Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs.

BACKGROUND: The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model. METHODS: Sixteen cadaveric foot-ankle-distal tibia specimens were used. All samples were prepared as a supination external rotation ankle fracture model. Axial load and cyclic axial rotations were applied on every specimen using a specifically designed frame. This test was performed without deltoid injury, with deltoid injury, and after repair. The reconstruction was performed in 4 different ways (anterior, posterior, middle, and combined). Medial clear space (MCS) was measured for each condition on simulated weightbearing (WB) and gravity stress (GS) radiographs. Reflective markers were used in tibia and talus, registering the kinematics through a motion analysis system to record the tibiotalar uncoupling. RESULTS: After deltoid damage, in all cases the MCS increased significantly on GS radiographs, but there was no increase in the MCS on WB radiographs. After repair, in all cases, the MCS was normalized. Kinematically, after deltoid damage, the tibiotalar uncoupling increased significantly. All isolated repairs achieved a similar tibiotalar uncoupling value as its baseline condition. The combined repair resulted in a significant decrease in tibiotalar uncoupling. CONCLUSION: Our results show that deltoid repair recovers the tibiotalar coupling mechanism in an ankle fracture model. Isolated deltoid repairs recovered baseline MCS and tibiotalar uncoupling values. Combined repairs may lead to overconstraint, which could lead to postoperative stiffness. Clinical studies are needed to prove these results and show clinically improved outcomes. CLINICAL RELEVANCE: This study helps in finding the optimum deltoid repair to use in an acute trauma setting.

Influence of Physical Fitness, Anthropometric Profile, and Biological Maturation on Technical Performance and Enjoyment of Untrained Children Who Participate in Continuous and Fractional Small-Sided Games.

The objective is to determine the relationship between physical fitness, anthropometric measures, and biological maturation as they relate to technical performance in small-sided games (SSGs) of continuous and fractioned regimes. Methodology: A crossover-design study in which 12 children participated in two regimens of SSG (continuous and fractional). At the beginning of the study, all children were evaluated using physical fitness tests (horizontal jump test, vertical jump, cardiorespiratory fitness, and agility), anthropometric profile (weight, height, Body Mass Index (BMI), and waist circumference (WC)), and biological maturation (peak years of growth velocity). All sessions were recorded and analyzed with the Performance Assessment in Team Sports instrument, and at the end of each game each child was asked to answer a scale of enjoyment for physical activity. Results: The results of the paired samples t-test showed no significant differences in the measures of technical performance and perceived enjoyment for the continuous and fractional regimens of SSGs (p > 0.05). The correlation results showed that technical performance in the continuous and fractional regimes was related to agility, horizontal jump, and height, while biological maturation was only related to technical performance in the fractional regimen of SSGs. Perceived enjoyment showed a negative relationship with weight, height, BMI, and WC. Conclusion: The fractional and continuous regimens of SSGs implemented in this study induced similar technical demands and enjoyment. Furthermore, the results suggest that physical fitness, anthropometric profile, and biological maturation may influence the technical performance and enjoyment of SSGs.

Efectos de un protocolo de entrenamiento excéntrico sobre el rendimiento de velocidad en adolescentes de Chile / Effects of an Eccentric Training Protocol on Speed Performance in Chilean Adolescents

Resumen Introducción: Los beneficios del entrenamiento de fuerza sobre la velocidad de carrera han sido descritos en la bibliografía especializada, sin embargo, la evidencia sobre la influencia de estímulos específicos, basados en contracciones excéntricas sobre la musculatura extensora de cadera, no han sido demostrados. Objetivo: Determinar los efectos de un protocolo de entrenamiento basado en contracciones excéntricas (curl nórdico) sobre la velocidad de carrera en 20 metros en adolescentes de la región de Ñuble, Chile. Metodología: 42 individuos escolares fueron divididos en grupo experimental (n=22) y grupo control (n=20). El entrenamiento se desarrolló durante 6 semanas, con una frecuencia de 2 sesiones/semana, pasando de un volumen de 8 a 32 repeticiones de curl nórdico por sesión para el grupo experimental. El rendimiento de velocidad fue evaluado en 20 metros. La prueba T de Student fue utilizada para comparar los resultados pre y post intervención y se calculó el tamaño del efecto (TE). Resultados: Se encontraron diferencias estadísticamente significativas (p<0,05) a partir de la intervención en el grupo experimental (pre= 3,43 s. vs post= 3,15 s.), y un TE grande (1,04). Conclusión: Se concluye que el entrenamiento excéntrico basado en la aplicación de Curl nórdico, mejora el rendimiento de la velocidad de carrera.

