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1.
Fisioter. Bras ; 22(3): 306-317, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1284264

ABSTRACT

Introdução: As características morfológicas do pé sugerem desalinhamento dos membros inferiores, tornando praticantes de corrida mais susceptíveis a dor e lesões. Objetivo: Analisar a prevalência de dor e comparar as características morfológicas dos pés e alinhamento do retropé entre corredoras com sintomas no joelho e assintomáticas. Métodos: Estudo caso-controle, exploratório com abordagem quantitativa, com 31 mulheres corredoras. A presença de dor e lesões foi avaliada por meio de um questionário padronizado. A morfologia dos pés foi realizada através da inspeção, com registros fotográficos no plano posterior e o arco longitudinal do pé foi analisado através de podometria de pressão. Os dados foram analisados pelo SPSS versão 18.0. Na comparação das médias das variáveis dos ângulos de retropé foi utilizado o teste t Student para amostras independentes, considerando o p < 0,05. Resultados: Observouse que 86% das mulheres relataram sintoma predominante no joelho (64,51%). Na análise das características morfológicas dos pés, encontrou-se predomínio do tipo rebaixado e assimetria dos retropés no grupo sintomático. Conclusão: Apenas a assimetria entre os membros e as caraterísticas morfológicas do pé apresentam associação com a presença de dor no joelho. (AU)


Introduction: The morphological characteristics of foot suggests lower limbs misalignment, making street runners more susceptible to pain. Objective: To compare the morphological characteristics of the foot and rearfoot alignment between runners with or without knee symptoms, as well as to analyze the prevalence of pain. Methods: Case-control, exploratory and quantitative approach study, with 30 female runners. The presence of pain and lesions was evaluated by a standardized questionnaire. Foot morphology was analyzed through inspection, with photographic records in the posterior plane, and the longitudinal arch of the foot was measured by pressure podometry. The data were analyzed by SPSS 18.0. In the comparison of the means of the variables of the hindfoot angles, the Student t test was used for independent samples, considering p < 0.05. Results: We observed that 86% of the women reported a symptom, predominant in the knee (64.51%). In the analysis of the foot morphological characteristics, we found a predominance of the recessed type and asymmetry of the symptomatic group backs. Conclusion: Asymmetry between the limbs and morphological features of the foot are associated with knee pain. (AU)


Subject(s)
Humans , Female , Pain , Running , Foot , Knee , Ankle
2.
Rev. bras. med. esporte ; 27(2): 218-224, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1280073

ABSTRACT

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .


RESUMEN Introducción: El uso de órtesis de tobillo reduce el riesgo de lesiones en el tobillo en jugadores de baloncesto. Sin embargo, los mecanismos de protección de lesión proporcionados por las órtesis durante el juego de baloncesto aún son desconocidos. Objetivos: Analizar el efecto del uso de órtesis de tobillo lace-up (con cordón) y de un protocolo de ejercicio que simuló la intensidad del juego de baloncesto sobre la fuerza de reacción del suelo (FRS) durante saltos verticales específicos del baloncesto. Métodos: Once jugadores de baloncesto del sexo masculino con menos de 18 años realizaron 48 saltos verticales, con y sin órtesis de tobillo, durante un protocolo de ejercicios compuesto por cuatro períodos de 10 minutos, que simularon el perfil de actividad e intensidad del juego de baloncesto, así como los intervalos típicos entre los períodos. Las FRS mediolaterales (variables: mayores picos medial y lateral) y verticales (variables: pico vertical, pico de impulso, impulso en 50 ms de aterrizaje, tasa de sobrecarga y altura del salto) fueron medidas durante las fases de despegue y aterrizaje de todos saltos realizados en el protocolo de ejercicio. Resultados: El uso de órtesis redujo la FRS mediolateral en todos los períodos analizados, durante las fases de despegue y aterrizaje (P < 0,05), sin afectar la FRS vertical (P > 0,05). La FRS mediolateral y vertical (picos mediolateral y vertical de despegue, picos mediolaterales de aterrizaje, pico de impulso de aterrizaje, tasa de sobrecarga en el despegue y aterrizaje) aumentaron significativamente durante cuatro períodos subsiguientes de 10 minutos (P < 0,05). Sin embargo, para la FRS mediolateral, el aumento a lo largo del tiempo fue mayor sin el uso de órtesis. Conclusiones: El uso de órtesis de tobillo redujo la FRS mediolateral en el miembro inferior, mientras que hubo un aumento progresivo de la carga externa aplicada al cuerpo durante los saltos en los períodos subsiguientes del protocolo de ejercicios con la misma intensidad del juego de baloncesto. Nivel de evidencia I; Ensayo clínico aleatorizado.


