Gait, balance, and functional independence level in stroke patients

Introduction: Most stroke patients present limited movement, which alters gait speed and balance. This study aimed to correlate balance and gait speed, and weight distribution and balance in post-stroke patients.Methods: In total, 36 participants were included. Data collection occurred as follows: filling out the assessment form; assessment with the Berg Balance Scale (BBS); assessment with the baropodometric platform; performing the 10 Meter Walk Test (10mWT) with accelerometer; measurements with the modified Rankin Scale (mRS); the Functional Ambulation Classification (FAC); and the Barthel Index (BI).Results: A negative correlation between FAC and mRS (r = −0.708; p < 0.05) and between BI and mRS (r = −0.716; p < 0.05) was found. The correlation between BI and FAC was positive (r = 0.591). There was a strong positive correlation between the 10mWT values and the BBS score (r = 0.708; p < 0.05). Moreover, a weak negative correlation was observed between BBS values and lower limb weight distribution (r = −0.378; p < 0.05).Conclusion: We found a correlation between the functional ambulation and the degree of independence.This study showed that the better the balance, the greater the gait speed, and the lower the difference on lower limbs weight distribution, the better the balance in post-stroke patients.

Reliability of plantar pressure and postural control measures of children from 4 to 12 years: analysis by baropodometry

Abstract Aim: Baropodometry is used to map pressure areas and plantar pressure oscillation, however, children's evaluation reliability is not established. To establish the intra-rater and inter-rater reliability of baropodometry for analysis of plantar support and postural control (stabilometry) of children. Materials and Methods: Reliability study. The sample consisted of 112 healthy children of both sexes; aged 4 to 12 years old. For the baropodometer analysis, children were positioned in orthostatic position, bipodal support, with parallel and bare feet during four rounds of 15-second evaluations, executed by two independent evaluators. In order to establish the reliability of the results at different age ranges, participants were divided into two groups: children ages 7 years and younger (n = 44) and children aged 8 to 12 years old (n = 68). The variables analyzed were pressure area and maximum plantar pressure, area, and amplitude of oscillation of the center of pressure. Results: Reliability was rated from good to excellent for the intra- and inter-evaluators (ICC 0.81-0.86 and ICC 0.87-0.95, respectively) on plantar pressure variables, and poor to moderate for the center of pressure oscillations (ICC 0.33-0.55; ICC 0.47-0.57, intra and inter-evaluators, respectively). Conclusion: Excellent baropodometry reliability was observed when analyzing children's plantar pressure at different age groups, and a single evaluation established reliable results. However, the stabilometry analysis with a baropodometer has poor reliability, and therefore, it should not be used for children aged 4 to 12 for postural control.

Gait in children and adolescents with idiopathic musculoskeletal pain

Abstract Introduction: Musculoskeletal pain is a constant complaint in pediatric practice. The pain may be related to a number of organic diseases and / or be part of the amplified musculoskeletal pain syndromes. Idiopathic musculoskeletal pain (IMSP) is defined as the presence of intermittent pain in three or more body regions for at least three months, excluding organic diseases that could explain the symptoms. Objective: To study the gait of children and adolescents with IMSP by dynamic baropodometry. Methodology: Thirty-two patients with IMSP and 32 healthy controls, matched by age, sex, social class, and body mass index (BMI) were enrolled. All were evaluated for pain intensity through the visual analogue scale (VAS) and gait evaluation using dynamic baropodometry. Results: The mean age of the IMSP group was 13.6 years (SD = 2.1, range 9.8-16.9) and of the control group was 13.5 years (SD = 2.0, range 9.6-16.5). The mean pain scale was 5.4 cm in the IMSP group and 0 cm in the control group (p < 0.001). In gait, the mean right foot velocity of the IMSP group was significantly lower (p = 0.034), the time of the step of the IMSP group was significantly higher (p = 0.003) and the pace of the IMSP group was significantly lower (p = 0.001). Conclusion: In our study we observed differences between the gait of children with IMSP and healthy controls according to the dynamic baropodometry. This finding indicates the need for individualized attention to the gait of children with musculoskeletal pain.

