Evaluation of ankle joint protection effect of parachute ankle brace on paratrooper landing / 中华劳动卫生职业病杂志

Objective: To study the protective effect of parachute ankle brace on ankle joint during simulated parachuting landing. Methods: In August 2021, 30 male paratroopers were selected as the test subjects by simple random sampling method. They jumped from the 1.5 m and 2.0 m height platforms respectively with and without parachute ankle brace, and landed on the sandy ground in a semi-squat parachute landing position. The experiment was divided into 1.5 m experimental group and control group and 2.0 m experimental group and control group. Angle sensor and surface electromyograph were used to measure and analyze the coronal tilt range of the ankle joint and the percentage of maximal voluntary contraction (MVE%) of the muscles around the ankle joint, respectively, to evaluate the protective effect of the parachute ankle brace. Results: At the same height, the tilt range of coronal plane of ankle in experimental group was significantly reduced compared with control group, and the difference was statistically significant (P<0.05). Under the same protection state, the tilt range of the coronal plane of the ankle in the 1.5 m group was significantly reduced compared with that in the 2.0 m group, and the difference was statistically significant (P<0.05). The coronal plane inclination range of the ankle in 2 m experimental group was significantly lower than that in 1.5 m control group, and the difference was statistically significant (P<0.05). Compared with 1.5 m control group, MVE% of right tibialis anterior muscle and bilateral lateral gastrocnemius decreased in 1.5 m experimental group, while MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle and right lateral gastrocnemius decreased in 2.0 m experimental group, while the MVE% of bilateral peroneus longus increased, with statistical significance (P<0.05). The MVE% of bilateral tibialis anterior muscle, bilateral lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m experimental group decreased compared with 2.0 m experimental group, and the differences were statistically significant (P<0.05). Compared with 2.0 m control group, the MVE% of bilateral tibialis anterior muscle, right lateral gastrocnemius muscle and right peroneus longus muscle in 1.5 m control group decreased, and the differences were statistically significant (P<0.05) . Conclusion: Wearing parachute ankle brace can effectively limit the coronal plane inclination range of ankle joint, improve the stability of ankle joint and reduce the load on the muscles around ankle joint by landing. Reducing the height of the jumping platform can reduce the coronal plane incline range of the ankle and the muscle load around the ankle during landing.

Effects of ankle exoskeleton assistance during human walking on lower limb muscle contractions and coordination patterns / 生物医学工程学杂志

Lower limb ankle exoskeletons have been used to improve walking efficiency and assist the elderly and patients with motor dysfunction in daily activities or rehabilitation training, while the assistance patterns may influence the wearer's lower limb muscle activities and coordination patterns. In this paper, we aim to evaluate the effects of different ankle exoskeleton assistance patterns on wearer's lower limb muscle activities and coordination patterns. A tethered ankle exoskeleton with nine assistance patterns that combined with differenet actuation timing values and torque magnitude levels was used to assist human walking. Lower limb muscle surface electromyography signals were collected from 7 participants walking on a treadmill at a speed of 1.25 m/s. Results showed that the soleus muscle activities were significantly reduced during assisted walking. In one assistance pattern with peak time in 49% of stride and peak torque at 0.7 N·m/kg, the soleus muscle activity was decreased by (38.5 ± 10.8)%. Compared with actuation timing, the assistance torque magnitude had a more significant influence on soleus muscle activity. In all assistance patterns, the eight lower limb muscle activities could be decomposed to five basic muscle synergies. The muscle synergies changed little under assistance with appropriate actuation timing and torque magnitude. Besides, co-contraction indexs of soleus and tibialis anterior, rectus femoris and semitendinosus under exoskeleton assistance were higher than normal walking. Our results are expected to help to understand how healthy wearers adjust their neuromuscular control mechanisms to adapt to different exoskeleton assistance patterns, and provide reference to select appropriate assistance to improve walking efficiency.