RESUMO Introdução: O uso de órtese de tornozelo reduz o risco de lesões no tornozelo em jogadores de basquetebol. No entanto, os mecanismos de proteção de lesão fornecidos pelas órteses durante o jogo de basquetebol ainda são desconhecidos. Objetivos: Analisar o efeito do uso de órtese de tornozelo lace-up (com cordão) e de um protocolo de exercício que simulou a intensidade do jogo de basquetebol sobre a força de reação do solo (FRS) durante saltos verticais específicos do basquetebol. Métodos: Onze jogadores de basquetebol do sexo masculino com menos de 18 anos realizaram 48 saltos verticais, com e sem órtese de tornozelo, durante um protocolo de exercícios composto por quatro períodos de 10 minutos, que simularam o perfil de atividade e intensidade do jogo de basquetebol, assim como os intervalos típicos entre os períodos. As FRSs mediolaterais (variáveis: maiores picos medial e lateral) e verticais (variáveis: pico vertical, pico de impulso, impulso em 50 ms da aterrissagem, taxa de sobrecarga e altura do salto) foram medidas durante as fases de decolagem e aterrissagem de todos os saltos realizados no protocolo de exercício. Resultados: O uso de órtese reduziu a FRS mediolateral em todos os períodos analisados, durante as fases de decolagem e aterrissagem (P < 0,05), sem afetar a FRS vertical (P > 0,05). A FRS mediolateral e vertical (picos mediolateral e vertical de decolagem, picos mediolaterais de aterrissagem, pico de impulso de aterrissagem, taxa de sobrecarga na decolagem e aterrissagem) aumentaram significativamente durante quatro períodos subsequentes de 10 minutos (P < 0,05). No entanto, para a FRS mediolateral, o aumento ao longo do tempo foi maior sem o uso de órtese. Conclusões: O uso de órtese de tornozelo reduziu a FRS mediolateral no membro inferior, enquanto houve um aumento progressivo da carga externa aplicada ao corpo durante os saltos nos períodos subsequentes do protocolo de exercícios com mesma intensidade do jogo de basquetebol. Nível de evidencia I; Estudo clínico randomizado .


Subject(s)
Humans , Male , Adolescent , Sprains and Strains/prevention & control , Basketball , Braces , Ankle Injuries/prevention & control , Biomechanical Phenomena , Ankle/physiology
3.
Rev. bras. ortop ; 56(2): 235-243, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1251356

ABSTRACT

Abstract Objective The present study aims to evaluate the prevalence of foot and ankle pain complaints, radiographic parameters, and functional performance in subjects with severe obesity (body mass index [BMI] > 40) who are candidates to bariatric surgery. Methods Forty severely obese patients were evaluated at a bariatric surgery outpatient facility. These severely obese subjects (BMI > 40) were divided into two subgroups: those with BMI < 50 (n = 24) and BMI > 50 (n = 16). These patients were compared with a control group of 42 volunteers with a mean BMI value of 24. The following parameters were assessed: foot pain (according to the visual analog scale [VAS]), functional performance (according to the American Orthopeadic Foot and Ankle Society [AOFAS] scale, including forefoot, midfoot and hindfoot domains), age, gender, hallux metatarsal-phalangeal angle, hallux intermetatarsal angle, talocalcaneal angle, calcanean pitch angle and Meary angle. Results Incidence of foot pain was higher in the severely obese group compared with the control group (p < 0.0001; odds ratio [OR]: 4.2). Functional performance according to the AOFAS scale was lower in obese subjects compared with the control group (p < 0.0001; OR for hindfoot, 4.81; OR for midfoot, 3.33). Conclusion The incidence of foot pain was higher in the group of severely obese patients compared with the control group. According to the AOFAS scale, functional forefoot, midfoot and hindfoot performance was worse in severely obese individuals.


Resumo Objetivo Avaliar a prevalência de queixas álgicas no pé e tornozelo, parâmetros radiográficos e o desempenho funcional de indivíduos com obesidade grave, Índice de Massa Corpórea (IMC) com valor > 40 e indicação de cirurgia bariátrica. Métodos Foram avaliados 40 pacientes com obesidade grave acompanhados em ambulatório de cirurgia bariátrica. Este grupo de obesos graves (IMC > 40) foi subdividido em dois subgrupos: obesos com IMC < 50 (n = 24); e outro de obesos com IMC > 50 (n = 16). Foi realizada comparação com grupo controle de 42 indivíduo voluntários com IMC médio de 24. Foram avaliados a presença de dor no pé pela escala visual (EVA), o desempenho funcional pela escala da Associação Americana de Cirurgia do Pé e Tornozelo (AOFAS, na sigla em inglês) (domínios antepé, mediopé e retropé), idade, gênero, ângulo (âng) metatarso-falangeano do hálux, âng intermetatarsal do hálux , âng talocalcaneano, "pitch" calcaneano e âng de Meary. Resultados Foi observada maior incidência de dor no pé no grupo de obesos graves em relação ao controle (p < 0,0001, razão de chances [odds ratio, OR]: 4,2). O desempenho funcional pela escala AOFAS foi inferior no grupo de obesos em relação ao controle (p < 0,0001, retropé com OR = 4,81; mediopé com OR = 3,33). Conclusão Houve maior incidência de dor no pé no grupo de obesos graves em relação ao controle. Houve pior desempenho funcional pela escala AOFAS nas regiões do antepé, mediopé e retropé no grupo de obesos graves.


