Biomechanic of ballroom dance: corporate adaptations with different footwear / Biomecânica da dança de salão: adaptações corporais com diferentes calçados

ABSTRACT The aim of this study was to compare the joint amplitude, spine angulation and displacement of the center of mass during the execution of gafieira samba with and without high heels at different speed. In addition, the reproducibility of the movement was tested. Fifteen experienced dancers performed a sequence of gafieira samba steps under the conditions: high heels (7.5cm) and flats at two speeds according to the beat of music (72 and 96bpm). Kinematic analysis was performed on the Vicon® system with 11 cameras (100 Hz). Twenty-one reflective markers were positioned over the participants' bodies to calculate the center of mass and joint angles of the lower limbs and spine. Reproducibility was determined by the intraclass correlation coefficient and the comparison between conditions was tested by a Two-way Analysis of Variance, with the factors footwear and speed. The results indicated to a moderate to very high reproducibility in all variables analyzed. No differences were found between lumbar curvature, thoracic and displacement of the center of mass. There was no interaction between types of footwear and step execution speed, but analyzing the main factors, there was a decrease in the left ankle plantiflexion angle with increasing speed. The ankle angles showed a significant decrease under the condition flats when compared to high heels. In conclusion, high heels do not alter lumbar curvature, displacement of the center of mass and knee and hip joint amplitude in the execution of gafieira samba.

RESUMO O objetivo deste estudo foi comparar a amplitude articular, angulação da coluna e deslocamento do centro de massa durante execução do samba de gafieira com e sem salto alto em diferentes velocidades. Adicionalmente, a reprodutibilidade do movimento foi testada. Quinze dançarinas experientes realizaram uma sequência de passos de samba de gafieira nas condições: salto alto (7,5 cm) e sapatilha em duas velocidades de execução de acordo com o compasso das músicas (72 e 96bpm). A análise cinemática foi realizada no sistema Vicon® com 11 câmeras (100 Hz). Vinte e um marcadores reflexivos foram posicionados sobre o corpo das participantes a fim de calcular o centro de massa e ângulos articulares dos membros inferiores e coluna. A reprodutibilidade foi determinada pelo coeficiente de correlação intraclasse e a comparação entre condições foi testada por uma análise de variância Two way, com os fatores calçados e velocidade. Os resultados indicaram para uma reprodutibildade de moderada a muito alta em todas as variavéis analisadas. Não foram encontradas diferenças entre as curvaturas da lombar, torácia e deslocamento do centro de massa. Não houve interação entre tipos de calçado e velocidade de execução dos passos, porém analisando os fatores principais, ocorreu uma diminuição do ângulo de plantiflexão do tornozelo esquerdo com o aumento da velocidade. Os ângulos de tornozelo apresentaram diminuição significativa em situação do uso de sapatilhas, quando comparados ao salto. Conclui-se que o salto alto não altera a curvatura da lombar, deslocamento de centro de massa e amplitude articular do joelho e quadril na execução do samba de gafieira.

Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis

Abstract: Background: In our country, the Brazilian Standard Series is the most used for the etiological diagnosis of allergic contact dermatitis to shoes. However, there is no assessment of the usefulness of specific allergens for shoes. Objectives: To measure the improvement in diagnostic accuracy of allergic contact dermatitis to shoes with the use of a specific complementary series in patch testing and describe the characteristics of the affected population, such as gender, location of lesions, time of evolution, and the most common allergens. Methods: This retrospective study evaluated the results of 52 patients with suspected shoe dermatitis subjected to patch tests with the standard and specific series to quantify the gain in diagnostic accuracy. Results: Among the 52 suspected cases, 29 cases (56%) were confirmed. In 13 (45%) cases the diagnosis was determined through the specific series, which results in an 81% increase in the number of diagnoses. Study limitation: Small sample size. Conclusions: Women were more commonly affected, with a mean time for the final diagnosis of 45 months, and the most common localization was the dorsum of the feet. There was an increase in diagnostic accuracy with the introduction of new haptens in the patch test of patients with suspected shoes dermatitis.