The effects of motor adaptation on ankle isokinetic assessments in older drivers

OBJECTIVES: This study sought to analyze the extent of motor adaptation in ankle plantar flexors and dorsiflexors among older drivers during clinical isokinetic testing. METHODS: One hundred older adults (70.4±5.7 years) participated in two bilateral ankle plantar flexor and dorsiflexor isokinetic assessments at 30°/sec. Peak torque (PTQ), PTQ adjusted for body weight (PTQ/BW), and total work (TW) were analyzed. RESULTS: On the dominant side, PTQ/BW and TW were significantly greater for the second plantar flexion test than were those for the first such test (p<0.001), whereas PTQ, PTQ/BW, and TW (p<0.001) were significantly greater for the second dorsiflexion test than were those for the first such test. On the non-dominant side, plantar flexion PTQ and TW were significantly lower for the second test than were those for the first test (p<0.001). CONCLUSION: Older drivers demonstrated better performance with the dominant limb on the second test. The low variability in test execution showed the existence of a motor adaptation effect for the tested movements, despite the short recovery period between the assessments.

Isokinetic performance of ankle evertor and invertor muscles in adolescent female volleyball athletes

This study aimed to analyze the muscular performance of evertor and invertor ankle muscles of adolescent volleyball athletes. Methods: The information provided by database concerning the isokinetic evaluation of ankle muscles from 20 female volleyball players between the ages of 14-17 years old were analyzed. The isokinetic dynamometer was used in a concentric-concentric mode for the ankle evertor and invertor muscles at angular velocities of 60°/s, and 180°/s. Results: Seven athletes had suffered ankle sprains (6 affected the non-dominant limb and all were lateral ankle sprain) in the one year prior to the isokinetic evaluation. The isokinetic results demonstrated that the mean peak torque values for eversion of the non-dominant limb were significantly lower in comparison to the dominant limb at 60°/s. Moreover, although no difference was observed in the average values of the evertor/invertor ratio between the limbs, the ratios were below the values suggested by the literature. Conclusion: We believe that although the athletes reported no ankle injury and no pain in the previous assessment month, the isokinetic results of the non-dominant limb seemed to be directly related to previous ankle sprains injuries in inversion of this limb. The athletes had similar results to those of subjects clinically diagnosed with ankle joint instabilities despite their being active in sports at the moment of the assessment.(AU)

Cambios asociados al envejecimiento normal en los parámetros angulares de la marcha a una velocidad controlada / Changes associated with aging in angular kinematic parameters during a controlled speed walk

Background: During normal aging, a reduction in walking speed and changes in stability are observed. Aim: To characterize and compare gait kinematic parameters of young (YA) and older adults (OA) at a controlled speed. Material and Methods: Gait angular kinematic parameters were analyzed in OA aged over 60 years and YA aged between 20 and 30 years. For data capture, six VICON Bonita cameras were used. Recording were made at a gait speed of 1.2 m/s. Kinematic data were normalized to 100% of the gait cycle using the Polygon 4.1 software. Time windows representing the phases of gait were created for analysis. Results: At the hip-pelvis level, OA reduce their pelvic obliquity motion and increase hip abduction. At the knee level OA reduce movements in the frontal plane during the plantar support and half swing phases. At the ankle level OA reduce their maximum ranges of plantar flexion, during the toe-off and final swing phases. Conclusions: At a controlled speed, kinematic changes observed in OA allow an increase in body support base to maintain gait stability.

Virtual movement of the ankle and subtalar joints using cadaver surface models / Movimiento virtual de las articulaciones talocrural y subtalar utilizando modelos de superficie de cadáveres

Medical students in the dissection room do not fully understand the ankle joint for dorsiflexion and plantar flexion as well as the subtalar joint for inversion and eversion. Thus, a three-dimensional simulation of the movements would be beneficial as a complementary pedagogic tool. The bones and five muscles (tibialis anterior, tibialis posterior, fibularis longus, fibularis brevis, and fibularis tertius) of the left ankle and foot were outlined in serially sectioned cadaver images from the Visible Korean project. The outlines were verified and revised; and were stacked to build surface models using Mimics software. Dorsiflexion and plantar flexion were simulated using the models on Maya to determine the mediolateral axis. Then, inversion and eversion were done to determine the anteroposterior axis. The topographic relationship of the two axes with the five affecting muscles was examined to demonstrate correctness. The models were placed in a PDF file, with which users were capable of mixed display of structures. The stereoscopic image data, developed in this investigation, clearly explain ankle movement. These graphic contents, accompanied by the sectioned images, are expected to facilitate the development of simulation for the medical students' learning and the orthopedic surgeons' clinical trial.