Análise das impressões plantares em praticantes de ballet clássico / Analysis of footprints in classic ballet practicers

O ballet clássico é uma forma de dança tradicional que utiliza a ponta como posição básica, com o pé em posições extremas, predispondo-o à diversas alterações morfológicas. O objetivo deste estudo foi analisar as impressões plantares de praticantes de ballet clássico, e correlacionar o tipo de pé com o tempo de prática de ballet e o tempo de uso de sapatilha de ponta. A amostra foi composta por 34 praticantes de ballet, do gênero feminino, de escolas de dança no município de Mineiros e Goiânia em Goiás. As variáveis registradas foram sexo, idade, tempo de prática de ballet e tempo de uso de sapatilha de ponta, medida do Índice de Massa Corporal (IMC) e avaliação da impressão plantar através da plantigrafia e baropodometria. A média de idade das praticantes foi de 18,059,39 anos, média do IMC de 18,79 kg/m2, 10,457,68 anos em média de tempo de prática de ballet, e média de 5,365,69 anos do tempo de uso de sapatilha de ponta. Análise geral das 68 impressões plantares apontou predomínio de pés planos. Quando a análise foi feita individualmente por pés, direito e esquerdo, evidenciou predomínio de pés planos e cavos, respectivamente. Os achados baropodométricos demonstraram maior pressão e área plantar nos pés do lado direito (quadrante anterior) e distribuição de pressão semelhante em ambos os pés. Não foi observada correlação significativa entre os tipos de pés e o tempo de prática de ballet clássico, e o tempo de uso de sapatilha de ponta. Estudos futuros podem contribuir para um consenso sobre os tipos de alterações encontradas nessa modalidade de dança...(AU)

Classic ballet is a traditional form of dance that uses the pointe as the basic position, with the foot in extreme positions, predisposing it to morphological changes. The objective of this study were to analyze the footprints of classic ballet practicers, and correlate the foot type with the practice time of ballet and time of use of pointe shoe. The sample consisted of 34 ballet dancers coming from dance schools in the cities of Goiania and Mineiros, state of Goias, Brazil. The personal characteristics recorded were sex, age, length of time practicing ballet and the use of pointe shoe, so as the Body Mass Index (BMI) and evaluation of footprints through plantigraphy and baropodometry. The average age of the ballet practicers was 189,39 years, with normative values of body mass, 107,68 years as the time average of ballet practice, and a time average of 55,69 years regarding the use of pointe shoes. An overview of the 68 footprints pointed prevalence of flat feet. Individual analysis of the feet, right and left, revealed a predominance of flat feet and cavus, respectively. The baropodometric findings demonstrated greater pressure on the feet and plantar area of the right side (anterior quadrant) and similar distribution of pressure on both feet. No significant correlation was observed between the types of feet and practice time of classic ballet, neither with the time of use of the pointe shoe. Future studies may contribute to a consensus about the types of changes found in this type of dance...(AU)

Tecnologia baropodométrica utilizada para analisar tipos de suporte de peso durante postura ortostática hemiparética / Baropodometric technology used to analyze types of weight-bearing during hemiparetic upright position

INTRODUCTION: Although baropodometric analysis has been published since the 1990s, only now it is found a considerable number of studies showing different uses in the rehabilitation. OBJECTIVE: To amplify the use of this technology, this research aimed to analyze baropodometric records during upright position of subjects with hemiparesis, describing a way to define weight-bearing profiles in this population. METHOD: 20 healthy subjects were matched by gender and age with 12 subjects with chronic spastic hemiparesis. This control group was formed to establish the limits of symmetry during weight-bearing distribution in the hemiparesis group. Next, hemiparesis group was submitted to procedures to measure baropodometric records used to provide variables related to the weight-bearing distribution, the arch index and the displacements in the center of pressure (CoP). Data were used to compare differences among kinds of weight-bearing distribution (symmetric, asymmetric toward non-paretic or paretic foot) and coordination system for CoP displacements. RESULTS: Hemiparesis group was compounded by eight symmetrics, eight asymmetrics toward non-paretic foot and four asymmetric toward paretic foot. Significant differences in the weight-bearing distributions between non-predominantly and predominantly used foot did not promote differences in the other baropodometric records (peak and mean of pressure, and support area). Mainly in the asymmetry toward non-paretic foot it was observed significant modifications of the baropodometric records. CONCLUSION: Baropodometric technology can be used to analyze weight-bearing distribution during upright position of subjects with hemiparesis, detecting different kinds of weight-bearing profiles useful to therapeutic programs and researches involving subjects with this disability.