The influence of heel height related on quality of life on the foot in a sample of women.

Many women have worn high-heel shoes (HHS) at some point in their lives and many wear them on a daily basis, with higher prevalence between 39% and 78% observed in institutional and clinical settings. The purpose of this study was to describe and compare the scores obtained with regard to foot health and health in general in a sample of women that use HHS as opposed to a sample of women without HHS with normalized reference values. A sample of 120 participants with a mean age of 41.94 ± 13.912 came to a health center where self-reported data were registered. The subjects with and without HHS were determined and the scores obtained were compared in the Foot Health Status Questionnaire (FHSQ). This questionnaire is made of 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The women in the HHS group showed a worse quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance (P<0.01). Women with HHS present a negative impact on the quality of life related to foot health.

Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis.

BACKGROUND: In our country, the Brazilian Standard Series is the most used for the etiological diagnosis of allergic contact dermatitis to shoes. However, there is no assessment of the usefulness of specific allergens for shoes. OBJECTIVES: To measure the improvement in diagnostic accuracy of allergic contact dermatitis to shoes with the use of a specific complementary series in patch testing and describe the characteristics of the affected population, such as gender, location of lesions, time of evolution, and the most common allergens. METHODS: This retrospective study evaluated the results of 52 patients with suspected shoe dermatitis subjected to patch tests with the standard and specific series to quantify the gain in diagnostic accuracy. RESULTS: Among the 52 suspected cases, 29 cases (56%) were confirmed. In 13 (45%) cases the diagnosis was determined through the specific series, which results in an 81% increase in the number of diagnoses. STUDY LIMITATION: Small sample size. CONCLUSIONS: Women were more commonly affected, with a mean time for the final diagnosis of 45 months, and the most common localization was the dorsum of the feet. There was an increase in diagnostic accuracy with the introduction of new haptens in the patch test of patients with suspected shoes dermatitis.

The influence of heel height related on quality of life on the foot in a sample of women

SUMMARY Many women have worn high-heel shoes (HHS) at some point in their lives and many wear them on a daily basis, with higher prevalence between 39% and 78% observed in institutional and clinical settings. The purpose of this study was to describe and compare the scores obtained with regard to foot health and health in general in a sample of women that use HHS as opposed to a sample of women without HHS with normalized reference values. A sample of 120 participants with a mean age of 41.94 ± 13.912 came to a health center where self-reported data were registered. The subjects with and without HHS were determined and the scores obtained were compared in the Foot Health Status Questionnaire (FHSQ). This questionnaire is made of 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The women in the HHS group showed a worse quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance (P<0.01). Women with HHS present a negative impact on the quality of life related to foot health.

RESUMO Muitas mulheres usaram sapatos de salto alto (SSA) em algum momento de suas vidas e muitas usam diariamente, com maior prevalência entre 39% e 78%, observadas em contextos institucionais e clínicos. O objetivo deste estudo foi descrever e comparar os escores obtidos em relação à saúde dos pés e à saúde em geral em uma amostra de mulheres que utilizam SSA em oposição a uma amostra de mulheres sem SSA com valores de referência normalizados. Uma amostra de 120 participantes com idade média de 41,94 ± 13,912 chegou a um centro de saúde onde os dados autorrelatados foram registrados, os informantes com e sem SSA foram determinados e os escores obtidos foram comparados no Foot Health Status Questionnaire (FHSQ). Esse documento tem 13 questões que avaliam quatro domínios de saúde dos pés, nomeadamente dor, função, saúde geral e calçado. As mulheres do grupo SSA apresentaram pior qualidade de vida relacionada à saúde em geral e à saúde dos pés, especificamente. As diferenças entre os dois grupos foram avaliadas por meio de um teste t para amostras independentes, mostrando significância estatística (P <0,01). As mulheres com SSA apresentam um impacto negativo na qualidade de vida relacionada à saúde dos pés.

Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear / Mudanças no fluxo sanguíneo das extremidades inferiores nas fases avançadas da gravidez e os efeitos de calçado especial

Background: During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives: The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods: Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen's d test to calculate effect size. Results: With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions: Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application

Contexto: Durante a gravidez, uma série de mudanças que afetam o fluxo venoso ocorrem no sistema circulatório, tais como menor tensão da parede venosa ou aumento da exposição a fibras de colágeno. Esses fatores podem causar estagnação sanguínea, inchaço das pernas ou dano endotelial e, consequentemente, levar ao desenvolvimento de doença venosa. Objetivos: O objetivo deste estudo foi avaliar o efeito do uso de calçados especiais projetados para melhorar a circulação sanguínea dos pés sobre as mudanças no fluxo venoso observadas nas fases avançadas da gravidez. Métodos: Trinta gestantes saudáveis participaram deste estudo às 25, 30 e 35 semanas de gestação. As participantes foram aleatoriamente designadas a um grupo experimental (n = 15) que recebeu calçados especiais, ou um grupo controle (n = 15). A cada sessão de coleta de dados, foram obtidas medidas Doppler do pico de velocidade do fluxo sanguíneo sistólico e da área transversal da veia poplítea direita, utilizando-se um aparelho de ultrassom MySonoU6 com transdutor linear (Samsung Medison). As diferenças foram comparadas utilizando-se o teste d de Cohen para calcular o tamanho do efeito. Resultados: Nas fases avançadas da gravidez, o pico da velocidade sistólica na veia poplítea diminuiu significativamente no grupo controle, porém aumentou significativamente no grupo experimental. Não houve mudanças significativas na área transversal da veia poplítea em nenhum dos grupos. Conclusões: Os achados do grupo experimental demonstraram que o uso dos calçados especiais testados pode evitar que a velocidade do fluxo venoso diminua nas fases avançadas da gravidez. No entanto, mais estudos são necessários para investigar os efeitos benéficos sobre o fluxo venoso do uso dos calçados testados e suas aplicações

Unna's boot: experience of care of people with venous ulcers.

OBJECTIVE: to understand the experience of care of people with venous ulcers using an Unna's boot. METHOD: a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories. RESULTS: the following categories emerged: "Unna's boot annoyance versus wound improvement", "Difficulties for accessing care with the Unna's boot", "Care for healing and preventing recurrence", and "Receiving more attention from the healthcare professional". CONCLUSION: the experience of care of people using an Unna's boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients' expectations regarding wound healing. The issues of these people's intersubjective universe should be considered in the management of care of venous ulcers.

Unna's boot: experience of care of people with venous ulcers / Bota de Unna: experiencia del cuidado de personas con úlcera varicosa / Bota de Unna: vivência do cuidado por pessoas com úlcera varicosa

ABSTRACT Objective: to understand the experience of care of people with venous ulcers using an Unna's boot. Method: a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories. Results: the following categories emerged: "Unna's boot annoyance versus wound improvement", "Difficulties for accessing care with the Unna's boot", "Care for healing and preventing recurrence", and "Receiving more attention from the healthcare professional". Conclusion: the experience of care of people using an Unna's boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients' expectations regarding wound healing. The issues of these people's intersubjective universe should be considered in the management of care of venous ulcers.

RESUMEN Objetivo: comprender la experiencia del cuidado de personas con úlcera varicosa utilizando la Bota de Unna. Método: estudio cualitativo, fundamentado en fenomenología social de Alfred Schütz, realizado con 12 adultos entrevistados en 2015. Testimonios analizados y organizados en categorías temáticas. Resultados: surgieron las categorías: "Incomodidad de la Bota de Unna versus mejora de la herida", "Dificultades para el acceso al cuidado con la Bota de Unna", "Cuidar para cicatrizar y prevenir recidivas" y "Recibir más atención del profesional de salud". Conclusión: la experiencia de cuidado de personas utilizando la Bota de Unna expresó la incomodidad del dispositivo, superado por la mejora de la herida. No obstante, el acceso al cuidado resultó comprometido por falta de estructura del servicio, frustrando expectativas de los participantes respecto a la cicatrización de la herida. Las cuestiones del universo intersubjetivo de estas personas deben considerarse en la gestión del cuidado de la úlcera varicosa.