Abstract Introduction: The specialized literature has described the benefits of strength training on running speed. In the same way, stimulation of training based on eccentric contractions has been shown to be effective in improving this quality. Objective: To determine the effects of a training protocol based on the stretch-shortening cycle (SSC) and another on eccentric contractions (Nordic curl) on the running speed in 20 meters in adolescents from the Ñuble Region, Chile. Methodology: 42 school subjects were divided into experimental group (n = 22) and control group (n = 20). The training was developed for 6 weeks, with a frequency of 2 sessions/week, going from a volume of 8 to 32 repetitions of Nordic curl per session for the experimental group. The speed performance was evaluated in 20 meters. With photocells, the T Student's was applied to compare the pre- and post-intervention results, and the effect size (ES) was calculated. Results: Statistically significant differences were found (p <0.05) from the intervention in the experimental group (pre= 3,43 s. vs post= 3,15 s.), and a large ES (1,04). Conclusion: It is concluded that the eccentric training based on the application of Nordic Curl improves the performance of the running speed.

Resumo Introdução: Os benefícios do treinamento de força na velocidade de corrida foram descritos na literatura especializada, no entanto, não foram demonstradas evidências sobre a influência de estímulos específicos, baseados em contrações excêntricas na musculatura extensora do quadril. Objetivo: Determinar os efeitos de um protocolo de treinamento baseado em contrações excêntricas (cacho nórdico) em velocidade de corrida de 20 m em adolescentes da região do Ñuble, Chile. Metodologia: 42 escolares foram divididos em um grupo experimental (n=22) e um grupo controle (n=20). O treino foi desenvolvido durante 6 semanas, com uma frequência de 2 sessões/semana, passando de um volume de 8 para 32 repetições de ondulação nórdica por sessão para o grupo experimental. O desempenho da velocidade foi avaliado acima de 20 metros. O teste T de Student foi usado para comparar os resultados pré e pós-intervenção e o tamanho do efeito (TE) foi calculado. Resultados: Foram encontradas diferenças estatisticamente significativas (p<0,05) da intervenção no grupo experimental (pré= 3,43 s. vs pós= 3,15 s.), e um TE grande (1,04). Conclusão: Conclui-se que o treinamento excêntrico baseado na aplicação do Curl nórdico melhora o desempenho da velocidade de corrida.

Biomechanical Cadaveric Evaluation of the Role of Medial Column Instability in Hallux Valgus Deformity.

BACKGROUND: Medial column instability is a frequent finding in patients with flatfeet and hallux valgus, within others. The etiology of hallux valgus is multifactorial, and medial ray axial rotation has been mentioned as having an individual role. Our objective was to design a novel cadaveric foot model where we could re-create through progressive medial column ligament damage some components of a hallux valgus deformity. METHODS: Ten fresh-frozen lower leg specimens were used, and fluorescent markers were attached in a multisegment foot model. Constant axial load and cyclic tibial rotation (to simulate foot pronation) were applied, including pull on the flexor hallucis longus tendon (FHL). We first damaged the intercuneiform (C1-C2) ligaments, second the naviculocuneiform (NC) ligaments, and third the first tarsometatarsal ligaments, leaving the plantar ligaments unharmed. Bony axial and coronal alignment was measured after each ligament damage. Statistical analysis was performed. RESULTS: A significant increase in pronation of multiple segments was observed after sectioning the NC ligaments. Damaging the tarsometatarsal ligament generated small supination and varus changes mainly in the medial ray. No significant change was observed in axial or frontal plane alignment after damaging the C1-C2 ligaments. The FHL pull exerted a small valgus change in segments of the first ray. DISCUSSION: In this biomechanical cadaveric model, the naviculocuneiform joint was the most important one responsible for pronation of the medial column. Bone pronation occurs along the whole medial column, not isolated to a certain joint. Flexor hallucis longus pull appears to play some role in frontal plane alignment, but not in bone rotation. This model will be of great help to further study medial column instability as one of the factors influencing medial column pronation and its relevance in pathologies like hallux valgus. CLINICAL RELEVANCE: This cadaveric model suggests a possible influence of medial column instability in first metatarsal pronation. With a thorough understanding of a condition's origin, better treatment strategies can be developed.

Biased instantaneous regional muscle activation maps: Embedded fuzzy topology and image feature analysis.

