Influence of the medial longitudinal arch of the foot in adult women in ankle isokinetic performance: a cross-sectional study.

BACKGROUND: Maintenance of the medial longitudinal arch (MLA) of the foot is fundamental during functional tasks and disorders can lead to clinical alterations. Studies have demonstrated that deficits in ankle isokinetic performance can predispose an individual to lower limb injuries. OBJECTIVES: To evaluate the muscular performance of cavus, planus, and normal feet by means of torque/body mass and the isokinetic phases, to generate 3D surface map analysis, and to verify whether there is a relationship between MLA height and arch height flexibility with isokinetic performance. METHODS: The sample consisted of 105 healthy adult women, divided into three groups: normal, cavus, and planus. Assessment in concentric mode at 30, 60, and 90 °/s in the dorsiflexion and plantarflexion of the ankle joint were analyzed during the three isokinetic phases (acceleration, sustained velocity, and deceleration). The variables total range of motion, peak of torque (PT), and angle of PT were extracted within the sustained velocity. RESULTS: In dorsiflexion at 60 °/s, the phase where the velocicty is sustained (load range phase) was higher in the planus group (MeanDifference=10.9 %; ω2p = 0.06) when compared with the cavus group. Deficits in the peak torque/body mass in dorsiflexion at 60 °/s (cavus feet: MD=-3 N.m/kg; ω2p = 0.06; and planus feet: MD=-1.1 N.m/kg; ω2p = 0.06) were also observed as well as in the 3D surface maps, when compared with the normal group. The flexibility of MLA had a negative correlation of PT at 30 °/s in cavus group. The heigth of MLA had a postive correlation with the PT for the cavus and planus group ate 60 °/s. All other results did not show differences between the groups. CONCLUSIONS: The planus groups showed a better capacity of attain and sustained the velocity in dorsiflexion in relation the cavus group. The cavus and planus group had deficts in torque in relation the normal. The correlations were weak between the measures of MLA and PT. Thereby, in general the differences between foot types showed small effect in isokinetic muscle performance measures of the plantar and dorsi flexores. TRIAL REGISTRATION: Study design was approved by the IRB (#90238618.8.0000.5231).

Non-radiographic validity and reliability measures for assessing foot types: A systematic review.

BACKGROUND: Foot type classification is well recognized in clinical practice and orthopedic literature, a universally accepted classification or standardized measures to determine foot types are lacking. The objective of this study was to identify which non-radiographic assessment methods are considered valid and/or reliable for the classification of foot types. METHOD: A systematic database search was performed. Only cross-sectional studies that performed reliability and/or validity analysis of non-radiographic methods were included. To evaluate the risk of bias, the Critical Appraisal Tool (CAT) was used to evaluate the measurement properties of objective clinical methods. RESULTS: Twenty-six studies were included. The results of reliability and validity, in general, demonstrated high scores, but, inconsistencies were related to the variability of the measurements, heterogeneity of the methods used to determine reliability and validity, and lack of parameters for classifying foot types, which resulted in few elements to determine which method of foot type evaluation is valid and reliable. CONCLUSION: Given the Intraclass Correlation Coefficient and CAT results and the presence of normative values, the static measurements of the "Arch Height Index", "Foot Posture Index", and "Staheli Arch Index" can be suggested to classify foot types.

Comparing the effects of aquatic exercises with or without high intensity on the functional status, muscular endurance, and performance of patients with chronic low back pain.