RESUMO Objetivo: compreender a vivência de cuidado de pessoas com úlcera varicosa em uso da Bota de Unna. Método: estudo qualitativo fundamentado na fenomenologia social de Alfred Schütz, realizado com 12 adultos entrevistados em 2015. Os depoimentos foram analisados e organizados em categorias temáticas. Resultados: foram desveladas as categorias: "O incômodo da bota de Unna versus a melhora da ferida", "Dificuldades para o acesso ao cuidado com a Bota de Unna", "Cuidar para cicatrizar e prevenir recidivas" e "Receber mais atenção do profissional de saúde". Conclusão: a vivência de cuidado de pessoas em uso da Bota de Unna revelou o incômodo proporcionado por este dispositivo, superado pela melhora da ferida. Porém, o acesso ao cuidado foi comprometido pela falta de estrutura do serviço, frustrando as expectativas dos participantes em relação à cicatrização da ferida. As questões do universo intersubjetivo dessas pessoas devem ser consideradas na gestão do cuidado da úlcera varicosa.

Shoe heel abrasion and its possible biomechanical cause: a transversal study with infantry recruits.

BACKGROUND: Excessive shoe heel abrasion is of concern to patients and shoe manufacturers, but little scientific information is available about this feature and its possible causes. The purpose of this study was to relate this phenomenon with biomechanical factors that could predispose to shoe heel abrasion. METHODS: Ninety-seven recruits (median age 25) were enrolled in this study. Shoe abrasion was assessed manually with a metric plastic tape on the posterior part of the heel that comes in contact with the ground. The number of sprains, foot alignment, and calf muscle shortening (Silfverskiold test) was also assessed in order to relate it with shoe heel abrasion. After using our exclusion criteria, 86 recruits and 172 were considered for this study. RESULTS: The most common abrasion site was the lateral portion of the heel surface (50 %). Forty-four percent of the participants had neutral hind-foot alignment and 39 % had valgus alignment. Twenty-six (30 %) patients have had previous ankle or foot sprains. Neutral foot was related with less calf muscle shortening. On the other hand, valgus hind-foot alignment was more associated with Achilles shortening (p < 0.05). Patients with neutral alignment were associated with more uniform shoe heel abrasion and varus feet were associated with more central and lateral abrasion (p < 0.05). The pattern of shoe heel abrasion was not statistically related with calf muscle shortening nor with number of sprains. CONCLUSION: This study was able to correlate shoe heel abrasion with biomechanical causes (neutral alignment-uniform abrasion/varus alignment-central and lateral abrasion). More effort has to be done to continue evaluating outsole abrasion with its possible biomechanical cause in order to predict and treat possible associated injuries.

Influência do calçado de salto alto na atividade eletromiográfica do músculo quadríceps em mulheres com e sem síndrome da dor femoropatelar durante a tarefa de levantar e sentar / Influence of high-heeled shoes on the quadriceps electromyographic activity in women with and without patellofemoral pain syndrome during the sit-to-stand task / Influencia del calzado de tacón alto en la actividad electromiográfica del músculo cuádriceps en mujeres con y sin síndrome de dolor patelofemoral durante la tarea de levantarse y sentarse

O objetivo do estudo foi analisar a influência do calçado de salto alto na atividade eletromiográfica (EMG) do músculo quadríceps durante a tarefa de sentar e levantar. Participaram deste estudo 10 voluntárias assintomáticas com 20,2±3,0 anos e 10 voluntárias com síndrome da dor femoropatelar (SDFP) com 21,3±3,4 anos. As voluntárias executaram a tarefa de sentar e levantar em 3 diferentes condições: descalças, com tênis e com calçado de salto de 10 cm. A atividade EMG do vasto medial oblíquo (VMO), vasto lateral (VL) e reto femoral (RF) foi registrada durante a execução das tarefas por meio de eletrodos de superfície simples diferencial conectados ao eletromiógrafo. Para comparação entre grupos e tarefas, foi utilizado o teste ANOVA com medidas repetidas e o post hoc do teste de Tukey (p<0,05). Os resultados demonstraram maior atividade EMG do músculo VMO, no grupo Controle, durante as tarefas de levantar e sentar utilizando o salto alto. No grupo SDFP, foi observado aumento da atividade EMG do VL na tarefa de levantar do banco e diminuição da razão VMO:VL com o uso do salto alto. Os resultados mostraram que o uso do salto alto pode provocar um aumento da atividade do VL em relação ao VMO em mulheres com SDFP, fato esse que pode colaborar para o mau alinhamento patelar e agravamento da SDFP. Portanto, os resultados sugerem que esse tipo de calçado deve ser evitado por mulheres com SDFP.

