Flexible flatfoot in the childhood: negative influence of inappropriate footwear

An analysis was carried out in relation to the adverse effects produced by the use of inadequately made footwear in patients with flexible flat feet in pediatric ages; we carried out an anatomical-functional reminder of the foot as a basic structure for standing and walking. The functional adaptability of the feet was valued in those populations with the habit of walking barefoot, also making a description of the basic characteristics that a properly made footwear must have. We address the different therapeutic approaches and their behavior over time. We highlight the widespread use in our society of inappropriate footwear, mainly of the flip-flop type, and its negative influence on the feet of those children with flexible flat feet and valgus of the ankle.

Se llevó a cabo un análisis en relación a los efectos adversos producidos por el uso de calzados de confección inadecuada en los pacientes portadores de pies planos flexibles en edades pediátricas. Se realizó un recordatorio anatomo-funcional del pie como estructura básica para la bipedestación y la marcha. Se valoró la adaptabilidad funcional de los pies en aquellas poblaciones con hábito de andar descalzos, haciéndose, además, una descripción de las características básica que debe reunir un calzado adecuadamente confeccionado. Se abordó los diferentes enfoques terapéuticos y su comportamiento en el tiempo, destacando el uso generalizado en la sociedad cubana de calzados inapropiados, principalmente del tipo chancletas, y su influencia negativa sobre los pies de aquellos niños con pies planos flexibles y tobillo valgo.

Footwear Usage and Practice in Indian Healthcare Centres

Healthcare Centres are where the patients get treated, but most of the time, we ignore that it is also a major source of Infections, to both patients and visitors. In India, many hospitals don抰 allow patients & visitors to enter with their Footwear on, whereas, Doctors & other Health Care Workers can. There are no specific guidelines for visitors and patients for wearing Footwear in India. Also, the Indian National Guidelines of infection prevention & control doesn抰 provide sufficient protocol regarding the importance of wearing Footwear for patients and visitors in Healthcare Centres. This article focuses on finding the risk of acquiring Infection & transmission of microorganisms when a patient walks barefoot within the hospital.

Effects of Footwear on the Stability of Older Adults: A Systematic Review / 医用生物力学

Older adults have decreased control of body balance with aging and are prone to fall. As the primary point of contact between human body and ground, footwear is critical for stability of older adults. The relationship between shoe characteristics and stability of older adults was systematically reviewed to determine the effect of footwear characteristics on stability of older adults. The results show that wearing shoes with shoelaces or velcro, low heels, wide outsole and appropriate soles, or using vibrating insoles and arch support insoles can help older adults improve their stability. Excessive sole spring and low sole hardness may have adverse effects on stability of older adults. This study can provide theoretical references for older adults to choose shoes reasonably and for the manufacturers to design and make shoes to prevent falls.

Influence of unstable shoes on women with lumbopelvic postpartum pain: randomized clinical trial

ABSTRACT BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

Autocuidado en profesional de enfermería con relación al uso del calzado. Hospital de Clínicas, San Lorenzo- Paraguay 2017 / Self-care in nursing professional with regard to the use of the footwear. Hospital de Clínicas, San Lorenzo-Paraguay 2007

El objetivo fue analizar si el profesional de enfermería aplicaba el autocuidado en el uso del calzado en horario laboral. Es un estudio observacional, analítico, de corte trasversal con enfoque cuantitativo. La población estuvo constituida por 1.037 profesionales de Enfermería del Hospital de Clínicas, institución de carácter público, situada en la ciudad de San Lorenzo, Paraguay. Se incluyeron 366 profesionales de Enfermería a través de un muestreo probabilístico, la selección de la muestra fue multietápica con muestreo aleatorio simple. Se aplicó estadística descriptiva y chi2 para determinar asociaciones. Los hallazgos más relevantes fueron que mayoritariamente eran del grupo etario de 24 a 48 años con una media de 35 años; soltero, con una antigüedad de 10 años, con más de un empleo y del servicio de urgencias. Solo el 11,7% refirió conocer el calzado anatómico, sin embargo, 50,2% lo utilizaba. Más del 60% no tenía en cuenta las características del calzado anatómico al momento de adquirirlo, entre otros aspectos relacionados al utilizarlo en horario laboral. En el grupo etario de 31 a 35 años se concentró la mayor cantidad de trastornos músculo-esqueléticos (40%). En conclusión, el profesional de enfermería utilizaba de forma deficitaria el calzado adecuado; además, se ha encontrado evidencia de asociación (chi2 0,05) entre el tipo de calzado utilizado y la cantidad de trastornos músculo-esqueléticos que presentaba cada individuo