Los estudiantes de medicina en la sala de disección no entienden completamente la dorsiflexión y flexión plantar de la articulación talocrural, así como la inversión y eversión de la articulación subtalar. Por tanto, la simulación 3D de estos movimientos resultaría beneficiosa como herramienta pedagógica complementaria. Los huesos y cinco músculos (tibial anterior, tibial posterior, fibular largo, fibular corto y fibular tercero), se describen en imágenes del proyecto "Visible Korean", de cadáveres seccionados en serie. Los contornos fueron verificados, revisados, y agrupados para construir modelos de superficie utilizando el programa Mimics. Los movimientos de dorsiflexión y flexión plantar fueron simulados utilizando los modelos generados en el programa Maya, para determinar el eje mediolateral. La inversión y eversión se realizó para determinar el eje anteroposterior. Se examinó la relación topográfica de los dos ejes con los cinco músculos estudiados para demostrar la exactitud de movimientos. Los modelos fueron colocados en un archivo PDF, mediante el cual los usuarios fueron capaces de obtener una visualización combinada de las estructuras. Los datos procedentes de imágenes estereoscópicas, obtenidos en esta investigación, permiten explicar claramente el movimiento de las articualciones talocrural y subtalar. Estos contenidos gráficos, acompañados de las imágenes seccionadas, facilitarán el desarrollo de la simulación en el aprendizaje de los estudiantes y su uso en ensayos clínicos por parte de cirujanos ortopédicos.

Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls.Objective:To compare the performance of young and active elderly adults in three proprioceptive tests.Method:Twenty-one active elderly participants (66.9±5.5 years) and 21 healthy young participants (24.6±3.9 years) were evaluated in the following tests: perception of position of the ankle and hip joints, perceived force level of the ankle joint, and two-point discrimination of the sole of the foot.Results:No differences (p>0.05) were found between groups for the joint position and perceived force level. On the other hand, the elderly participants showed lower sensitivity in the two-point discrimination (higher threshold) when compared to the young participants (p < 0.01).Conclusion:Except for the cutaneous plantar sensitivity, the active elderly participants had maintained proprioception. Their physical activity status may explain similarities between groups for the joint position sense and perceived force level, however it may not be sufficient to prevent sensory degeneration with aging.

Isokinetic analysis of ankle and ground reaction forces in runners and triathletes

OBJECTIVE: To analyze and compare the vertical component of ground reaction forces and isokinetic muscle parameters for plantar flexion and dorsiflexion of the ankle between long-distance runners, triathletes, and nonathletes. METHODS: Seventy-five males with a mean age of 30.26 (±6.5) years were divided into three groups: a triathlete group (n=26), a long-distance runner group (n = 23), and a non-athlete control group. The kinetic parameters were measured during running using a force platform, and the isokinetic parameters were measured using an isokinetic dynamometer. RESULTS: The non-athlete control group and the triathlete group exhibited smaller vertical forces, a greater ground contact time, and a greater application of force during maximum vertical acceleration than the long-distance runner group. The total work (180º/s) was greater in eccentric dorsiflexion and concentric plantar flexion for the non-athlete control group and the triathlete group than the long-distance runner group. The peak torque (60º/s) was greater in eccentric plantar flexion and concentric dorsiflexion for the control group than the athlete groups. CONCLUSIONS: The athlete groups exhibited less muscle strength and resistance than the control group, and the triathletes exhibited less impact and better endurance performance than the runners.

effect of cryotherapy on the normal ankle joint position sense

To determine whether a fifteen-minute water immersion treatment affects the normal ankle joint position sense [JPS] at the middle range of dorsiflexion and plantar flexion actively and passively. Thirty healthy female volunteers aged between 18 and 30 years were treated by a 15-minute cryotherapy [6 +/- 1°C]. The subject's skin temperature over antromedial aspect of dominant ankle was measured by the Mayomed device before, immediate and 15 minutes after water immersion. Ankle JPS was tested trough the pedal goniometer at 3 stages similar to the skin temperature. ANOVA [a = 0.05] was performed on each of variables using SPSS 19.0 software. Skin temperature was seen to decrease after water immersion but subjects did not return to pre-test skin temperature after 15 minutes [P<0.001]. The research found no significant difference in JPS at middle range of dorsiflexion and plantar flexion actively and passively before and after cryotherapy. These findings suggest that 15-minute water immersion at 6°C dose not significantly alter the middle range of plantar flexion/ dorsiflexion JPS at the ankle and is not deleterious to JPS