The instantaneous spatial representation of electrical propagation produced by muscle contraction may introduce bias in surface electromyographical (sEMG) activation maps. Here, we described the effect of instantaneous spatial representation (sEMG segmentation) on embedded fuzzy topological polyhedrons and image features extracted from sEMG activation maps. We analyzed 73,008 topographic sEMG activation maps from seven healthy participants (age 21.4 ± 1.5 years and body mass 74.5 ± 8.5 kg) who performed submaximal isometric plantar flexions with 64 surface electrodes placed over the medial gastrocnemius muscle. Window lengths of 50, 100, 150, 250, 500, and 1,000 ms and overlap of 0, 25, 50, 75, and 90% to change sEMG map generation were tested in a factorial design (grid search). The Shannon entropy and volume of global embedded tri-dimensional geometries (polyhedron projections), and the Shannon entropy, location of the center (LoC), and image moments of maps were analyzed. The polyhedron volume increased when the overlap was <25% and >75%. Entropy decreased when the overlap was <25% and >75% and when the window length was <100 ms and >500 ms. The LoC in the x-axis, entropy, and the histogram moments of maps showed effects for overlap (p < 0.001), while the LoC in the y-axis and entropy showed effects for both overlap and window length (p < 0.001). In conclusion, the instantaneous sEMG maps are first affected by outer parameters of the overlap, followed by the length of the window. Thus, choosing the window length and overlap parameters can introduce bias in sEMG activation maps, resulting in distorted regional muscle activation.

Changes in the Mechanical Properties of the Horizontal Force-Velocity Profile during a Repeated Sprint Test in Professional Soccer Players.

The objective was to analyze the changes in the horizontal force-velocity profile (HFVP) during the execution of repeated sprinting. Methods: Seventeen first-division Chilean soccer players completed a repeated sprint protocol consisting of eight sprints of 30 m with 25-s pauses between repetitions. The behavior of HFVP variables in each attempt was recorded from video recordings and analysis in the MySprint® application. Results: Differences (p < 0.05) were found between sprints in the following: time (T), starting from sprint 5 (F = 35.6; η2p = 0.69); theoretical maximum speed (V0), starting from sprint 4 (F = 29.3; η2p = 0.51); maximum power (PM), starting from sprint 5 (F = 17; η2p = 0.52); rate of decrease in force index produced at each step (DRF), starting from sprint 1 (F = 3.20; η2p = 0.17); and RF10, starting from sprint 1 (F = 15.5; η2p = 0.49). In comparison, F0 and RFpeak did not present any differences (p > 0.05). Conclusion: The HFVP variables more sensitive to the effects of fatigue induced by an RSA protocol are those associated with the production of force at high speeds, being V0, DRF, and Pmax, while those that contribute to the generation of force at the beginning of the sprint, F0 and RFpeak, do not present essential variations.

An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate Mechanical Resistance.

INTRODUCTION: Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique. METHODS: A total of 12 cadaveric pieces were randomized into two groups: the isolated flexible frame group (n = 6) and the standard Krackow fixation group (n = 6). A traumatic rupture of the patellar tendon was performed, and a transosseous displacement sensor was installed on a validated biomechanical system. Gap formation was measured during 50 cycles of flexion and extension with traction on the quadriceps (250 N). Subsequently, specimens underwent progressive loading in a fixed flexion position until failure occurred. The data were analyzed using nonparametric statistical tools with a significance level of 5%. RESULTS: The isolated frame group had a smaller gap formation (1.7 mm) than the Krackow group (3.4 mm; P = 0.01). No significant difference existed in the median failure end points of the two groups (676 and 530 N, respectively; P = 0.11). DISCUSSION: Patellar tendon repair using an isolated, transosseous, flexible, suture frame outperformed using the traditional Krakow repair technique in gap formation. Further studies are needed to determine if this will result in better functional outcomes or fewer clinical failures. LEVEL OF EVIDENCE: Level IV, experimental case series.