The objective was to analyze if the nursing professional applied self-care in the use of footwear during working hours. It was an observational, analytical, cross-sectional study with a quantitative approach. The population was constituted by 1,037 nursing professionals from the Hospital de Clínicas, a public institution, located in the city of San Lorenzo, Paraguay. The sample included 366 nursing professionals and the sampling wasprobabilistic while the selection of the multistage sample with simple random sampling. Descriptive statistics and Chi2 were applied to determine associations. The most relevant findings were that they were mainly in the age group of 24 to 48 years with an average of 35 years, single, with a career of 10 years, more than one job and from the emergency service. Only 11.7% referred to know the anatomical footwear, however, 50.2% used it. More than 60% did not take into account characteristics of the anatomical footwear at the time of purchase, among other aspects related to using it during working hours. The greatest number (40%) of musculoskeletal disorders were concentrated in the age group from 31 to 35 years. In conclusion, the nursing professional uses the right footwear in a loss-making way. In addition, evidence was found of an association between the type of footwear used and the number of musculoskeletal disorders that each individual presents

A study on non-healing plantar diabetic foot ulcers to assess the effect of compliance of using customised footwear in wound healing

Background: Foot infection is one of the commonest reasons for hospital admission of individuals with diabetes in India. Prescription footwear is an intricate aspect of a treatment program, not a therapy unto itself. Custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient as advised. This study was done in patients who are already prescribed customised footwear and evaluated the need for compliance based on the healing of these plantar foot ulcers.Methods: 85 diabetic patients with severe neuropathy and a non-healing callus ulcer or trophic ulcer (diameter 1-3 cm) for more than 3 months were included in the study. All these patients were followed up on weekly basis for 3 months and questioned about the use of customized footwear on regular basis. At the end of three months, the healing of these foot ulcers was compared based on whether they had been compliant with the customized footwear advice.Results: Of the 85 patients, 25 (29.4%) had shown improvement in wound healing with regular use of footwear. 60 (70.5%) patients who were not using the customized footwear had not shown any improvement in the plantar ulcers. The reasons for not using the recommended footwear were many commonest being wearing footwear only when going out and not inside the home.Conclusions: Non-compliance with customised footwear is emerging as an important cause of delay in wound healing of plantar foot ulcers.

Barefooted vs with footwear: functional mobility assessment on community dwelling elders

Background: Affected balance, restricted mobility and probability of fall is more common in elder. Most of the geriatric individuals prefer walking independently as one of the prime function, so maintenances of that even with affecting factors of fall it is essential. Footwear is one extrinsic factor which may affects postural stability and increase risk of fall.Methods: A cross sectional study conducted among community dwelling elders. Participants (n=40) have performed time up and go test (TUG) and ten meter walk test (TMW) in or out of the house with barefoot and two different type of pre-screened footwear. Descriptive statistics were done and ANOVA was performed.Results: The calculated F ratio (0.7817), (1.3100) is lesser than the table F ratio (3.0737), (3.0737) for the TMW and even For TUG so the TUG score for barefoot and two different type of footwear do not differ significantly.Conclusions: Functional mobility is not influenced by routine footwear. Barefooted and with footwear dynamic balance and gait speed is not significantly different from each other.