Respostas cardiovasculares durante avaliação muscular isocinética em claudicantes / Cardiovascular responses during isokinetic muscle assessment in claudicant patients

FUNDAMENTO: A dinamometria isocinética tem tido crescente importância para avaliação da função muscular em indivíduos com claudicação intermitente. No entanto, ainda há escassez de informações sobre as respostas cardiovasculares desses doentes durante este tipo de avaliação. OBJETIVO: Avaliar e comparar as respostas cardiovasculares na avaliação da força e resistência muscular de dois exercícios comumente utilizados para de pacientes com CI (flexão plantar/dorsiflexão e flexão/extensão de joelhos). MÉTODOS: Dezessete claudicantes com doença estável há pelo menos 6 meses compuseram a amostra avaliada no dinamômetro isocinético. Frequência cardíaca, pressão arterial e duplo produto foram mensurados não invasivamente em repouso e no pico do esforço, em protocolos específicos para avaliação de força e resistência muscular. RESULTADOS: Com exceção da pressão arterial diastólica, a frequência cardíaca, pressão arterial sistólica e o duplo produto aumentaram durante o exercício em comparação ao repouso (p < 0,05). A frequência cardíaca e o duplo produto sofreram maior elevação durante o exercício de extensão/flexão de joelho, em comparação ao exercício de flexão plantar/dorsiflexão (P < 0,05). Maiores incrementos na frequência cardíaca foram observados durante o protocolo de avaliação da resistência em comparação ao da avaliação da força muscular. CONCLUSÃO: Os testes isocinéticos de avaliação da força e resistência musculares em pacientes com CI promovem aumento da frequência cardíaca, da pressão arterial sistólica e do duplo produto durante sua execução. Estes aumentos são maiores nos testes de resistência muscular e nos que envolvem maior massa muscular, sugerindo que testes de força de pequenos grupamentos musculares promovem menor sobrecarga cardiovascular nesses pacientes.

BACKGROUND: Isokinetic dynamometry is becoming increasingly important for the assessment of muscle function in individuals with intermittent claudication. However, there is still little information available about the cardiovascular responses of these patients during this type of assessment. OBJECTIVE: To assess and compare the cardiovascular responses recorded during the assessment of muscle strength and endurance for two exercises commonly used in patients with IC (plantar flexion/dorsiflexion and knee flexion/extension). METHODS: The sample consisted of 17 claudicant patients with stable disease for at least 6 months. During the isokinetic dynamometer testing, non-invasive measurements of heart rate, blood pressure and double product at rest and at peak exertion were obtained according to specific protocols established for muscle strength and endurance assessment. RESULTS: Except for diastolic blood pressure, heart rate, systolic blood pressure and double product values rose during the exercise compared to the resting stage (p < 0.05). Elevations in heart rate and double product values were higher during knee extension/flexion than during plantar flexion/dorsiflexion (p < 0.05). Increases in heart rate were also higher during the endurance assessment protocol than during muscle strength assessment. CONCLUSION: Isokinetic strength and endurance testing in patients with IC results in elevation of heart rate, systolic blood pressure and double product values during the exercises. These increases are higher during the muscle endurance exercises and in those involving greater muscle mass, suggesting that strength testing of small muscle groups causes less cardiovascular overload in these patients.