Evaluación y Comparación de dos Sistemas de Cánula Nasal de Alto Flujo Artesanales / Evaluation and Comparison of Two Artisan alternative of High Flow Nasal Cannula Systems

Introducción: Una de las estrategias principales de atención para los pacientes con infección por SARS-CoV2 es el soporte respiratorio, incluida la terapia de oxígeno para pacientes con hipoxemia, en la que se ha informado que la cánula nasal de alto flujo (CNAF) es efectiva para mejorar la oxigenación, existiendo reportes de disminución en la intubación en pacientes con insuficiencia respiratoria hipoxémica aguda, en comparación con dispositivos de oxigenoterapia convencional. Dada la falta de insumos y equipos durante el periodo de pandemia, han surgido diversas formas de construir de manera artesanal equipos de alto flujo. Objetivo: Medir y comparar dos sistemas de alto flujo artesanales, en relación con su rendimiento teórico, en la entrega real de flujo total y en la fracción inspirada de oxígeno (FiO2). Métodos: Se confeccionaron dos modelos de CNAF artesanales. El primer equipo (CNAF-A) se confeccionó utilizando 2 flujómetros de aire y un flujómetro de oxígeno unidos a un conector que recibe los flujos provenientes de los 3 flujómetros mencionados y cuya mezcla de aire pasa por un sistema de termo-humidificación. El segundo modelo (CNAF-B) se construyó usando un inyector de un equipo de oxigenoterapia de concentración variable (tipo "Venturi"), conectado a un flujómetro de oxígeno, en donde se realiza una mezcla con aire ambiental para entregar un flujo final y una concentración de oxígeno determinada. Se confeccionaron 10 equipos de cada modelo de sistema de CNAF artesanal. Se evaluó el flujo final y la FiO2 entregada por cada CNAF. Los resultados obtenidos fueron comparados con los valores teóricos que debiera entregar cada equipo de CNAF artesanal y se evaluó la correlación entre los valores medidos. Resultados: Se observó una baja correlación entre el flujo esperado teórico y el flujo medido. Resultados similares se encontraron al evaluar valores teóricos y medidos de FiO2. El modelo CNAF-A demostró generar flujos mas altos de lo esperado logrando cumplir con niveles requeridos para considerarse un sistema de alto flujo. El sistema CNAF-B entregó flujos significativamente menores a los valores esperados. Conclusiones: Ambos modelos de CNAF presentan bajo nivel de concordancia con sus valores teóricos, tanto en la FiO2 como en el flujo entregado. Sin embargo, la CNAF-A se logra comportar como sistema de alto flujo. Un sistema de CNAF confeccionado con un sistema Venturi no es suficiente para generar terapia de alto flujo.

Introduction: One of the main care strategies for patients with SARS-CoV2 infection is respiratory support, including oxygen therapy for patients with hypoxemia, in which the high-flow nasal cannula (CNAF) has been reported to be effective to improve oxygenation, there are reports of decreased intubation in patients with acute hypoxemic respiratory failure, compared to conventional oxygen therapy devices. Given the lack of supplies and equipment during the pandemic period, various ways have emerged to build high-flow equipment by hand. Objective: Measure and compare two artisanal high-flow systems, in relation to their theoretical performance, in the actual delivery of total flow and in the fraction of inspired oxygen (FiO2). Methods: Two models of artisanal CNAF were made. The first equipment (CNAF-A) was made using 2 air flow meters and an oxygen flow meter connected to a connector that receives the flows from the 3 mentioned flow meters and whose air mixture passes through a thermo-humidification system. The second model (CNAF-B) was built using an injector of a variable concentration oxygen therapy equipment ("Venturi" type), connected to an oxygen flow meter, where a mixture is made with ambient air to deliver a final flow and a given oxygen concentration. 10 kits of each model of the artisanal CNAF system were made. The final flow and the FiO2 delivered by each CNAF were evaluated. The results obtained were compared with the theoretical values ​​that each artisanal CNAF equipment should deliver and the correlation between the measured values ​​was evaluated. Results: A low correlation was observed between the theoretical expected flow and the measured flow. Similar results were found when evaluating theoretical and measured FiO2 values. The CNAF-A model proved to generate higher flows than expected, achieving the required levels to be considered a high flow system. The CNAF-B system delivered flows significantly lower than the expected values. Conclusions: Both CNAF models show a low level of agreement with their theoretical values, both in FiO2 and in the delivered flow. However, CNAF-A manages to behave as a high-flux system. A CNAF system made with a Venturi system is not sufficient to generate high-flow therapy.

Criteria and Concurrent Validity of DIVA 2.0: A Semi-Structured Diagnostic Interview for Adult ADHD.