A Case Of Chemical Leukoderma Effectively Treated With Punch Graft Surgery

Chemical leukoderma is a hypomelanotic disorder due to destruction of melanocytes or inhibition of melanogenesis secondary to application of harmful chemicals household or industrial. It can be easily diagnosed clinically by a positive history of frequent exposure to a depigmenting agent at the site corresponding with the pattern of the object applied. It has a psychosocial significance because of the dyspigmented presentation of the disease which often simulates other conditions associated with social stigma, like leprosy or vitiligo. Here, we report a case of thirty year old female with chemical leukoderma who presented to us with depigmented patches over forehead (bindi leukoderma) and dorsae of feet (footwear dermatitis) caused by application of sticker bindi and wearing of rubber footwear respectively. Complete repigmentation was observed after treatment with topical corticosteroids and melanocyte transfer surgery.

Etiología y fisiopatología del Hallux Valgus / Etiology and phisiology of Hallux Valgus

El hallux valgus es uno de los motivos de consulta más frecuentes dentro de las patologías que afectan el pie, el 90% de los pacientes son mujeres. Se caracteriza por deformidad en varo de primer metatarsiano y valgo del primer dedo, dolor en la prominencia ósea medial y debajo de cabeza de los metatarsianos. Además, se puede acompañar de artejos menores en garra y metatarsalgia. El uso de calzado inadecuado, ya sea en punta y con tacón alto, así como el antecedente genético, se han descrito como las principales causas de esta patología. El tratamiento depende exclusivamente de la sintomatología y está encaminado inicialmente al uso de calzado amplio y cómodo, plantillas cuando hay metatarsalgia asociada. El tratamiento ortopédico puede mejorar el dolor más no la deformidad. Si este manejo no da resultado, se recurre al tratamiento quirúrgico. La cirugía tiene como objetivo realinear las estructuras óseas para corregir la deformidad mediante osteotomías y liberación de tejidos blandos, lo cual mejora el dolor y facilita el uso de calzado. Existen múltiples técnicas quirúrgicas descritas, que se escogen dependiendo de la severidad del hallux y de la experiencia del cirujano. Los resultados del tratamiento quirúrgico son exitosos aproximadamente en el 85% de los casos. Como en todas las patologías hay riesgo complicaciones post operatorias y estas pueden ocurrir en el 15% de los pacientes; las más frecuentes son la recidiva de la deformidad e infecciones superficiales. El riesgo de recidiva aumenta en deformidades severas, pacientes con pie plano o inestabilidad de articulación cuneo metatarsiana.

The hallux valgus is one of the most frequent reasons for consultation within the pathologies that affect the foot, 90% of patients are women. It is characterized by varus deformity of the first metatarsal and valgus of the first toe, pain in the medial bony prominence and below the head of the metatarsals, in addition minor claw and metatarsalgia can be accompanied. The use of inappropriate shoes, narrow and high-heeled, as well as the genetic background have been described as the main causes of this pathology. The treatment depends exclusively on the symptomatology and is initially aimed at the use of wide and comfortable shoes, insoles when there is associated metatarsalgia. Orthopedic treatment can improve pain, not deformity. Surgical treatment is reserved for those patients who, despite performing adequate orthopedic treatment, do not improve. The aim of the surgical treatment is to realign the bony structures to correct the deformity by means of osteotomies and soft tissues release, this improves the pain and facilitates the use of footwear. There are multiple surgical techniques described, which are chosen depending on the severity of the hallux and the experience of the surgeon. The results of surgical treatment are successful in approximately 85% of cases. As in all pathologies there is a risk of post-operative complications, which may occur in 15% of patients; the most frequent are the recurrence of deformity and superficial infections.

Prevention of diabetic foot complications

This paper discussed the importance of prevention of diabetic foot ulcers and our institution's protocol for prevention, reviewing the existing evidence in the literature regarding the effectiveness of the preventive approach. Diabetes mellitus is the second most significant cause of disease in Singapore after ischaemic heart disease. National University Hospital, Singapore, adopts a two-pronged strategy for the management of diabetic foot ulcers. The most important strategy is prevention, and education is key. Education should mainly be directed at patients and caregivers, but also professionals (general practitioners, allied health professionals and nurses) so that they can effectively educate patients and caregivers. Patient education includes care of diabetes mellitus, care of the foot and use of appropriate footwear. Patients also tend to have poor foot hygiene. Annual foot screening for diagnosed diabetics plays an important role. However, prolonged and sustained government intervention is necessary to provide education and screening on a national scale.