INTRODUÇÃO: Embora análises baropodométricas sejam encontradas desde a década de 1990, somente agora é observado número considerável de estudos mostrando usos na reabilitação. OBJETIVOS: Para ampliar o uso dessa tecnologia, objetivou-se analisar registros baropodométricos durante a posição ortostática de sujeitos com hemiparesia, descrevendo o suporte de peso nessa população. MÉTODOS: 20 sujeitos saudáveis foram pareados por gênero e idade com 12 sujeitos com hemiparesia espástica crônica. Controles foram formados para estabelecer limites de simetria na distribuição do suporte de peso no grupo hemiparesia. Em seguida, o grupo hemiparesia foi submetido a procedimentos usados para fornecer variáveis como: distribuição no suporte de peso, índice de arqueamento e deslocamentos no centro de pressão (CoP). Os dados diferenciaram tipos de distribuição do suporte de peso (simétrico, assimétrico em direção ao pé não parético ou parético) e estabeleceram sistemas de coordenadas para deslocamentos do CoP. RESULTADOS: O grupo hemiparesia apresentou oito simétricos, oito assimétricos em direção ao pé não parético e quatro em direção ao pé parético. Distribuição assimétrica do suporte entre os pés não predominantemente ou predominantemente usados não promoveram diferenças em registros baropodométricos (pico e média de pressão e área de suporte). Principalmente para a assimetria em direção ao pé não parético, observou-se modificações significativas nos registros baropodométricos. CONCLUSÃO: Tecnologia baropodométrica pode ser usada para analisar a distribuição no suporte de peso durante a posição ortostática de sujeitos com hemiparesia, detectando diferentes tipos de suporte de peso, úteis para serem usados em programas terapêuticos e em pesquisas envolvendo sujeitos com essa incapacidade.

Relação entre o ângulo quadriciptal (ÂQ) e a distribuição da pressão plantar em jogadores de futebol / Relationship between quadriceps angle (Q) and plantar pressure distribution in football players

OBJETIVOS: Verificar possível associação entre ângulo quadriciptal (ÂQ) e distribuição de pressão plantar em jogadores de futebol, comparando-os com indivíduos não praticantes da modalidade. MÉTODOS: Cento e vinte e um participantes do sexo masculino foram selecionados: 50 jogadores de futebol (JF) e 71 sujeitos para o grupo controle (GC). Avaliaram-se concomitantemente o ÂQ, por meio do Software para Avaliação Postural (SAPO), e a pressão plantar, pela plataforma F-Scan/F-Mat System. Para verificar correlação entre o ÂQ e os valores de picos de pressão em quatro segmentos do pé (antepé medial e lateral, médio-pé e retropé), utilizou-se o Coeficiente de Pearson (r) para análises paramétricas. O teste t independente foi empregado para comparar isoladamente essas mesmas variáveis entre os grupos. A normalidade dos dados foi verificada pelos valores de skewness, adotando nível de significância de 5 por cento. RESULTADOS: Encontrou-se correlação negativa e fraca (r=-0,32) somente entre ÂQ e médio-pé direito. Os grupos diferiram quanto ao ÂQ bilateralmente, sendo que o grupo JF teve média de 11,36º, e GC, de 13,80º à direita e de 11,03º contra 13,96º à esquerda, respectivamente. Em relação à pressão plantar, o JF teve maior média de força nas faces laterais do antepé direito (0,77 contra 0,63 kg/cm²) e esquerdo (0,65 e 0,54 kg/cm²), enquanto o GC apresentou maior pico de pressão no médio-pé esquerdo (JF: 0,37 e GC: 0,46 kg/cm²). CONCLUSÕES: Não houve relação entre os valores de ÂQ na distribuição da pressão plantar nos jogadores de futebol. Os atletas apresentaram, porém, ÂQ diminuído e maiores picos de pressão nas faces laterais de ambos os pés, o que sugere alinhamento em varo dos joelhos e distribuição supinada das bases plantares.

