Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study.

AIM/HYPOTHESIS: The etiology of plantar fasciitis (PF) has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage. OBJECTIVE: Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the chronic stage of the injury in relation to healthy runners. METHODS: Forty-five runners with unilateral PF (30 acute and 15 chronic) and 30 healthy control runners were evaluated while running at 12 km/h for 40 meters wearing standardized running shoes and Pedar-X insoles. The contact area and time, maximum force, and force-time integral over the rearfoot, midfoot, and forefoot were recorded and the loading rate (20-80% of the first vertical peak) was calculated. Groups were compared by ANOVAs (p<0.05). RESULTS: Maximum force and force-time integral over the rearfoot and the loading rate was higher in runners with PF (acute and chronic) compared with controls (p<0.01). Runners with PF in the acute stage showed lower loading rate and maximum force over the rearfoot compared to runners in the chronic stage (p<0.01). CONCLUSION: Runners with PF showed different dynamic patterns of plantar loads during running over the rearfoot area depending on the injury stage (acute or chronic). In the acute stage of PF, runners presented lower loading rate and forces over the rearfoot, possibly due to dynamic mechanisms related to pain protection of the calcaneal area.

Static and dynamic biomechanical adaptations of the lower limbs and gait pattern changes during pregnancy.

The purpose of this literature review is to evaluate the studies that have investigated static and dynamic biomechanical changes of the lower limbs and gait patterns during pregnancy. Original articles on this subject, published between 1934 and 2012, were considered. In general, pregnant women demonstrated greater hip flexion, more extended knees and less plantar flexion ankles. These changes could explain the gait patterns of pregnant women characterized by increased hip angles, decreased propulsion forces associated with increased durations of stance phase and changes in distributions of the plantar loads with increased loads in the forefoot and decreased ones in the rearfoot. This can lead to arthrokinematic deviations that, with time, contribute to the development of musculoskeletal discomfort. In summary, these findings showed the importance of further longitudinal studies to investigate the relationships between musculoskeletal discomfort in pregnant women in the lower limbs and gait changes observed throughout this period.

A influência da ocupação profissional na flexibilidade global e nas amplitudes angulares dos membros inferiores e da lombar / The influence of occupation on overall flexibility and lower limb and lumbar range of motion

O desenvolvimento tecnológico no ambiente de trabalho gerou um aumentono tempo em que os indivíduos permanecem sentados enquanto trabalhamem escritórios. Isto pode estar influenciando negativamente capacidades físicas inatas como a flexibilidade da cadeia posterior do corpo, porém poucos são os estudos que avaliaram a influência do trabalho nesta capacidade física. Esta avaliação pode contribuir para intervenção precoce e paralela à atividade ocupacional, prevenindo disfunções musculoesqueléticas. O objetivo foi verificar se a atividade profissionaldetermina alguma modificação na flexibilidade global da cadeia posterior na postura de flexão do tronco e analisar os segmentos corporais contribuidores desta modificação. Participaram do estudo 24 mulheres saudáveis e sedentárias, entre 18 e 55 anos, que trabalhavam em manutenção (n=13) e em escritório (n=11). Foram avaliados o teste do terceiro dedo ao solo (fita métrica) e os ângulos articulares tíbio-társico, do joelho, do quadril, da lombar e a técnica de Chaffin Modificadapor meio da fotogrametria (software SAPo) na postura de flexão do tronco. Os grupos foram comparados por meio de teste t (?=5%). Mulheres que trabalham em escritório mostraram maiores distâncias do terceiro dedo ao solo (p=0,0518) e técnica de Chaffin Modificada significativamente menor . (p=0,0134), enquanto os ângulos tíbio- tarsico e do quadril mostraram valores marginalmente maiores nestas mulheres (p=0,0609 e p= 0,0713, respectivamente). Mulheres que trabalhampredominantemente na posição sentada apresentam menor flexibilidade global da cadeia posterior quando comparadas com as que realizam um trabalho que exige flexão cíclica do tronco. Sugere-se que os ângulos tíbio-tarsico e quadril, em conjunto, são os segmentos corporais que contribuem para esta menor flexibilidade.