¿Afecta una clase de Educación Física a las dimensiones del pie de los niños? / Does a Physical Education lesson affect the foot morphology in school-aged children?

Resumen: Introducción: Analizar las variaciones que se producen en las medidas morfológicas del pie de los niños escolares, tras la realización de una clase de Educación Física. Metodología: Participaron voluntariamente 10 escolares (5 niños y 5 niñas) con una media de edad de 9.3 ± 0.5 años. Se llevó a cabo la digitalización de ambos pies de manera consecutiva, a través de un escáner en 3D modelo IFU-S-01, Japón. Se calcularon las dimensiones del pie en dos momentos diferentes, antes y después de una clase de Educación Física (pre y post ejercicio) donde se realizaron diferentes actividades que implicaban desplazamientos, saltos y amortiguaciones. Resultados: Al comparar las medidas del pie antes y después del ejercicio se observaron diferencias significativas en la altura del arco plantar, que fue mayor tras la realización de actividad física (p<0.05). El ancho del antepié presentó mayores valores tras el ejercicio sin significancia estadística (p=0.07; tamaño del efecto [ES] = 0.2). Además, se observaron correlaciones positivas entre el ancho del antepié y la altura del arco (r = 0.6; p<0.05); y negativas entre la longitud del talón a la cabeza del metatarso I y el ancho del antepié (r = - 0.7; p<0.05). Conclusiones: El tipo de actividades realizadas durante la clase de Educación Física (desplazamientos, saltos y amortiguaciones) podría causar mayor presión en la zona del antepié, provocando mayor altura del arco plantar. Los sistemas de desarrollo del calzado deportivo infantil deberían tener en cuenta tanto las longitudes del pie, cómo sus anchuras y alturas, para un mejor ajuste del zapato, previniendo lesiones osteomusculares futuras.

Abstract: Background: To analyze the changes in foot morphology in school-age children, after a Physical Education lesson. Methods: A total of 10 school-age children (5 girls and 5 boys) were recruited with a mean age of 9.3 ± 0.5 years that voluntary participated in this study. Measurements of both feet were obtained using a 3D foot digitizer model IFU-S-01 (Japan) in two different moments, before and after a physical education lesson (per-exercise and post-exercise), where different activities involving displacements, jumps and landings were performed. Results: By comparing foot morphology before and after exercise, significant differences in the arch height were found, which increased after exercise (p<0.05). The ball width shows greater changes after exercise but without significant differences (p= 0.07; effect size [ES] = 0.2). Furthermore, a positive correlation between the ball width and the arch height (p<0.05) and negative correlation between the distance from the heel to the first metatarsal and the ball width (r = - 0.7; p<0.05), were observed. Conclusions: The type of activities undertaken during physical education lesson (displacements, jumps and landings) increased the pressure on the forefoot, which would lead to a lager arch height. Development of children's sport footwear systems should take into account the foot lengths, widths and heights, for a better fit, preventing future musculoskeletal injuries.

The influence of shod conditions and foot-strike patterns on foot force characteristics during jogging / 医用生物力学

Objective To investigate the influence of barefoot running and shod running with different foot-strike patterns on characteristics of plantar pressures and ground reaction force (GRF).Methods Kistler force plates and Medilogic insole plantar pressure system were used to collect the kinetic data from a total of 12 healthy male volunteers under shod and barefoot conditions with heel strike and forefoot strike at the speed of 3 m/s,including the GRF,the peak impact force,the maximum loading rate,the peak plantar pressure and impulse.Results (1) Shod running with heel strike significantly reduced the maximum loading rate and extended the time to reach the peak impact force.Under forefoot strike pattern,shod running significantly increased the maximum push-off force than barefoot running.(2) More plantar pressure parameters were influenced by the foot-strike patterns as compared to those under the shod conditions,and there was a significant difference in the peak pressure and the time to reach the peak pressure in the mid-foot and heel region between two foot-strike patterns.Conclusions The foot-strike pattern shows a more obvious influence on plantar pressure during jogging than the shod conditions.Shod running with heel strike can reduce the impact load,while barefoot running with forefoot strike can cause an excessive concentration of plantar pressure on the forefoot region,indicating that a suitable pair of sports shoes is needed for both foot-strike patterns to reduce the plantar pressure during jogging.