Fatores preditivos da marcha em pacientes diabéticos neuropático e não neuropáticos / Predictive factors of gait in neuropathic and non-neurophatic diabetic patients

OBJETIVO: Analisar a amplitude de movimento do tornozelo e as forças de reação vertical do solo envolvidas na marcha de pacientes portadores de diabetes com e sem neuropatia periférica. CASUÍSTICA E MÉTODO: 36 indivíduos divididos em três grupos: Controle - GC: 10 indivíduos sem diabetes, Diabetes - GD: 10 indivíduos portadores de diabetes sem neuropatia periférica e Neuropatia - GDN: 16 indivíduos portadores de diabetes e neuropatia diabética periférica. Foi realizada análise da marcha - AMTI® OR6/6, e da amplitude de movimento articular tíbio-társica - Sistema Vicom 640® - de todos os participantes. RESULTADOS: O primeiro e segundo pico de força vertical de reação do solo são maiores no grupo Neuropatia e a amplitude de movimento articular do tornozelo é menor nos grupos Diabetes e Neuropatia. CONCLUSÃO: A amplitude de movimento da articulação tíbio-társica está diminuida nos diabetéticos, independente da presença ou ausência de neuropatia periférica, e os diabéticos com neuropatia periférica, apresentaram aumento no primeiro e no segundo pico da força de reação vertical do solo durante a marcha.

OBJECTIVE: The purpose of this study was to analyze the range of movement of the ankle and the vertical ground reaction force involved in gait among diabetic patients with and without peripheral neuropathy. SAMPLE AND METHOD: 36 individuals were divided into three groups: Control group - CG: 10 individuals without diabetes, Diabetic group - DG: 10 individuals with diabetes without peripheral neuropathy and Neuropathy, and Diabetic neuropathic group - DNG: 16 individuals with diabetes and peripheral diabetic neuropathy. Gait - AMTI® OR6/6m and range of tibiotarsal joint movement - System Vicom 640® was carried out in all the participants. RESULTS: The first and second vertical ground reaction force peaks were statistically higher in the neuropathy group, and the range of ankle motion was lower in the Diabetes and Neuropathy groups. CONCLUSION: The range of movement of the tibiotarsal joint is lower in diabetics, regardless of the presence or absence of peripheral neuropathy, and diabetics with peripheral neuropathy show an increase in the first and second vertical ground reaction force peaks during walking.

pattern of modulation of short latency reflex linking the pretibial muscles to the knee extensors during gait in human

To find out pattern of modulation of heteronymous reflex linking the pretibial muscles to quadriceps motoneurones in normal subjects during treadmill walking. A non-randomized quasi-experimental study was performed in ten cases in Shahid Beheshti University [MC] Tehran, Iran, from September 2006 to August 2007. The reflex was elicited by applying stimuli of three time's motor threshold in tibialis anterior to common peroneal nerve at several instants of gait cycle. Surface EMGs from tibialis anterior, vastus medialis and rectus femoris of the right leg was used to measure the intensity of the muscular activity and the magnitude of the reflex. The data were analysed by Pearson test for the strength of their correlation. The reflex showed a significant correlation with the intensity of contraction in quadriceps especially during the early stance phase. The correlation was poor during transition period from stance to swing where rectus femoris showed a small peak of activity. The peak of activity in tibialis anterior was on average 69 +/- 21 ms preceded that of quadriceps. This precedence of activity in tibialis anterior and the strong presence of the reflex during the early stance phase may indicate a positive feed-forward effect from ankle flexor afferents to quadriceps

Estudo comparativo dos parâmetros angulares da marcha humana em ambiente aquático e terrestre em indivíduos hígidos adultos jovens / Comparative study of the angular parameters of human gait in water and land media in young higid adults

Há um grande interesse em estudar o movimento humano dentro da água, uma vez que o meio já é utilizado para treinamento e reabilitação devido às diferentes propriedades mecânicas que oferece. No entanto, há uma carência de estudos sobre as características biomecânicas do andar em ambiente aquático. O presente estudo teve como objetivo determinar as variáveis angulares do joelho e tornozelo da marcha em ambiente aquático, e compará-las com o ambiente terrestre. Fizeram parte deste estudo dezenove adultos do sexo masculino, saudáveis, com média de idade de 24 anos. Os indivíduos caminharam em ambiente terrestre e em seguida no ambiente aquático com a água ao nível do processo xifóide do esterno, com velocidade auto-selecionada e confortável. Para a coleta de dados foi utilizada a cinemetria. As variáveis angulares analisadas apresentaram diferenças significativas em ambiente aquático quando comparadas com as do ambiente terrestre. Os resultados encontrados neste estudo contribuem para um melhor entendimento do andar no AA no contexto de treinamento e reabilitação.