Subject(s)
Pain , Foot , Ankle , Obesity
4.
Article in Chinese | WPRIM | ID: wpr-879254

ABSTRACT

The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.


Subject(s)
Ankle , Ankle Joint , Biomechanical Phenomena , Humans , Knee Joint , Lateral Ligament, Ankle , Male , Tai Ji
5.
Article in Chinese | WPRIM | ID: wpr-877617

ABSTRACT

The origin and basis of wrist-ankle acupuncture were discussed based on the theory of


Subject(s)
Acupuncture Points , Acupuncture Therapy , Ankle , Books , Silk , Wrist
6.
Clinics ; 76: e2803, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278922

ABSTRACT

OBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3±9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners' group (HRG, n=24), and non-runners' group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer. RESULTS: The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120°/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG. CONCLUSION: Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Achilles Tendon , Tendinopathy , Biomechanical Phenomena , Cross-Sectional Studies , Muscle, Skeletal , Torque , Muscle Strength , Ankle , Ankle Joint
7.
Article in Chinese | WPRIM | ID: wpr-879386

ABSTRACT

OBJECTIVE@#To explore clinical effects of single-tunnel pullout structure fixation and anatomical reconstruction of lateral ligament complex in treating chronic lateral ankle instability.@*METHODS@#From January 2016 to December 2018, clinical data of 23 patients with chronic lateral malleolus instability who underwent anatomical reconstruction of lateral malleolus ligament complex with single-tunnel pullout structure fixation, were retrospectively studied. Among them, including 7 males and 16 females, aged from 17 to 33 years old with an avergae of (26.0±4.3) years old;16 patients classified to grage 0, and 7 patients classified to gradeⅠaccording to Kellgren-Lawrence(K-L) grading;the time of sprain ranged form 2 to 15 with an average of (5.7±2.9) times;the time from injury to operation ranged to 4 to 18 months with an average of (9.0±3.3) months. The range of movement of operative and uninjured ankle joints were measured at 24 months after opertaion, visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate ankle joint function and improvement of pain, K-L grading and MRI scoring of osteoarthritis of ankle (MSOA) were used to evaluate degree of cartilage degeneration of ankle joint.@*RESULTS@#All patients were followed up from 24 to 48 months with an average of (33.4±6.7) months. All the anterior talofibular ligaments and calcaneofibular ligaments were dissected and reconstructed by single-tunnel pullout structure fixation. The range of motion of dorsiflexion, plantarflexion, varus, and valgus on the operative side of ankle joint were smaller than those on the healthy side. There were no statistically differences in dorsiflexion and eversion between operative side and healthy side of ankle joint (@*CONCLUSION@#Treatment of chronic lateral ankle instability with reconstruction of lateral ligament complex with single-tunnel pullout structure fixation could provide better tendon and bone healing conditions, improve surgical safety and could achieve satisfactory clinical outcomes.


Subject(s)
Aged , Ankle , Ankle Joint/surgery , Female , Humans , Infant , Joint Instability/surgery , Lateral Ligament, Ankle/surgery , Male , Retrospective Studies
8.
Rev. bras. ortop ; 55(5): 620-624, Sept.-Oct. 2020. tab
Article in English | LILACS | ID: biblio-1144222

ABSTRACT

Abstract Objective To verify the applicability and agreement of the Ottawa ankle rules applied by medical students and orthopedic residents in a tertiary trauma service thus validating the Ottawa protocol for use on Brazilian soil. Prospective This was a prospective study, conducted in a tertiary hospital, including all patients with acute torsial trauma of the tibiotarsal joint. The patients underwent ankle and/or foot radiographs, and the questionnaire with the Ottawa ankle rules was applied by academics and, subsequently, by residents. The radiographs were evaluated by on-call orthopedists and specialist in foot and ankle, and the expert opinion was considered the gold standard for analysis. Results Two hundred and sixty-three patients were evaluated, and, after application of the established inclusion criteria, 226 cases remained for evaluation. The sensitivity to detect lesions and negative predictive value (NPV) was 100%. The most sensitive test with higher NPV for both academics and residents was palpation of the lateral malleolus. The study presented potential for a reduction of 30% in the total number of tests requested. Conclusion The data showed applicability and agreement between academics and residents, which allows for the validation of the Ottawa protocol in emergency care in Brazil.