The influence of shod conditions and foot-strike patterns on foot force characteristics during jogging / 医用生物力学

Objective To investigate the influence of barefoot running and shod running with different foot-strike patterns on characteristics of plantar pressures. Methods Kistler force plates and Medilogic insole plantar pressure system were used to collect and compare the kinetic data from a total of 12 healthy male volunteers under shod and barefoot conditions with heel-toe run and toe-toe run at the speed of 3 m/s, including the GRF, loading rate, plantar pressure and impulse. Results (1) Shod running with heel-toe strike significantly reduced the maximum loading rate and extended the time to reach the peak of impact force. Under forefoot strike pattern, shod running significantly increased the maximum push-off force than barefoot running. (2) More plantar pressure parameters were influenced by the foot-strike patterns as compared to those under the shod conditions, and there was a significant difference in the peak pressure and the time to reach the peak pressure in the mid-foot and heel region between the two foot-strike patterns. Conclusions The foot-strike pattern shows a more obvious influence on plantar pressure during jogging than the shod conditions. Shod running with heel strike can reduce the impact force, while barefoot running with forefoot strike can cause an excessive concentration of plantar pressure on the forefoot region, which indicates that a suitable pair of sports shoes is needed for both foot-strike patterns to reduce plantar pressure during jogging.

The influence of shod conditions and foot-strike patterns on foot force characteristics during jogging / 医用生物力学

Objective To investigate the influence of barefoot running and shod running with different foot-strike patterns on characteristics of plantar pressures and ground reaction force (GRF).Methods Kistler force plates and Medilogic insole plantar pressure system were used to collect the kinetic data from a total of 12 healthy male volunteers under shod and barefoot conditions with heel strike and forefoot strike at the speed of 3 m/s,including the GRF,the peak impact force,the maximum loading rate,the peak plantar pressure and impulse.Results (1) Shod running with heel strike significantly reduced the maximum loading rate and extended the time to reach the peak impact force.Under forefoot strike pattern,shod running significantly increased the maximum push-off force than barefoot running.(2) More plantar pressure parameters were influenced by the foot-strike patterns as compared to those under the shod conditions,and there was a significant difference in the peak pressure and the time to reach the peak pressure in the mid-foot and heel region between two foot-strike patterns.Conclusions The foot-strike pattern shows a more obvious influence on plantar pressure during jogging than the shod conditions.Shod running with heel strike can reduce the impact load,while barefoot running with forefoot strike can cause an excessive concentration of plantar pressure on the forefoot region,indicating that a suitable pair of sports shoes is needed for both foot-strike patterns to reduce the plantar pressure during jogging.

The influence of shod conditions and foot-strike patterns on foot force characteristics during jogging / 医用生物力学

Objective To investigate the influence of barefoot running and shod running with different foot-strike patterns on characteristics of plantar pressures and ground reaction force (GRF).Methods Kistler force plates and Medilogic insole plantar pressure system were used to collect the kinetic data from a total of 12 healthy male volunteers under shod and barefoot conditions with heel strike and forefoot strike at the speed of 3 m/s,including the GRF,the peak impact force,the maximum loading rate,the peak plantar pressure and impulse.Results (1) Shod running with heel strike significantly reduced the maximum loading rate and extended the time to reach the peak impact force.Under forefoot strike pattern,shod running significantly increased the maximum push-off force than barefoot running.(2) More plantar pressure parameters were influenced by the foot-strike patterns as compared to those under the shod conditions,and there was a significant difference in the peak pressure and the time to reach the peak pressure in the mid-foot and heel region between two foot-strike patterns.Conclusions The foot-strike pattern shows a more obvious influence on plantar pressure during jogging than the shod conditions.Shod running with heel strike can reduce the impact load,while barefoot running with forefoot strike can cause an excessive concentration of plantar pressure on the forefoot region,indicating that a suitable pair of sports shoes is needed for both foot-strike patterns to reduce the plantar pressure during jogging.