BACKGROUND: The prevalence of low back pain is lower when physical fitness (aerobic and muscular) is higher. Strength exercises are important for subjects with low back pain, but there are few studies on the inclusion of aerobic exercise in low back pain programs. The aim of this study was to compare the effects of aquatic exercises with or without high-intensity component on the functional status, lumbar and abdominal muscle endurance, and performance of subjects with chronic low back pain. METHODS: Forty-eight volunteers between 20 and 60 years old were randomly allocated to an experimental group AEDWR (aquatic exercises plus deep-water running group, N.=25) or to a control group AE (aquatic exercises only group, N.=23). The dependent variables included functional status (Repeated Sit-to-Stand test), lumbar (Sorensen test) and abdominal (One Minute Abdominal test) muscle endurance, and physical performance (Maximum Physical Fitness test), which were measured before and after the 9-week intervention and at 21 weeks of follow-up. RESULTS: Lumbar endurance was higher in the AEDWR group at the end of the treatment, with a mean difference (MD) of 43.2 seconds, 95% confidence intervals (CI) (9.6; 76.7), P=0.01, d̅=0.74, and better in the follow-up with MD=40.2 seconds, 95% CI (7.1; 73.3), P=0.02, d̅=0.71, than in the AE group. Participant performance also improved on the 9th week in the AEDWR group, with an MD=0.53 kgf, 95% CI (0.008; 0.98), P=0.02, d̅=0.60. CONCLUSIONS: The addition of deep-water running exercise to aquatic exercises improved lumbar muscle endurance and performance when compared with aquatic exercises only, and this effect was maintained during the follow-up to lumbar muscle endurance.

Test-retest reliability of multiscale fractal dimension measurements of plantar pressure maps during dynamic tasks.

The tools used to evaluate foot types are divergent since they adopt classic linear analyzes, based on anthropometric or image measurements, which do not dynamically contemplate the variability of foot shape. The use of newer techniques such as multiscale fractal dimension (MFD) may be a key to this type of problem. However, for these measures to be used safely and consistently, it is essential to evaluate their reliability. The aim of this study was to evaluate the test-retest reliability of MFD measurements of adult plantar pressure maps during gait, as well as the standard error of measurement (SEM), and minimal detectable change (MDC90). Seventy-two subjects were included in the test-retest, with a one week interval. The plantar pressure maps were constructed using a pressure platform. The data were processed in a routine for extracting the MFD curve measurements (maximum and integral values). The Intraclass Correlation Coefficient results (ICC3,k) were excellent for both measurements (maximum value 0.96, 95% confidence interval [0.93-0.97], and integral 0.95 [0.92-0.97]) with low SEM and MDC90 values below 10% of the mean. The application of MFD to the plantar pressure data generated by the pressure platform is reliable and could allow exploration of the complexity of foot shapes, enabling their classification.

Effectiveness of additional deep-water running for disability, lumbar pain intensity, and functional capacity in patients with chronic low back pain: A randomised controlled trial with 3-month follow-up.

BACKGROUND: Aquatic exercise (AQE) programme is commonly used as an alternative to the chronic low back pain (CLBP) treatment. The addition of aquatic aerobic exercises to AQE may be beneficial to patients with CLBP. DESIGN: Randomised controlled trial. OBJECTIVES: To assess the effectiveness of AQE with the addition of aerobic exercise - deep-water running (DWR) - compared to exclusive AQE in improving disability, lumbar pain intensity, and functional capacity in patients with CLBP. METHODS: Fifty-four adult patients with CLBP were randomised either to the experimental group (AQE + DWR) or the control group (AQE). An assessor who was blinded to the group allocation performed both pre- and post-interventions assessments. Both treatments lasted 9 weeks, with a 3-month follow-up. The primary outcome was disability, as evaluated using the Roland Morris Disability Questionnaire. The secondary outcomes were pain and functional capacity; pain was assessed using a visual analogue scale (VAS), and functional capacity (travelled distance) was measured using the 6-min walk test (6WT). RESULTS: A significant difference in pain was observed between groups after intervention in favour of DWR (mean difference -1.3 cm [95% confidence interval (CI) -2.17 to -0.45], d‾ = 0.80 [95% CI 0.22 to 1.33]). CONCLUSION: Treatment with DWR was effective in the short term for achieving the desired outcome of pain reduction when compared with AQE only but not for disability and functional capacity.

Low back pain affects coordination between the trunk segments but not variability during running.