The technological development in the working environment has prolongedsitting time for office employees. This prolonged sitting time may negatively influence innate physical capacities such as flexibility of the posterior chain; however, few studies have evaluated the influence of occupation on this physical capacity. This assessment might contribute to establish an early intervention approach, in parallel to the occupational activity, in order to prevent musculoskeletal dysfunctions. The aim of this study wasto determine whether occupational activity influences posterior chain muscle flexibility during trunk-flexed posture and to analyze the body segments that are responsible for any flexibility changes. Twenty-four healthy women aged 18 to 55 years, who worked in cleaning and maintenance (n=13) and in offices (n=11), participated in the study.The following measurements were obtained to evaluate trunk flexion: fingertip-to-floor distance test (measuring tape), tibiotarsal angle, knee extension/flexion angle, hip angle, lumbar angle, and modified Chaffin technique (digital photogrammetry using the SAPo software). The groups were compared using the independent t-test. Women working inoffices presented the worst fingertip-to-floor test result (p=0.0518) and a lower modified Chaffin technique value (p=0.0134), whereas their tibiotarsal and hip angles were marginally greater (p=0.0609 and p=0.0713, respectively). Women who mainly work seatedpresented lower overall flexibility of the posterior chain muscles than women who perform occupations that require cyclic flexion of the trunk. The tibiotarsal and hip angles seem to be the body segments responsible for this reduction in flexibility.

What is the best method for child longitudinal plantar arch assessment and when does arch maturation occur?

BACKGROUND: The medial longitudinal arch modifies significantly during growth. Nevertheless, authors differ on the age at which the foot acquires the adult-like shape. The best method to assess this arch in children is also controversial. OBJECTIVES: Characterize the longitudinal arch of children between 3 and 10 years and compare the applicability of five evaluation methods. METHODS: Plantar prints were acquired from 391 healthy preschools children from the University of Sao Paulo, Brazil. We calculated the arch indexes of: Cavanagh and Rodgers, Chipaux-Smirak, Staheli and the Alfa Angle, and compared them with the feet posture assessment. Non-parametric tests were used to compare among methods and ages. Spearman correlation was used to establish relationships among indexes. RESULTS: 3 and 4 years old showed a high prevalence of low arches (36-86%). Between 4 and 5 years old, significant difference was observed for all indexes. The indexes presented good correlation among them, although the proportions of the different arch types were different for each age group (p<0.001). CONCLUSIONS: The longitudinal arch acquires an adult-like shape progressively, being statistically notorious the moment of medial longitudinal arch's formation between 4 and 5 years old. The Chipaux-Smirak Index is the best index to assess children's feet; it provides a better classification for lower arches and is easily calculated.

Caracterização postural dos membros inferiores de crianças obesas de 7 a 10 anos / Postural assessment of lower limbs 7 through 10 years-old children

A obesidade é uma enfermidade crônica caracterizada por acúmulo excessivo de gordura, determinando maior suscetibilidade a disfunções crônico-degenerativas. Embora existam estudos sobre as consequências da obesidade, poucos deles são biomecânicos...

Obesity is a common chronic disease which can be defined by an excessive deposit of fat and corporal mass, that affects health and life expectancy. Excess of fat and owerweight are accompanying even more secondary chronic-degenerative disorders. Although there are many researches about obesity and its consequences, there is too little available examining the biomechanical point of view...

Efeitos da intervenção fisioterapêutica nas respostas sensoriais e funcionais de diabéticos neuropatas / Effects of a physical treatment in sensory and functional responses of neuropathic diabetic patients

O objetivo foi elaborar e aplicar um tratamento fisioterapêutico para diabéticos neuropatas e comparar suas respostas sensoriais, motoras e funcionais pré e pós-intervenção, com um grupo de sujeitos não diabéticos assintomáticos...

The purpose of this study was to elaborate an apply a physical therapy treatment for diabetic neuropathic patients, comparing the sensorial, motor an functional responses before and after treatment to those of a healthy control group. Ten healthy subjetcs (CG) and 10 neuropathic diabetes patients...