Resumo Objetivo Verificar a aplicabilidade e a concordância das regras do tornozelo de Ottawa aplicadas por estudantes de medicina e residentes de ortopedia em um serviço de trauma terciário, validando assim as regras de Ottawa para utilização em solo brasileiro. Método Estudo prospectivo, realizado em um hospital terciário, incluindo todos os pacientes com trauma torcional agudo da articulação tibiotársica. Os pacientes realizaram radiografias de tornozelo e/ou pé, tendo sido aplicado o questionário com as regras do tornozelo de Ottawa por acadêmicos e, na sequência, por residentes. As radiografias foram avaliadas por ortopedistas plantonistas e especialista em pé e tornozelo, sendo a opinião do especialista considerada padrão-ouro da análise. Resultados Foram avaliados 263 pacientes e, após aplicados os critérios de inclusão estabelecidos, restaram para a avaliação 226 casos. A sensibilidade para detectar lesões e o valor preditivo negativo (VPN) foi de 100%. O teste mais sensível e com maior VPN para ambos, acadêmicos e residentes, foi a palpação do maléolo lateral. O estudo apresentou potencial de redução de 30% no total de exames solicitados. Conclusão Os dados demostraram aplicabilidade e concordância entre acadêmicos e residentes, o que permite a validação do protocolo de Ottawa nos atendimentos de urgência e emergência no Brasil.


Subject(s)
Humans , Male , Female , Wounds and Injuries , Prospective Studies , Surveys and Questionnaires , Ankle Injuries , Emergency Medical Services , Tertiary Care Centers , Fractures, Avulsion , Foot , Orthopedic Surgeons , Ankle
9.
Int. j. morphol ; 38(4): 894-898, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124872

ABSTRACT

SUMMARY: The Stieda process (SP) and os trigonum (OT) are primary risk factors for posterior ankle impingement syndrome. The aim of this study was to elucidate the prevalence of the elongated lateral tubercle of the posterior talar process (SP) and OT in Turkish subjects using lateral ankle radiographs. In this study, 1088 ankle radiographs in the lateral view were evaluated retrospectively using a picture archiving and communication system at two large medical centers. Subjects with a history of mild-to-moderate trauma were selected from the emergency departments of both hospitals from January to June 2019. Data on the presence of SP and OT, the side of the foot that was evaluated, sex, and age were recorded. The prevalence of SP and OT was 16.7 % and 9.3 %, respectively, in the Turkish population. The prevalence of SP was significantly higher in men (20.3 %) than in women (12.7 %) (p = 0.001). The prevalence of OT was also significantly higher in men (13.7 %) than in women (4.3 %) (p = 0.000). The SP and OT were found in 17 % and 9.9 % of the right feet, respectively, and 16.4 % and 8.6 % of the left feet, respectively, with no statistical difference. Approximately one-fourth of the Turkish population had SP or OT, which made them susceptible to posterior ankle impingement syndrome. The prevalence of SP was higher than that of OT, and both were more common in men than in women.


RESUMEN: El proceso de Stieda (Stieda process) (SP) y el Os trigonum (OT) son factores de riesgo primarios para el síndrome de pinzamiento del tobillo posterior. El objetivo de este estudio fue determinar la prevalencia del tubérculo lateral alargado del proceso talar posterior (SP) y OT en sujetos turcos mediante radiografías laterales de tobillo. Se evaluaron retrospectivamente 1088 radiografías de tobillo con vista lateral, utilizando un sistema de archivo y comunicación de imágenes en dos centros médicos importantes. Los sujetos con antecedentes de trauma leve a moderado fueron seleccionados en las unidades de urgencia de ambos hospitales de enero a junio de 2019. Se registraron datos sobre la presencia de SP y OT, el lado del pie que se evaluó, el sexo y la edad. La prevalencia de SP y OT fue de 16,7 % y 9,3 %, respectivamente, en la población turca. La prevalencia de SP fue significativamente mayor en hombres (20,3 %) que en mujeres (12,7 %) (p = 0,001). La prevalencia de OT también fue significativamente mayor en hombres (13,7 %) que en mujeres (4,3 %) (p = 0,000). El SP y OT se encontraron en 17 % y 9,9 % de los pies derechos, respectivamente, y 16,4 % y 8,6 % de los pies izquierdos, respectivamente, sin diferencia estadística. Aproximadamente un cuarto de la población turca tenía SP u OT, lo que los hizo susceptibles al síndrome de pinzamiento del tobillo posterior. La prevalencia de SP fue mayor que la de OT, y ambos fueron más comun en hombres que en mujeres.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ankle/abnormalities , Ankle/diagnostic imaging , Turkey , Radiography , Talus , Prevalence , Retrospective Studies
10.
Rev. bras. ortop ; 55(3): 367-373, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1138036

ABSTRACT

Abstract Objective The present study aims to describe a new weightbearing radiographic method to visualize the heads of the five metatarsals on the coronal plane, evaluating their accuracy through intraclass correlation coefficients. Methods The subjects were evaluated, with weightbearing, with the ankle at 20 degrees of plantar flexion and the metatarsophalangeal joints at 10 degrees of extension, positioned on a wooden device. Two independent foot and ankle surgeons evaluated the radiography, with one of them doing it twice, at different moments, achieving an inter and intraobserver correlation, with intraclass correlation coefficients. Results We radiographed 63 feet, achieving an interobserver correlation coefficient of the radiographic method for the metatarsal heads heights in the coronal plane of the 1st, 2nd, 3rd, 4th, and 5th metatarsals of, respectively, 0.90, 0.85, 0.86, 0.83, 0.89. The intraobserver correlation coefficient were, respectively, 0.95, 0.93, 0.93, 0.86, 0.92. Conclusion Those correlations demonstrate that the method is accurate and can be used to investigate metatarsal head misalignments in this plane.