This study aimed to analyze the coordination and variability between the thorax, lumbar, and pelvis segments in runners with chronic low back pain group (LBPG) and matched control group (CG). Twenty-six recreational runners were evaluated on a treadmill at 3.3 m/s. The coordination of the pelvis-lumbar and lumbar-thorax in all three planes and between the transverse and frontal plane of the lumbar segment were evaluated using the vector coding technique. Coordination was analyzed via histograms with the percentage of each pattern and the coupling angle during the cycle. The variability coordination was calculated from the angular deviation between the cycles. Differences were observed in the coordination patterns and in the coupling angle during the cycle. Between the pelvis-lumbar in the frontal plane, the LBPG (x¯ = 50.6% (SD = 10.7)) presented more in-phase pattern than the CG (38.6% (8.7; P = 0.05). For the lumbar-thorax, differences occurred in all planes. Between the frontal-transverse plane of the lumbar segment, the LBPG (27.6% (7.9)) presented more in-phase pattern than the CG (38.6% (8.7); P = 0.02). The variability did not demonstrate the differences between the groups; these differences were observed in coordination between the lumbar and adjacent segments in all planes. The model of rigid segments and the coordination analyses were sensitive to detect these differences, and the presence of more in-phase patterns could be related to the protection mechanism in order to avoid painful movements.

Velocity-specific knee strength between professional and under-17 female volleyball players.

BACKGROUND: Many studies have investigated isokinetic performance in volleyball players but not through surface maps. OBJECTIVES: The goals of this study were to assess velocity-specific isokinetic knee extensor-flexor muscle strength and to compare the isokinetic knee extensor-flexor muscles between professional (PRO) and under-17 (U17) female volleyball players. METHOD: This cross-sectional laboratory study was developed with two groups: PRO (n = 12), medianage = 21.3 years, and U17 (n = 9), medianage = 15 years. Peak torque, total work, mean power, angle of peak torque, hamstring-quadriceps torque ratio (H-Q ratio) and torque-angle-velocity surface maps were analysed from knee extension-flexion at 60, 120 and 300 degrees per second (°/s). RESULTS: Significant differences were identified for extensor peak torque between PRO x = 202.3 Newton metre (N·m) (standard deviation [SD] = 24.4) and U17 x = 141.6 N·m (30.1) at 60 °/s (p < 0.001; d = 2.21) as well as flexor peak torque (PRO x = 75.7 N·m [10.3] and U17 x = 57.7 N·m [11.4]) at 120 °/s (p < 0.001; d = 1.65) for the dominant limb. There were also significant group differences for total work and mean power at all velocities for extension and flexion. Surface maps demonstrated higher torque at lower speeds for both groups with smaller torque changes across velocities for flexion. CONCLUSION: Different groups of female volleyball players showed contrasting concentric knee muscle strength across isokinetic velocities. CLINICAL IMPLICATIONS: These results demonstrate the importance of specific strength training for different age groups, even within the same sport, and provide insight into muscle strength.

ISOKINETIC MUSCLE PERFORMANCE AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A CASE-CONTROL STUDY.

BACKGROUND: and Purpose: Knee muscle strength deficits have been reported in individuals who have undergone anterior cruciate ligament reconstruction (ACLR). Isokinetic testing is a valid way to assess muscle strength. Some isokinetic variables, including the range of motion in the phases to attain a specific velocity, load range (sustained specific velocity), time to achieve deceleration, and qualitative analysis of the torque-angle velocity relationship, may contribute to understanding recovery of these individuals after surgery. Thus, the purpose of this study was to compare the load range (LR), time to attain velocity (TTAV), deceleration time (DT) phases, total range of motion (ROM), peak torque/body mass (PT/BM), angle of peak torque (AngPT) during LR and torque-angle-velocity relationships (TAV3D) between post ACLR and matched control subjects.Study design: Case-control. METHODS: Seven men who underwent ACLR and seven matched controls were evaluated from four to six months after surgery. Testing was performed on a Biodex System 4 isokinetic dynamometer in concentric mode at 60, 120 and 300 °/s, for knee flexion and extension. RESULTS: Statistically significant differences were seen for extension ROM at 60 °/s where ROM was greater in the control group. PT/BM for extensors was also significantly greater in controls by 20 % compared to ACLR at 60 and 120 °/s. PT/BM for flexors was significantly greater for controls at 60 °/s (∼15 %). TAV3D showed differences in torque and, specifically, the control group sustained knee flexion torque for a greater range of motion when compared to the ACLR group. CONCLUSION: The ACL group presented with lower ROM and PT/BM, therefore exhibiting worse muscle performance in comparison to the control group.Level of Evidence: 3.