Objective: The aim of this study was to assess for the first time the criterion validity of the semi-structured Diagnostic Interview for ADHD in adults (DIVA 2.0), and its concurrent validity in comparison with the Conners' Adult ADHD Diagnostic Interview for DSM-IV (CAADID) and other ADHD severity scales, following the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria. Method: A transversal study was performed on 40 out-patients with ADHD to check the criteria and concurrent validity of the DIVA 2.0 compared with the CAADID. Results: The DIVA 2.0 interview showed a diagnostic accuracy of 100% when compared with the diagnoses obtained with the CAADID interview. The concurrent validity demonstrated good correlations with three self-reported rating scales: the Wender Utah Rating Scale (WURS; r = .544, p < .0001), the ADHD-Rating Scale (r = .720, p < .0001), and Sheehan's Dysfunction Inventory (r = .674, p < .0001). Conclusion: The DIVA 2.0 is a reliable tool for assessing and diagnosing Adult ADHD and is the only one that offers free online access for clinical and research purposes.

Spectral components in electromyograms from four regions of the human masseter, in natural dentate and edentulous subjects with removable prostheses and implants.

OBJECTIVE: To compare the frequency or spectral components between different regions of the superficial masseter in young natural dentate and total edentulous older adults rehabilitated with removable prostheses and fixed-implant support. A secondary objective was to compare these components between the three groups. DESIGN: 21 young natural dentate and 28 edentulous (14 with removable prostheses and 14 with fixed-implant support) were assessed. High-density surface electromyography (sEMG) was recorded in four portions of the superficial masseter during submaximal isometric bites. Spectral components were obtained through a spectral analysis of the sEMG signals. An analysis of mixed models was used to compare the spectral components. RESULTS: In all groups, the spectral components of the anterior portion were lower than in the posterior region (p < 0.05). Both edentulous groups showed lower spectral components and median frequency slope than the natural dentate group (p < 0.05). The removable prostheses group showed the greatest differences with natural dentate group. CONCLUSIONS: There were significant differences in the spectral components recorded in the different regions of the superficial masseter. The lower spectral components and fatigability of older adults rehabilitated with prostheses could be a cause of a greater loss of type II fibers, especially in the removable prostheses group.

Biomechanical Cadaveric Evaluation of Partial Acute Peroneal Tendon Tears.

BACKGROUND: No clear guideline or solid evidence exists for peroneal tendon tears to determine when to repair, resect, or perform a tenodesis on the damaged tendon. The objective of this study was to analyze the mechanical behavior of cadaveric peroneal tendons artificially damaged and tested in a cyclic and failure mode. The hypothesis was that no failure would be observed in the cyclic phase. METHODS: Eight cadaveric long leg specimens were tested on a specially designed frame. A longitudinal full thickness tendon defect was created, 3 cm in length, behind the tip of the fibula, compromising 66% of the visible width of the peroneal tendons. Cyclic testing was initially performed between 50 and 200 N, followed by a load-to-failure test. Tendon elongation and load to rupture were measured. RESULTS: No tendon failed or lengthened during cyclic testing. The mean load to failure for peroneus brevis was 416 N (95% confidence interval, 351-481 N) and for the peroneus longus was 723 N (95% confidence interval, 578-868 N). All failures were at the level of the defect created. CONCLUSION: In a cadaveric model of peroneal tendon tears, 33% of remaining peroneal tendon could resist high tensile forces, above the physiologic threshold. CLINICAL RELEVANCE: Some peroneal tendon tears can be treated conservatively without risking spontaneous ruptures. When surgically treating a symptomatic peroneal tendon tear, increased efforts may be undertaken to repair tears previously considered irreparable.

Association Between Vitamin D Status and Schizophrenia: A First Psychotic Episode Study.

Vitamin D deficiency has been linked with schizophrenia. We aimed to determine whether patients with a first episode of psychosis (FEP) had lower vitamin D levels compared with controls considering their final diagnosis. We conducted a cross-sectional study determining 25-hydroxyvitamin D blood levels. 25-Hydroxyvitamin D levels were considered optimum at 20 ng/mL or greater. A group of 45 adult patients with FEP and a group of 22 healthy controls matched for age were recruited. The patient group was subdivided in two final diagnosis groups (schizophrenia versus other psychoses) after a 6-month follow-up. Average vitamin D values were deficient for FEP patients, especially those 22 with a final diagnosis of schizophrenia. These results relating vitamin D and schizophrenia generate interest to further examine this association.