Footwear appropriateness, preferences and foot ulcer risk among adult diabetics at Makati Medical Center Outpatient Department / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To determine general and clinical characteristics associated with the use of inappropriate footwear among Filipino patients with diabetes. @*Methodology@#Adult patients with diabetes were recruited. Comprehensive foot examination was done checking on foot deformities, neuropathies and peripheral arterial disease. Footwear was then examined as to length and width. Appropriateness of footwear to patient’s foot was measured using International Working Group on the Diabetic Foot (IWGDF) criteria. @*Results@#We classified 170 adults with diabetes based on foot ulcer risk classification of IWGDF. In this population, 62% of respondents were at risk for foot ulcer. Flipflops are the primary choice of footwear among 82% and 47% of the respondents for indoor and outdoor footwear respectively. Inappropriate footwear was see in 91% of the patients. Binary logistic regression showed insufficient evidence to determine an association between the use of inappropriate footwear and patient sex, educational attainment, foot care evaluation and examination. Foot ulcer risk classification showed a trend for higher group levels to wear inappropriate footwear. @*Conclusion@#Flipflops and sandals are the primary preferences of the participants. Majority (91%) of the participants wear inappropriate footwear. This finding were due to multifactorial causes: preference, climate, economic reasons, and foot ulcer risk category. Educational attainment and foot care education did not improve the statistics of footwear appropriateness.

Non operative treatment of chronic ankle sprain: a study conducted in teaching general hospital, Telangana, India.

Background: Chronic ankle sprain due to “sprained ankle syndrome” may be particularly troublesome. Some causes of chronic ankle instability may be symptomatic insufficiency of pathologic laxity, arthro-kinematic changes, degenerative changes, decrease of proprioception and inadequate neuromuscular control. This study was conducted to review our experience with footwear correction of chronic ankle sprains of grade 2 and 3. Methods: Ankles of 280 patients, who had chronic ankle sprains grade 2, grade 3 were considered in this study, to assess results of non-operate treatment. Diagnosis was made with history of pain, swelling on walking, clinical findings of swelling, tenderness on antero-lateral aspect of lateral malleolus. All patients were given 3 days of anti-inflammatories, analgesics and footwear modifications. Later patients were advised exercise program. Results: Out of 280 patients, who were regularly followed, 92% people had relief, 3.4% of patients continued footwear as they had associated symptoms, 3.9% of patient continued to have pain maybe obscure or not following doctor orders. Conclusion: The study concludes that lateral elevated foot wear made of micro cellular rubber of 0.75 cm is the choice of treatment for grade 2 and 3 ankle sprains. This foot wear helps in biomechanical correction from varus and also decreases symptoms and signs. Cosmetically acceptable.

Effects of footwear and barefoot on movement coordination of lower extremities and metatarsophalangeal joints during push-off in badminton footwork / 医用生物力学

Objective To explore the influence of footwear and barefoot on movement coordination of the lower extremities and metatarsophalangeal (MP) joints during push off phase in typical lunge footwork of badminton, so as to provide theoretical basis for scientific training of badminton, as well as choice and development of badminton shoes. Methods Male badminton elites were recruited and required to perform the typical push-off footwork in playing badminton under two shod conditions (commercial badminton footwear and a prototype) and the barefoot condition. A Vicon motion capture system and a high-speed video camera were simultaneously employed to collect the kinematics and coordination characteristics of the hip, knee, ankle and MP joints during the push-off stage of the lunge step. Results (1) No substantial difference was found in joint kinematics of the lower extremities during push-off stage for wearing two types of badminton shoes adopted in this study. Compared with barefoot, wearing badminton shoes could increase the angular velocity of ankle and MP joints to some extent and significantly decrease the time of peak angular velocity occurrence in each joint; (2) With respect to characteristics of movement coordination, the hip, knee, ankle and MP joints were accelerating successively in a proximal-to-distal way during push-off under three foot-shoe conditions. Conclusions Footwear can provide the dynamic source during push-off, and contribute to improve the velocity and effects of push off in order to enhance performance. The movement coordination of the lower extremities during push off in the lunge step is more inclined to be a rational combination of sequence and synchronization. Consequently, more attention should be paid to the speed/strength training of the ankle and MP joints.

