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ABSTRACT Objective The extrinsic muscles, such as the posterior tibialis and long flexor of the hallux and the intrinsic of the foot, are part of the active subsystem of the central system of the foot and play an essential role in the control of the medial longitudinal arch resulting from difficulty in contracting the muscle, neuromuscular electrostimulation (NMES) becomes a resource combined with strengthening and recommended for rehabilitation. T this work aims to evaluate the effectiveness of NMES associated with exercise in deforming the medial longitudinal arch. Methods This is a randomized blind clinical trial. 60 asymptomatic participants were divided into three groups: NMES, exercise and control. The NMES and exercise group performed seven exercises for the intrinsic and extrinsic muscles twice a week for 6 weeks, and the NMES group used an NMES associated with five exercises. Navicular height and medial longitudinal arch angle were taken before and after the intervention period. Results No statistically significant differences existed between groups for navicular height and medial longitudinal arch angle. Conclusion NMES associated with exercise does not change the characteristics of the medial longitudinal arch in association with asymptomatic. Level of Evidence I; Randomized clinical trial.
RESUMO Objetivo Os músculos extrínsecos, como o tibial posterior e flexor longo do hálux e os intrínsecos do pé fazem parte do subsistema ativo do foot core system e exercem papel essencial no controle do arco longitudinal medial. Devido à dificuldade na contração desses músculos, a eletroestimulação neuromuscular (EENM) torna-se um recurso aliado ao fortalecimento e é recomendada para reabilitação. O objetivo desse trabalho é avaliar a eficácia da EENM associada ao exercício na deformação do arco longitudinal medial. Métodos Este é um ensaio clínico randomizado cego. 60 participantes assintomáticos foram divididos em três grupos: EENM, exercício e controle. O grupo EENM e exercício realizaram sete exercícios para os músculos intrínsecos e extrínsecos duas vezes por semana por seis semanas, sendo o grupo EENM utilizou a EENM associada a cinco exercícios. A altura do navicular e o ângulo do arco longitudinal medial foram medidos antes e após o período de intervenção. Resultados Não houve diferenças estatisticamente significativas entre os grupos para a altura do navicular e ângulo do arco longitudinal medial. Conclusão A EENM associada ao exercício não altera as características do arco longitudinal medial em indivíduos assintomáticos. Nível de Evidência I; Estudo Clínico Randomizado.
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Objective@#To observe the clinical utility of continuous passive movement (CPM) of the ankle joint in treating children with cerebral palsy and foot valgus.@*Methods@#Thirty-six children with cerebral palsy and foot valgus were divided into a control group, a non-continuous passive exercise (NCPM) group and a CPM group with 12 children (24 feet) in each group. The NCPM and CPM groups were given conventional rehabilitation treatment for the first 20 days and then home rehabilitation for a further 10 days. The CPM group additionally received CPM treatment during the first 20 days. The control group was only given home rehabilitation for 30 days. Each subject′s plantar pressures were measured along with GMFM-88 scores for "standing" and "walking, running and jumping" before the treatment and 2 and 4 months later.@*Results@#There was no significant difference in the average values of the output measures among the control group before and after the treatment. After four months, significantly better improvement was observed in the average percentages of medial forefoot (MMF) pressure among the NCPM group compared with the CPM group. There were also significant differences between the two groups in the [initial contact phase(ICP) + forefoot contact phase(FFCP)] and foot flat phase (FFP) percentages, as well as in the standing, running and jumping scores. Significant differences were also observed between the NCPM and CPM groups in terms of the average percentage of FFP pressure and their average standing scores, but not in the average percentage of MMF or the average jumping and running scores.@*Conclusions@#CPM usefully supplements conventional comprehensive rehabilitation therapy in improving the walking ability of children with cerebral palsy and talipes valgus.
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Objective To observe the treatment of continuous passive motion(CPM) on talipes valgus in the chil-dren with cerebral palsy. Methods There were 57 children in this research including normal group and valgus group, the children in valgus group were randomly divided into control group, non-CPM group and CPM group. The control group didn’t receive any rehabilitation treatment. The non-CPM group received conventional rehabilita-tion treatment. The CPM group received conventional rehabilitation and CPM therapy. Evaluate the children in nor-mal group with plantar pressure analysis and evaluate each patient before treatment two and four months after treat-ment with plantar pressure analysis. Results Compared with the normal group, the percentage of medial midfoot (MMF) pressure, HEEL pressure, initial contact phase(ICP) and forefoot contact phase(FFCP) were obviously higher in valgus groups. On the other hand, the percentage of lateral forefoot ( LFF) pressure, lateral midfoot (LMF) pressure and foot flat phase(FFP) were obviously lower in valgus groups(P < 0. 05). The percentage of MMF pressure, and FFP became lower after treatment in both CPM group and non-CPM group while the percentage of ICP and FFCP became higher(P < 0. 05). In CPM group there was a more obvious change with the percentage of MMF pressure, ICP and FFCP compared with non-CPM group and the control group(P < 0. 05). Conclusion U-sing CPM can alleviate muscle spasms and contracture, correct the deformity of midfoot, enhance the muscle group coordination on foot and further more improve gait of patients with cerebral palsy.
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Objective To explore the clinical significance of the footprints and lateral X-rays in weight loading in evaluating the rehabilitation of talipes valgus in the children with cerebral palsy.Methods One hundred footprints of 56 children who were cerebral palsy with talipes valgus in the hospital-community-family-based rehabilitation mode were divided into light,middle and heavy types,and they were counted with two footprint-based approaches,and the two approaches were compared with chi-square criterion,and the dependability on consequence of the footprint and lateral X-rays in weight loading were analyzed.Results One hundred feet evaluated by the method of footprint were flatfeet radically,and the occurrence of flatfoot evaluated by three define lines were 11,57,32,respectively,and evaluated by footprint ratio were 6,7,87,respectively,but the degrees were different with two footprint-based approaches.There was a close correlation between two footprint-based approaches and lateral X-rays in weight loading.Conclusions Flat foot caused by talipes valgus can be evaluated by footprint in static state,while the development of bones of foot and the constitution of instep can be monitored on the lateral X-rays in weight loading.