Reductions in rearfoot eversion posture due to proximal muscle strengthening are dependent on foot-ankle varus alignment.

BACKGROUND: Strengthening the hip and trunk muscles may decrease foot pronation in upright standing due to expected increases in hip passive torque and lower-limb external rotation. However, considering the increased pronation caused by a more varus foot-ankle alignment, subjects with more varus may experience smaller or no postural changes after strengthening. OBJECTIVE: To investigate the effects of hip and trunk muscle strengthening on lower-limb posture during upright standing and hip passive torque of women with more and less varus alignment. METHODS: This nonrandomized controlled experimental study included 50 young, able-bodied women. The intervention group (n = 25) performed hip and trunk muscle strengthening exercises, and the control group (n = 25) maintained their usual activities. Each group was split into two subgroups: those with more and less varus alignment. Hip, shank, and rearfoot-ankle posture and hip passive external rotation torque were evaluated. Mixed analyses of variance and preplanned contrasts were used to assess prepost changes and between-group differences (α = 0.05). RESULTS: The less-varus subgroup of the intervention group had a reduced rearfoot eversion posture (P = 0.02). No significant changes were observed in the less-varus subgroup of the control group (P = 0.31). There were no significant differences in posture between the control and intervention groups when varus was not considered (P ≥ 0.06). The intervention group had increased hip passive torque (P = 0.001) compared to the control group, independent of varus alignment. CONCLUSION: Despite the increases in hip passive torque, the rearfoot eversion posture was reduced only in women with a less-varus alignment. Having more foot-ankle varus may prevent eversion reductions.

Extracorporeal shock-wave therapy for the treatment of non-calcific rotator cuff tendinopathy: A systematic review and meta-analysis.

OBJECTIVE: To systematically review the short, intermediate, and long-term effects of extracorporeal shockwave therapy (ESWT) on pain intensity and shoulder function in individuals with non-calcific rotator cuff tendinopathy. DESIGN: The MEDLINE, CINAHL, SPORTDiscus, and EMBASE were searched from inception up to June 2023. We included randomized controlled trials that investigated the effects of ESWT on pain intensity and shoulder function. RESULTS: Nine studies were included with a total sample of 543 individuals. ESWT was superior to sham ESWT in improving pain intensity at short-term follow-up (SMD = -0.29, 95% CI -0.57 to -0.01). ESWT was not superior to sham ESWT in improving pain intensity at intermediate-term and long-term follow-ups (p > 0.05). ESWT was not superior to other treatments in improving pain intensity at short-term and intermediate-term follow-ups (p > 0.05). ESWT was not superior to sham ESWT and other treatments in improving shoulder function at short-term, intermediate-term, and long-term follow-ups (p > 0.05). CONCLUSION: Moderate-certainty evidence indicated that ESWT showed small improvement in shoulder pain over sham ESWT at short-term follow-up. In addition, ESWT was not superior to sham ESWT in improving function and it was not superior to other treatments in improving shoulder pain and function.

Cross-cultural adaptation and reliability of the Functional Gait Assessment in older Brazilian adults.

BACKGROUND: The Functional Gait Assessment (FGA) is a standardized instrument for assessing postural stability during various walking tasks. It was developed to increase the reliability and to decrease the potential ceiling effect observed with the Dynamic Gait Index (DGI). OBJECTIVE: To translate and cross-culturally adapt the FGA into Portuguese-Brazilian, and to evaluate its reliability in community-dwelling Brazilian older adults. METHODS: The process of translation and cross-cultural adaptation followed the recommendations of international guidelines. The pre-final version was applied to a sample of 55 older adults of both sexes living independently in the community. For the assessment of reliability (i.e. inter- and intra-rater reliability, standard error of measurement (SEM), and internal consistency), 70 older adults aged 60-87 years were evaluated. RESULTS: There was a conceptual equivalence between the original and the translated versions. All FGA items that used measurements in inches and feet were modified to use matching values in centimeters to reflect the measurement unit used in Brazil. The FGA-Brazil showed excellent inter- and intra-rater reliability (ICC2,1 > 0.90), low SEM (ranging from 1.03 to 1.52), and good internal consistency (Cronbach's alpha = 0.858). CONCLUSION: The FGA-Brazil is a semantically and linguistically valid and reliable instrument to assess walking balance among community-dwelling older adults.