Static balance in patients presenting diabetes mellitus type 2 with and without diabetic polyneuropathy / Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética

OBJECTIVES: To contrast the static balance in patients presenting diabetes mellitus type 2 (DM2) with and without polyneuropathy (DPN); and to correlate the rates from the scale Diabetic Neuropathy Examination (DNE) with the mean ratio of the center of pressure (CoP). SUBJECTS AND METHODS: Twenty patients, aged between 40 and 54, presenting DM2 and classified, according to DNE scale, in groups with (n = 10) and without (n = 10) DPN, were compared. Static balance was evaluated by means of the CoP mean ratio on a Wii Balance Board® under the conditions of open and closed eyes. After normality verification (Shapiro-Wilk), balance between both groups was compared by means of the Student t test and Mann-Whitney U test, as applicable. DNE rating was correlated with the mean ratio of CoP in the group with DPN, considering a significance level p < 0.05. RESULTS: Significant differences (p = 0.049) were found under the condition of closed eyes, with greater CoP ratio in the group with DPN (0.548 cm vs. 0.442 cm). The group with DPN showed a tendency (p = 0.059) towards a greater CoP mean ratio under the open eyes condition (0.351 cm vs. 0.239 cm). There was a strong correlation (r = 0.751) between the DNE rating and the CoP mean ratio under the closed eyes condition (p = 0.012). CONCLUSIONS: Patients showing DPN demonstrated worse static balance than patients without DPN in the closed eyes condition. Furthermore, the higher the rating in DNE, the stronger the displacement of CoP, which may be associated with higher risk of falls.

OBJETIVOS: Comparar o equilíbrio estático em pacientes com diabetes melito tipo 2 (DM2) com ou sem polineuropatia diabética (PND) e correlacionar os escores da escala de Exame da Neuropatia Diabética (EDN) com a média da relação do centro de pressão (CoP). SUJEITOS E MÉTODOS: Vinte pacientes, com idades entre 40 e 54 anos, que apresentavam DM2 e classificados, de acordo com a escala EDN, em grupos com (n = 10) e sem (n = 10) PDN foram comparados. O equilíbrio estático foi avaliado segundo a média da relação do CoP em um Wii Balance Board® na condição com os olhos abertos e os olhos fechados. Depois da verificação da normalidade (Shapiro-Wilk), o equilíbrio entre os dois grupos foi comparado por meio dos testes t de Student e U de Mann-Whitney, como aplicável. O escore na EDN foi correlacionado com a média da relação do CoP no grupo com PND, considerando um nível de significância de p < 0,05. RESULTADOS: Diferenças significativas (p = 0,049) foram observadas nas condições de olhos fechados, com uma maior média da relação do CoP no grupo com PND (0,548 cm vs. 0,442 cm). O grupo com PND mostrou uma tendência (p = 0,059) para maior média da relação do CoP na condição com os olhos abertos (0,351 cm vs. 0,239 cm). Foi observada uma forte correlação (r = 0,751) entre o escore EDN e a média da relação do CoP na condição com os olhos fechados (p = 0,012). CONCLUSÕES: Os pacientes com PND demonstraram pior equilíbrio estático do que os pacientes sem PND na condição com os olhos fechados. Além disso, quanto maior o escore no EDN, mais forte o deslocamento do CoP, o que pode estar associado com maior risco de quedas.

Static balance in patients presenting diabetes mellitus type 2 with and without diabetic polyneuropathy.

OBJECTIVES: To contrast the static balance in patients presenting diabetes mellitus type 2 (DM2) with and without polyneuropathy (DPN); and to correlate the rates from the scale Diabetic Neuropathy Examination (DNE) with the mean ratio of the center of pressure (CoP). SUBJECTS AND METHODS: Twenty patients, aged between 40 and 54, presenting DM2 and classified, according to DNE scale, in groups with (n = 10) and without (n = 10) DPN, were compared. Static balance was evaluated by means of the CoP mean ratio on a Wii Balance Board® under the conditions of open and closed eyes. After normality verification (Shapiro-Wilk), balance between both groups was compared by means of the Student t test and Mann-Whitney U test, as applicable. DNE rating was correlated with the mean ratio of CoP in the group with DPN, considering a significance level p < 0.05. RESULTS: Significant differences (p = 0.049) were found under the condition of closed eyes, with greater CoP ratio in the group with DPN (0.548 cm vs. 0.442 cm). The group with DPN showed a tendency (p = 0.059) towards a greater CoP mean ratio under the open eyes condition (0.351 cm vs. 0.239 cm). There was a strong correlation (r = 0.751) between the DNE rating and the CoP mean ratio under the closed eyes condition (p = 0.012). CONCLUSIONS: Patients showing DPN demonstrated worse static balance than patients without DPN in the closed eyes condition. Furthermore, the higher the rating in DNE, the stronger the displacement of CoP, which may be associated with higher risk of falls.