-diabetic. Participants with diabetes presented similar results to the control group for variables such as strength, plantar flexor endurance, and dorsiflexion amplitude. However, they had lower scores on the VISA-A, which is associated with the level of physical activity in this group.