Resumo Objetivo Este estudo tem como objetivo descrever um novo método radiográfico com carga fisiológica para visualizar as cabeças dos cinco metatarsos no plano coronal. Métodos Os indivíduos foram radiograficamente avaliados com carga, com o tornozelo a 20º de flexão plantar e as articulações metatarsofalângicas a 10º de extensão, posicionadas em um dispositivo de madeira. As medidas foram aferidas por dois avaliadores independentes, sendo que um deles mediu em dois momentos distintos, obtendo a correlação inter e intraobservador, com o coeficiente de correlação intraclasses. Resultados Examinamos 63 pés, obtendo um coeficiente de correlação interobservador do método radiográfico para as alturas das cabeças dos metatarsos no plano coronal do 1º, 2º, 3º, 4º e 5º metatarsos de, respectivamente, 0,90, 0,85, 0,86, 0,83, 0,89. O coeficiente de correlação intraobservador foi, respectivamente, 0,95, 0,93, 0,93, 0,86, 0,92. Conclusão Essas correlações demonstram que o método é preciso e pode ser usado para investigar os desalinhamentos de cabeça dos metatarsos nesse plano.


Subject(s)
Humans , Forefoot, Human/diagnostic imaging , Metatarsal Bones , Radiography , Metatarsalgia , Equipment and Supplies , Surgeons , Foot Diseases , Ankle , Metatarsophalangeal Joint
11.
Fisioter. Bras ; 21(2): 215-227, Mai 16, 2020.
Article in Portuguese | LILACS | ID: biblio-1282977

ABSTRACT

Introdução: A entorse é definida como uma lesão ligamentar cujo trauma é causado por estiramento ou por ruptura das faixas fibrosas que constituem a estrutura ligamentar, acometendo o complexo articular de tornozelo e pé causado por movimentos bruscos de inversão e eversão. Objetivo: Identificar e analisar através da escala PEDro os ensaios clínicos sobre a aplicação da cinesioterapia como tratamento para indivíduos com entorse de tornozelo. Métodos: Trata-se de uma revisão de literatura na qual foram incluídos estudos do tipo ensaio clínico randomizado e não randomizado, referentes aos anos de 2009 a 2019, que usassem exercícios fisioterapêuticos em seu protocolo. A qualidade metodológica dos estudos foi avaliada com base na escala PEDro. Resultados: Os estudos selecionados utilizaram protocolos fisioterapêuticos contendo exercícios terapêuticos isolados e combinados associados ao treinamento de propriocepção para tratamento de curto a longo prazo da entorse de tornozelo. Conclusão: Para pacientes com entorse de tornozelo, o tratamento deve ser baseado na combinação de diferentes métodos fisioterapêuticos para a obtenção do efeito terapêutico positivo na fase aguda e crônica da lesão. (AU)


Introduction: Sprain is defined as a ligament injury whose trauma is caused by stretching or rupture of the fibrous bands that constitute the ligamentous structure, affecting the ankle and foot joint complex, caused by sudden inversion and eversion movements. Objective: To identify and analyze through the PEDro scale clinical trials on the application of kinesiotherapy as a treatment for individuals with ankle sprains. Methods: This is a literature review that included studies of the randomized and nonrandomized clinical trial, referring to the years 2009 to 2019, that used physical therapy exercises in its protocol. The methodological quality of the studies was assessed based on the PEDro scale. Results: The selected studies used physical therapy protocols containing isolated and combined therapeutic exercises associated with proprioception training for short-term long-term treatment of ankle sprains. Conclusion: For patients with ankle sprains, treatment should be based on the combination of different physical therapy methods to obtain a positive therapeutic effect in the acute and chronic phase of the injury. (AU)


Subject(s)
Humans , Sprains and Strains , Physical Therapy Modalities , Ankle , Kinesiology, Applied , Exercise Therapy
12.
Rev. méd. Chile ; 148(4): 496-499, abr. 2020. tab
Article in English | LILACS | ID: biblio-1127090

ABSTRACT

ABSTRACT Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.