Análise do impacto do tênis e coturno fornecidos pelo exército brasileiro durante a marcha / Analysis of shock absortion during gait wearing tennis shoes and military boots from Brazilian Army

O objetivo do presente estudo foi comparar a absorção de impacto durante a marcha descalço e com tênis e coturno fornecidos pelo Exército Brasileiro. A amostra foi composta por 20 soldados saudáveis recém-incorporados sem sintomas ou lesões musculoesqueléticas ou neurológicas que interferissem na marcha. Os sujeitos foram instruídos a caminhar em uma plataforma de madeira de 10 metros de comprimento por um metro de largura, com duas plataformas de força (Bertec, EUA) embutidas no centro. O componente vertical da força de reação do solo foi avaliado durante a marcha nas situações tênis, coturno e descalço. O sistema de cinemetria (Qualysis, Suécia) foi utilizado para medir a velocidade da marcha em cada situação de teste. O primeiro pico de força (PPF), o tempo para atingir o PPF (T_PPF), pico transiente de impacto (IPF) e a taxa de aceitação do peso (TAP) entre 10% e 30%, 30% e 50%, 50% e 70%, 70% e 90% e 10% e 90% do PPF foram avaliadas. O T_PPF foi em média 1s menor (p < 0,0001), o IPF e a TAP entre 10% e 30% do PPF foram maiores (p < 0,0001, ambos) descalço comparados a marcha com tênis e coturno. Não foi observado diferença estatística nas outras variáveis estudadas nas três condições de teste, bem como em nenhuma variável na comparação entre tênis e coturno. Os calçados avaliados são eficientes em reduzir o impacto durante a marcha por atrasar em média 1 s o tempo em que o PPF foi atingido, reduzir o IPF e a TAP nos primeiros 30% do PPF

This study aimed at comparing shock absorption during gait while walking barefoot, tennis shoes and military boots. Twenty healthy soldiers without neurologic or musculoskeletal disorders were evaluated. Subjects walked 10 meters along a straight and level walkway at a comfortable speed in barefoot condition and using tennis shoes and military boots. Two force platforms (Bertec, EUA) were placed in serial at the middle of the walkway used to measure the ground reaction forces (GRF). The kinematic system (Qualysis, Sweden) was used to measure gait speed in each test condition. The first peak of force (FPF) of the vertical component of the GRF, time to reach to FPF (T_FPF), transient impact peak force (IPF) were evaluated and the weight acceptance rate at 10% to 30%, 30% to 50%, 50% to 70%, 70% to 90% and 10% to 90% of FPF. T_FPF was 1 s shorter (p < 0.0001), as well as IPF and weight acceptance rate at 10% to 30% in barefoot was higher (p < 0.0001, both) than tennis shoes and military boots gait patterns. None statistical difference was found in the others analyzed variables, even as in the tennis shoes and military boots comparisons. The analyzed footwear delayed the FPF impact during gait, reduce the IPF and the weight acceptance phase during 10% to 30% of FPF, being efficient in reduce impact forces during gait

Reestruturação produtiva, trabalho informal e a invisibilidade social do trabalho de crianças e adolescentes / Production restructuring, informal work and the social invisibility of children and adolescents' labor

Este texto problematiza alguns elementos que podem auxiliar na compreensão do trabalho precoce, nos dias atuais. A partir da realidade local, município de Franca, SP, faz apontamentos acerca da reestruturação produtiva, da expansão do trabalho informal, autônomo e doméstico e a inserção de meninos e meninas precocemente no mercado de trabalho, mantendo a distância entre o paradigma de proteção integral das crianças e adolescentes e a realidade cotidiana em que eles estão inseridos.

This article questions some elements that can help to make early work understood nowadays. From a local reality, the city of Franca in São Paulo, it records the production restructuring, the expansion of the informal, autonomous and domestic work, and the early inclusion of boys and girls in the work market, as well as the maintenance of the distance between the paradigm of whole protection to children and adolescents and the daily reality in which they are inserted.