There is a great interest to study the human movement under water, once it is a means has been utilized as an alternative way for both training and rehabilitation value owing to different mechanical proprieties it offers. However, there is some information about the biomechanical characteristics of shallow water walking. For collection of the data the cinemetry was used. The present study aims purpose the determination angular characteristics knee and ankle during walking in water and comparing it to the standard of the gait done on land. They were part of this nineteen healthy adults of the sex male with mean 24 years. The individuals walked on land and water with xiphoid process level, with self-selected comfortable walking speeds. The variables joint angles investigated was differences considerably between in shallow water on land. The results in the present study contribute to a better understanding of this activity in the context of training and rehabilitation.

Correlation between body mass index and postural balance

OBJECTIVE: To evaluate the correlation between body mass index (BMI) and postural balance in unipodal support. METHOD: 40 males, age 26 ± 5 yrs, body mass 72.3 ± 11 kg, height 176 ± 6 cm and BMI 23.3 ± 3.2 kg/m², were submitted to functional stability tests using the Biodex® Balance System (stability evaluation protocol level 2, which allows an inclination of up to 20° in the horizontal plane in all directions) to compare stability with BMI. RESULTS: The general stability index showed a correlation between BMI and postural balance - measured as imbalance (R=0.723-dominant side and R=0.705-non-dominant side). The anteroposterior stability index - measured as instability - showed correlations on the dominant (R=0.708) and non-dominant side (R=0.656). Lateral instability showed a correlation on the dominant side (R=0.721) and non-dominant side (R=0.728). The comparison of the balance indexes for dominant and non-dominant sides showed no statistically significant differences. CONCLUSION: High BMI demands more displacements to maintain postural balance.

OBJETIVO: Avaliar a correlação entre o índice de massa corporal (IMC) e o equilíbrio postural no suporte unipodal. MÉTODOS: 40 homens, idade: 26 ± 5 anos, massa corporal: 72.3 ± 11 kg, altura: 176 ± 6 cm and IMC: 23.3 ± 3.2 kg/m² foram submetidos a testes funcionais de estabilidade corporal usando o Biodex Balance System (protocolo de avaliação nível 2, que permite uma inclinação acima de 20° no plano horizontal em todas as direções, índice que foi comparado ao IMC RESULTADOS: O índice de estabilidade geral - medido como instabilidade - mostrou correlação entre IMC e o equilíbrio postural (R=0.723- lado dominante) e (R=0.705 - lado não dominante). O índice de estabilidade ântero-posterior e médio-lateral mostraram correlação no lado dominante (R=0.708 e R=0728) e não dominante (R=0.656 e R=0,721). A comparação entre os indices do lado dominante e não dominante não mostrou diferença estatística. CONCLUSÃO: IMC alto exige maior deslocamento corporal para manter o equilíbrio postural.

Estudo eletromiográfico comparativo de movimentos de facilitaçäo neuromuscular proprioceptiva com os realizados nos planos sagital / Comparative eletromyographic study of movements of proprioceptive neuromuscular facilitation with the realized in sagittal planes

O objetivo deste estudo foi comparar a atividade eletromiográfica dos músculos semitendinosus (SEMI) e bíceps femuris (caput logum) - (BCCL) aos 30§, 60§ e 90§ de flexão do joelho durante movimentos realizados no plano igual, que caracterizam os padrões do Facilitação Neurouscular Proprieceptiva - FNP (Kabat), e os movimentos realizados no plano sagital comumente indicados para reabilitação e treinamento. Estes movimentos foram realizados com e sem aplicação de resistência mecânica por meio do Sistema de Polias Duplas e os graus foram registrados por eletrogoniômetro. Os padrões de movimento no plano diagonal foram: 1) extensão, abdução, rotação medial do quadril, flexão do joelho, flexão plantar com eversão do tornozelo, flexão e adução dos dedos; 2) extensão, adução e rotação lateral do quadril, com flexão do joelho, flexão plantar com inversão do tornozelo, flexão e adução dos dedos. Em ambos os movimentos o voluntário estava em decúbito dorsal. O movimento realizado no plano sagital foi: flexão do joelho com o voluntário posicionado em decúbito ventral. No delineamento estatístico foi verificado os fatores: movimento; carga: sem (L) e com (C); e ângulo: 30§, 60§ e 90§. Para cada um dos músculos, separadamente, foi efetuada Analise de Variância. A interação entre estes fatores foi detalhada para verificar diferenças entre níveis de um fator em cada nível do outro. Nestes casos, calculou-se a DMS para contrastes entre pares de médias pelo método de TUKEY. Os resultados obtidos foram: Efeito de movimento: (M1= M2) < M3, p