Antecedentes El índice de rigidez arterial ambulatorio (AASI), derivado del monitoreo ambulatorio de presión arterial de 24 h (MAPA), puede ser un buen indicador de rigidez arterial. Objetivo Evaluar la correlación entre el AASI y la velocidad de onda de pulso braquial (VOP), el índice tobillo-brazo (ITB) y el índice vascular cardio-tobillo (CAVI) en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Material y Métodos Estudio transversal en 28 pacientes con diabetes de 49 ± 7 años (40% mujeres). El AASI se calculó como 1 menos la pendiente de regresión de la presión arterial diastólica sobre la sistólica, usando datos del MAPA de 24 h, el cual se midió en el brazo, usando un dispositivo oscilométrico. El ITB se calculó como la razón entre la presión arterial sistólica del tobillo sobre la del brazo. El CAVI se derivó de la velocidad de onda de pulso medida con el dispositivo Vasera VS-1000. Para el análisis estadístico se utilizó el coeficiente de correlación bivariada de Spearman. Resultados Los valores de AASI, VOP, ITB y CAVI fueron 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s y 7.60 ± 1.90, respectivamente. Hubo una correlación negativa significativa entre AASI e ITB (r = -0.491, p < 0.01). Conclusiones Hay una asociación entre AASI, un marcador de rigidez arterial e ITB, un indicador de aterosclerosis, en estos pacientes con diabetes mellitus tipo 2.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arteries/physiopathology , Blood Pressure/physiology , Brachial Artery/physiopathology , Diabetes Mellitus, Type 2/complications , Vascular Stiffness/physiology , Ankle/blood supply , Carotid Arteries/diagnostic imaging , Cross-Sectional Studies , Predictive Value of Tests , Blood Pressure Monitoring, Ambulatory , Diabetes Mellitus, Type 2/blood , Ankle Brachial Index , Pulse Wave Analysis
13.
Int. j. morphol ; 38(2): 472-476, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1056464

ABSTRACT

El ligamento tibiofibular anterior suele presentar un fascículo distal independiente de la banda principal, denominado fascículo distal del ligamento tibiofibular anterior (FD-LTFA). Este discurre oblicuamente, cubriendo sus fibras más inferiores la zona anterolateral de la articulación talocrural. Su presencia se asocia a pellizcamiento del tobillo en esta zona, el cual puede producir un desgaste cartilaginoso de la cara anterolateral de la tróclea talar. El propósito de este estudio fue determinar la presencia y biometría del FD-LTFA, y su relación con la troclea talar en tobillos de un grupo de individuos Chilenos. En este estudio se utilizaron 30 miembros inferiores de cadáveres de individuos adultos. Se evaluó en el fascículo distal: Ancho en la inserción tibial, ancho en la inserción fibular, longitud del margen superior, longitud del margen inferior y el espesor. Se determinó si había contacto talar por parte del FD-LTFA y se observó desgaste articular en la superficie del domo talar, a nivel de la región de contacto del mencionado ligamento. El FD-LTFA fue encontrado en un 76,7 % de los casos, su anchura a nivel del sitio de fijación tibial fue de 5,30 mm (± 1,4) y a nivel fibular 4,43 mm (± 0,85). En cuanto a su longitud en el margen superior fue de 14,26 mm (± 3,66) y a nivel del margen inferior fue de 16,74 mm (± 2,91). Su espesor fue de 2,1 mm (± 0,36). En las 23 muestras de tobillo con presencia del FD-LTFA, hubo contacto talar en el 100 % de los casos y desgaste articular en esta zona en 3 de ellas (13,04 %). Los datos biométricos aportados por este estudio complementarán el conocimiento anatómico del FD-LTFA en la población Chilena.


The anterior tibiofibular ligament usually presents an independent distal fascicle of the main band, denominated distal fascicle of the anterior tibiofibular ligament (DF-ATiFL). Which obliquely passes, covering its most inferior fiber to the anterolateral corner of the talocrural articulation. Its presence is associated with the anterolateral impingement of the ankle in this area, which can produce cartilage wear of the anterolateral surface of the talar trochlea. The purpose of this study was to determine the presence and biometry of DF-ATiFL and its relation with the talar trochlea on the ankles of a group of Chilean individuals. Thirty inferior members were used in this study, all from adult individuals. It was evaluated: Width of the tibial insertion, width of the fibular insertion, length of the top margin, length of the bottom margin, and the thickness. It was determined whether there was talar contact by the distal fascicle of the anterior tibiofibular ligament. Also, it was observed the articular wear on the surface of the talar dome, at the level of the contact region of the distal fascicle of the anterior tibiofibular ligament. The DFATiFL was found in 76.7 % of the cases, its width at the level of the place of tibial fixation was 5.30 mm (± 1.40), and at the fibular level 4.43 mm (± 0.85). Regarding its length on the top margin was 14.26 mm (± 3.66), and at the bottom, the margin level was 16.74 mm (± 2.91). Its thickness was 2.1 mm (± 0.36). In the 23 ankles samples with the presence of DF-ATiFL, there was talar contact in 100 % of the cases and articular wear in this area in 3 of them (13.04 %). The biometric data contributed by this study will supplement the anatomical knowledge of the distal fascicle of the anterior tibiofibular ligament on the Chilean population.


