Intervening factors in forward flexibility of the trunk in adolescents in sitting and standing position.

AIM: Forward flexibility of the trunk (FFT) is used as an indicator of vertebral function and assessed using the sit-and-reach and fingertip-ground tests. METHODS: FFT was investigated in adolescents and comparisons were made among genders, sitting and standing positions, and low and high speed; 102 males and females (16 to 20 years of age) participated in the study. RESULTS: The position of the body and gender factor had no influence over the flexibility assessment. When executed slowly, the values obtained in the test were significantly lower; 60% of the participants were unable to reach their feet in the slow form and 50% were unable to reach their feet in the fast form. Thus, the assessment of vertebral function in adolescents should not use the ability to reach their feet as a criterion of normality. The fingertip-ground and sit-and-reach tests proved to be equally adequate. Greater height and length of limbs are associated to lower FFT values. Greater height and lower trunk-head height explain the lesser FFT in women; greater length of the lower limbs and lesser arm span explain the results for men. CONCLUSIONS: Reaching the feet in either the standing or sitting position is a criterion that excludes approximately 50% of adolescents from the normality of vertebral function, whereas reaching 12 cm above the ground is achieved by 90% of the population. Therefore, the criteria for assessing FFT in adolescents need to be reviewed.

Mobilizaçäo precoce da mäo pós-reimplantes ou revascularizaçöes / Early mobilization of the post-replantation hand or revascularizations

A alta frequência de complicaçöes pós-operatórias nos traumatismos das mäos e dedos por aderências cicatriciais, sugerem a aplicaçäo de técnicas de reabilitaçäo precoce, uma vez que a mobilizaçäo da mäo neste período fornece melhor aporte vascular à área lesada, promove melhor qualidade nutricional, mantém as superfícies de deslizamento e evita a täo rotineira aderência tendinosa, que impossibilita a integridade funcional da mäo e dedos comprometidos, além de evitar edemas e outros problemas pós-cirúrgicos. No entanto, há divergências em relaçäo ao início devido, talvez, à insegurança dos cirurgiöes na aplicaçäo da técnica de cinesioterapia pós-operatória imediata após uma cirurgia que normalmente teve muitas horas de duraçäo. Sugere-se neste estudo que a mobilizaçäo pós-reimplante ou revascularizaçäo dos dedos e/ou da mäo seja iniciada após 48 horas, conforme o protocolo utilizado nos 3 casos apresentados neste trabalho, justificando, dessa forma, a integridade funcional e a reabilitaçäo funcional da mäo e dedos traumatizados. Preconizou-se o ínico das atividades diárias a partir do 21§ dia após a cirurgia, sem qualquer incidente traumático em funçäo da precocidade e com integridade funcional da mäo.