OBJECTIVES: To determine whether there is an association between the Q-angle (Q) and the distribution of plantar pressure in football players, and to compare the characteristics of these athletes with non-practitioners of this sport. METHODS: 121 male participants were selected: 50 football practitioners (FP) and 71 non-practitioners (NP). We concurrently evaluated the Q-angle and the plantar pressure through the software of postural assessment (SPA) and the F-Mat System, respectively. To verify the correlation between the Q-angle and peak pressure values in four segments of the foot (medial and lateral forefoot, medium-foot and hind-foot), the Pearson coefficient (r) for parametric analysis was used. The independent t-test was used to compare these variables between the groups. Data normality was verified by the skewness values, adopting a significance level of 5 percent. RESULTS: A negative and weak correlation was found (r=-0.32) between the Q-angle and the plantar pressure in the right medium-foot. The groups differed with regards to the right Q-angle (11.36º in FP versus 13.80º in NP) and the left Q-angle (11.03º in FP versus 13.96º in NP). Plantar pressure was also different between the groups, with FP showing higher mean values for the right side and for the left side of the forefoot (0.77 kg/cm² in FP versus 0.63 kg/cm² in NP, and 0.65 kg/cm² in FP versus 0.54 kg/cm² in NP, respectively). However, mean peak pressure values for the left medium-foot were higher among NP (0.37 kg/cm² in FP versus 0.46 kg/cm² in NP). CONCLUSIONS: There was no evidence of an association between the Q-angle and the distribution of plantar pressure in FP. The athletes showed reduced Q-angle values and higher mean peak pressure values for the right and left aspects of the forefoot, suggesting a varus malalignment and a supine distribution of plantar bases.

Estudo comparativo de possíveis desequilíbrios posturais em pacientes apresentando má oclusão de classe I, II e III de angle, através da plataforma de baropodometria / A comparative study of possible postural unbalancings in class I, II, and III malocclusion (angle) patients by baropodometry platform

O presente estudo avaliou, de acordo com o tipo de má oclusão pertencente, a ocorrência de desequilíbrios posturais através da medida de pressão plantar, obtida pelo exame de baropodometria. Utilizou-se uma amostra de 12 indivíduos de ambos os sexos, sendo 4 indivíduos apresentando má oclusão de classe I de Angle, 4 de classe II e 4 de classe III. Cada indivíduo foi submetido a uma avaliação odontológica para determinar a qual classe pertenciam e, em seguida, realizaram o exame baropodométrico. Os resultados foram comparados com os descritos por Marczak (2004), que cita como parâmetros de normalidade 35 a 40% da pressão plantar no ante pé e 55 a 60% no retro pé. Seguindo esses critérios, na classe I, 100% dos indivíduos demonstraram desequilíbrios no sentido anterior. Na classe II, 100% dos indivíduos também demonstraram desequilíbrios do tipo anterior, e na classe III, obteve-se o mesmo resultado com 100% dos indivíduos demonstrando desequilíbrios do tipo anterior. Conclui-se, com isso, que nessa amostra encontraram-se alguns resultados diferentes do que vem sendo citado pela literatura, ou seja, nos pacientes do tipo classe I e III, sendo que os pacientes pertencentes a má oclusão do tipo II obtiveram resultados parecidos com os da bibliografia. Pode-se sugerir que haja um predomínio das síndromes ascendentes sobre as síndromes descendentes. Ainda existe a necessidade de mostrar que existem diversos captores que podem desregular o sistema tônico postural: pele, cicatriz patológica, ansiedade e outros.

The postural unbalancing occurrence through the plantar pressure measurement, according to the kind of malocclusion, acquired by the baropodometry exam was evaluated in this article. The sample consisted of 12 individuals, both male and female. 4 individuals presented Class I malocclusion (angle); 4 presented Class II, and 4 presented Class III. Each individual was submitted to an odontological evaluation in order to determine which Class they would match, and then, the baropodometric examination. The results were compared with those described by Marczak (2004), who quotes as values of normality, 35 to 40% of the plantar pressure in the front foot, and 55 to 60% in the rear foot. According to these criteria, in Class I, 100% of the individuals demonstrated unbalancings in the front part. In class II, 100% of the individuals demonstrated unbalancings in the front part as well, and in Class III, 100%, of the individuals also demonstrated the same unbalancings. It was concluded that there are some results different from those found in the literature û Class I and III patients û whereas Class II patients presented similar. It might be suggested that there is a predominance of ascending syndromes over the descending ones. It is still necessary to demonstrate the existence of several captors which might deregulate the postural tonic system: skin pathologic scar, anxiety, etc.