Subject(s)
Humans , Tibia/anatomy & histology , Fibula/anatomy & histology , Ligaments/anatomy & histology , Ankle/anatomy & histology , Talus/anatomy & histology
14.
Article in Chinese | WPRIM | ID: wpr-828243

ABSTRACT

OBJECTIVE@#To explore clinical effect of internal and external fixation combined with second-stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC.@*METHODS@#From May 2014 to July 2017, 20 patients with Gustilo-Anderson types ⅢB and ⅢC ankle fracture dislocation were treated with internal and external fixation combined with second-stage perforator fiap, including 14 males and 6 females, aged from 18 to 58 years old with an average of (39.0±9.7) years old;17 patients were type ⅢB and 3 patients were type ⅢC according to Gustilo-Anderson classification;4 patients were type A, 7 patients were type B, and 9 patients were type C according to AO classification. The size of wound ranged from 4 cm×3 cm to 20 cm×9 cm. Second-stage perforator flap, 11 patients were performed with posterior tibial artery perforator flap, 5 patients were performed with fibular artery perforator flap, 1 patient was performed with anterior ankle flap, and 3 patients were performed with posterior tibial artery perforator flap combined with fibular artery perforator flap. Postoperative wound healing, flap survival and fracture healing were observed, AOFAS score was used to evaluate at the latest follow up.@*RESULTS@#All limbs were preserved successfully without amputation. Nine patients occurred superficial infection without deep infection and osteomyelitis occurring. The flaps of 19 patients survived. All patients were followed up for 6 to 18 months with an average of (12.0±2.9) months. The flaps healed well without sinus tract, bone exposure and bone disunion occurring. Fracture healing time ranged from 4 to 10 months with an average of (6.6±1.7) months. PostoperativeAOFAS score was 76.7± 16.4, among which 4 patients got excellent result, 11 patients good, 3 patients fair, and 2 poor.@*CONCLUSION@#Internal and external fixation combined with second stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC could effectively close the wound, improve fracture healing and restore appearance and function of limbs to the maximum.


Subject(s)
Adolescent , Adult , Ankle , Female , Fracture Dislocation , Fracture Fixation, Internal , Humans , Male , Middle Aged , Perforator Flap , Reconstructive Surgical Procedures , Skin Transplantation , Soft Tissue Injuries , General Surgery , Treatment Outcome , Young Adult
15.
Article in Chinese | WPRIM | ID: wpr-828198

ABSTRACT

This paper describes how to develop a practical new type of atherosclerosis detection device, which can realize real-time measurement and analysis of human atherosclerosis. According to the mechanism of human atherosclerosis, the design objectives of the system are formulated to determine the construction of the platform. The system calculates the pulse wave velocity by measuring the pulse wave of human fingers and toes, adds four blood pressure measurements to the system design, calculates the ankle-brachial index, and comprehensively measures and analyses the degree of human arteriosclerosis.


Subject(s)
Ankle , Atherosclerosis , Blood Flow Velocity , Blood Pressure , Brachial Artery , Humans , Pulse Wave Analysis
16.
Article in Korean | WPRIM | ID: wpr-811452

ABSTRACT

PURPOSE: The study aimed to assess the average time to return to play following surgery for chronic lateral ankle instability in athletes.METHODS: A literature search was conducted (1976 to 2019) by two independent reviewers using the Medline, Embase, and Cochrane library databases. Articles were retrieved by an electronic search using individual keywords (“lateral ankle instability,” “surgery,” “operation,” “return to sport,” “return to play”) and their combinations. Studies that met the inclusion criteria were assessed for pertinent data.RESULTS: Six randomized controlled trials were included in this analysis. The mean follow-up period was 44.8 months (range, 31.8–58.1 months) in 219 patients (male, 126; female, 113). The mean age was 23.2 years (range, 18.2–28.2 years). Different criteria for returning to sports were used in each paper. In the papers included in this study, different methods and definitions were used for the postoperative recovery method for lateral ankle instability injury. The average time until return to play was 16.53 weeks.CONCLUSION: There are limitations to the application of different surgical techniques and data from different athletes for chronic lateral ankle instability. However, these results suggest that sports physicians evaluate the surgical outcome and may be utilized as reference data for informing the athletes about their time until return.


Subject(s)
Ankle Injuries , Ankle , Athletes , Female , Follow-Up Studies , Humans , Methods , Return to Sport , Sports
17.
Article in Korean | WPRIM | ID: wpr-811451

ABSTRACT

PURPOSE: This study aimed to investigate the effect of hospital-based intensive rehabilitation program after ankle ligament operation.METHODS: A total of 35 patients were included in this randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Home-based exercise was conducted in the control group. Outcomes were evaluated at baseline, 12 weeks, and 16 weeks. The primary outcome was measured using the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included the American Orthopedic Foot and Ankle Society (AOFAS) score, ankle strength measured using an isokinetic device, fall index measured using a Tetrax posturography device, and the Berg Balance Scale.RESULTS: Significant improvements in FAOS, AOFAS, ankle strength, and fall index were found in the intervention group after performing the hospital-based rehabilitation (all p<0.05) and these improvements were sustained at T2 (all p<0.05). Between-group comparisons demonstrated significantly greater improvements in FAOS, AOFAS, ankle strength, and fall index in the intervention group than those in the control group at both T1 (all p<0.05), and T2 (all p<0.05).CONCLUSION: The rehabilitation program in this study improved postoperative pain, sports function, quality of life, and strength and balance of the ankle significantly better than home-based self-care. Therefore, we recommend hospital-based systematic rehabilitation programs after surgical treatment for chronic ankle instability.