Estabilidade do tornozelo após ressecçäo do terço distal da fíbula: estudo de dois casos / Ankle stability after distal third fibula resection: study of 2 cases

Neste trabalho, a estabilidade lateral do tornozelo foi avaliada após ressecçao do terço distal da fíbula por sarcoma de Ewing, sem reconstruçao de nenhum dos elementos estabilizadores laterais. A técnica utilizada pelos autores foi comparada com as de reconstruçao lateral do tornozelo quanto à estabilidade, mostrando-se ser procedimento confiável, simples e de baixa morbidade. O seguimento pós-operatório de dois pacientes (cinco anos e nove meses e dois anos e oito meses) mostrou funçao satisfatória e estabilidade plena do tornozelo.

Fisioterapia em clínica de cirurgia vascular: resultados preliminares / Physical therapy in vascular surgery: preliminary results

A prática da fisioterapia no Brasil expandiu-se muito desde a sua implantaçao no começo do século e desde entao novos campos de atuaçao foram sendo criados. Devido às alteraçoes funcionais decorrentes dos distúrbios circulatórios, houve a necessidade da implantaçao dos serviços de fisioterapia na área da cirurgia vascular e angiologia. Sendo a insuficiência venosa crônica uma patologia que pode levar a incapacidade funcionais com comprometimento das atividades de vida diária, a fisioterapia, através da abordagem cinesioterápica por meio de alongamento de cadeias musculares, exercícios respiratórios e mobilizaçao global, tem papel importante na reeducaçao da funçao vascular dos pacientes portadores desta patologia. Participaram da fase de implantaçao deste serviço dez pacientes do sexo feminino com diagnóstico de insuficiência venosa crônica, submetidos à avaliaçao e tratamento fisioterápico. As variáveis edema, amplitude de movimento e dor foram comparadas antes e após o tratamento. Os resultados obtido sugerem uma melhora do quadro álgico, do edema e mobilidade articular dos pacientes, mostrando ser a fisioterapia um recurso importante para a melhora da qualidade de vida destes pacientes.

Luxofracturas del cuello del pie / Luxofractures of the foot's neck

Con el proposito de identificar un procedimiento quirurgico efectivo para el manejo de las luxofracturas del cuello del pie, restableciendo su mecanica en un tiempo minimo y evitando secuelas (rigidez articular, atrofia muscular y artrosis postraumatica) se revisan la evolucion del manejo medico y operatorio y la anatomia funcional de la articulacion. Se estudian 42 casos que llegaron al servicio de urgencias desde enero de 1980 hasta enero de 1982: 30 hombres y 12 mujeres entre 15 y 61 anos, con luxofractura de cuello del pie por trauma. El 33.3 por ciento en eversion y el 47.6 por ciento en aduccion-inversion. 4 de ello tenian traumas multiples asociados. En el examen de ingreso se buscaron lesiones cutaneas que contraindicaran la cirugia inmediata. Por Rx se descartaron arrancamientos corticales y fx. marginales y se clasificaron las lesiones segun los criterios de Weeber-Dannis. 7 pacientes tuvieron fracturas sindesmales que se redujeron quirurgicamente y se fijaron con tornillo de esponjosa 4mm; 16, presentaron fx transidesmales que fueron reducidas de manera similar y se fijaron con tornillos de cortical de 3.5mm o con placa de tercio de cana aplicando compresion interfragmentaria; 19 con fx srprasindesmales se manejaron con la misma tecnica complementada con tornillo de situacion. Todos se inmovilizaron con ferula posterior corta de yeso, recibieron antibioticos profilacticos y medidas antiedema. Permanecieron hospitalizados de 3 - 5 dias, a los 20 dias iniciaron movimientos activos con apoyo parcial y se retiro el material de osteosintesis antes de permitir apoyo total (6 sem). Los resultados fueron satisfactorios clinica y ..