Subject(s)
Ankle , Foot , Humans , Ligaments , Orthopedics , Pain, Postoperative , Quality of Life , Recovery of Function , Rehabilitation , Self Care , Sports
18.
Article in Korean | WPRIM | ID: wpr-811448

ABSTRACT

PURPOSE: The first aim of this study was to retrospectively survey sports injuries among 608 athletes participating in 26 sport events. The second aim was to compare the characteristics of sports injuries depending on the occurrences during the high school and university periods.METHODS: The data were collected based on the daily injury report form proposed by the International Olympic Committee from March to June 2019.RESULTS: Four hundred and thirty-nine athletes (313 men) of 608 participated athletes experienced a total of 747 sports injuries, indicating 0.7 injuries per 1,000 athlete exposures (AEs). The incidence rate during the university period was 6.1 injuries/1,000 AEs, which was approximately two-fold higher than that during the high school period (2.8 injuries/1,000 AEs). The reported frequency of injuries was the highest among long distance athletics (n=60, 8.0%), and in each subgroup as well.CONCLUSION: Many more injuries were incurred during practice wherein injuries in long-distance athletics were the most common than in competition athletics; handball injuries and taekwondo injuries were the most common during high school and university, respectively. The most contact injuries occurred in taekwondo and most noncontact injuries occurred in gymnastics during high school and in badminton during university. The most commonly affected body parts were the knee, shoulder, and ankle. Severe injuries were the most frequent in long distance athletics, and emergent situations were the most common in taekwondo.


Subject(s)
Ankle , Athletes , Athletic Injuries , Gymnastics , Human Body , Humans , Incidence , Knee , Racquet Sports , Retrospective Studies , Shoulder , Sports
19.
Article in Korean | WPRIM | ID: wpr-811285

ABSTRACT

PURPOSE: The purpose of this study was to compare the clinical and radiological outcomes of locking compression plate (LCP)-screw fixation and tension band wiring (TBW) fixation in isolated lateral malleolar fractures.MATERIALS AND METHODS: From May 2016 to August 2018, 52 patients with isolated lateral malleolar fracture were retrospectively reviewed. They were divided into 30 cases of the LCP fixation group (Group I) and 22 cases of the TBW fixation group (Group II). The clinical and radiological results of those groups were compared. Pearson chi-square tests and independent t-tests were used in the statistical analysis.RESULTS: The mean length of the surgical incision was 8.3 cm in Group I and 4.9 cm in Group II. Radiological union was obtained at a mean of 8.4 weeks in both groups. The mean American Orthopaedic Foot and Ankle Society score was 90 (range, 85–97) and 92 (range, 85–100) in Groups I and II, respectively, at the last follow up.CONCLUSION: Both the LCP-screw and TBW techniques revealed excellent results in isolated lateral malleolar fractures. The tension band technique may be a fine alternative method of fixation in the treatment of isolated lateral malleolar fracture.


Subject(s)
Ankle , Ankle Fractures , Follow-Up Studies , Foot , Humans , Methods , Retrospective Studies , Surgical Procedures, Operative
20.
Medisan ; 23(4)jul.-ago. 2019. tab, graf
Article in Spanish | LILACS-Express | LILACS, CUMED | ID: biblio-1091123

ABSTRACT

La artroscopia de tobillo es un procedimiento quirúrgico muy empleado actualmente en personas con afecciones de esta articulación. Teniendo en cuenta lo anterior se realizó el presente estudio con el objetivo de actualizar los pasos básicos para su realización y profundizar en los aspectos más importantes relacionados con el tema, entre los cuales figuran: anatomía, indicaciones quirúrgicas, instrumental necesario, métodos de distracción, portales y recorrido artroscópicos, así como complicaciones relacionadas con el proceder. Entre otras ventajas, permite diagnosticar gran número de enfermedades que afectan la articulación del tobillo y brindar un tratamiento oportuno.


The ankle arthroscopy is a very used surgical procedure at present in people with disorders of this joint. Keeping this in mind the present study was carried out with the objective of updating the basic steps for its use and to deepen in the more important aspects related to the topic, among which there are: anatomy, surgical indications, necessary tools, distraction methods, arthroscopic portals and route, as well as complications related to the procedure. Among other advantages, it allows to diagnose great number of diseases which affect the ankle joint and to offer an opportune treatment.


Subject(s)
Arthroscopy , Ankle/surgery , Surgical Procedures, Operative
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