The purpose of this study was to analyze the influence of high-heeled shoes on the quadriceps electromyographic activity (EMG) during the sit-to-stand task. Ten healthy females (20.2±3.0 years) and 10 females with patellofemoral pain syndrome (PFPS) (21.3±3.4 years) participated in this study. The subjects performed a standardized sit-to-stand task under 3 conditions: barefoot, wearing sneakers and wearing 10 cm high-heeled shoes. The electromyographic (EMG) activity was recorded from the vastus medialis obliquus (VMO), vastus lateralis (VL) and rectus femoris (RF) muscles during the tasks using simple differential surface electrodes connected to an EMG system. To compare data between groups and tasks, the ANOVA test with repeated measures and the Tukey post hoc test were applied (p<0.05). Results demonstrated higher EMG activity for the VMO muscles during stand and sit tasks performed with high-heeled shoes in the control group. In the PFPS group, an increased EMG activity for the VL muscle during the stand task was observed, and the VMO:VL ratio decreased with the use of high heels. Results show that the use of high-heeled shoes can further increase the EMG activity of the VL muscle than the VMO in women with PFPS, a fact that may contribute to the increased joint imbalance and worsened PFPS. Therefore, the results suggest that this type of footwear should be avoided by women with PFPS.

El objetivo del estudio fue analizar la influencia del calzado de tacón alto en la actividad electromiográfica (EMG) del músculo cuadríceps durante la tarea de sentarse y levantarse. Participaron de este estudio 10 voluntarias asintomáticas con 20,2±3,0 años y 10 voluntarias con síndrome de dolor patelofemoral (SDPF) con 21,3±3,4 años. Las voluntarias ejecutaron la tarea de sentarse y levantarse en tres diferentes condiciones: descalzas, con zapatillas y con calzado de tacón de diez centímetros. La actividad EMG del vasto medial oblícuo (VMO), vasto lateral (VL) y recto femoral (RF) fue registrada durante la ejecución de las tareas por medio de electrodos de superficie diferenciales conectados al electromiógrafo. Para la comparación entre grupos y tareas fue utilizada la prueba ANOVA con medidas repetidas y post test de Tukey (p<0,05). Los resultados demostraron más actividad EMG del músculo VMO, en el grupo Control durante las tareas de levantarse y sentarse utilizando el tacón alto. En el grupo SDPF fue observado un aumento de la actividad EMG del VL en la tarea levantarse del banco y disminución de la relación VMO:VL con el uso de tacón alto. Los resultados mostraron que el uso de tacón alto puede causar un aumento de la actividad del VL en relación al VMO en mujeres con SDPF, un hecho que puede colaborar para un mal alineamiento patelar y una agravación del SDPF. Por lo tanto, los resultados sugieren que ese tipo de calzado debe ser evitado por mujeres con SDFP.

Interference of high-heeled shoes in static balance among young women.

The aim of the present study was to assess the effect of the use of high-heeled shoes on static balance in young adult women. Fifty-three women between 18 and 30 years of age and accustomed to wearing high-heeled shoes participated in the study. None of the participants had any orthopedic or neurologic alterations. Static balance was assessed using a force plate. Oscillations from the center of pressure in the mediolateral and anteroposterior directions were measured both when barefoot and when wearing high-heeled shoes [7 centimeters (cm) in height and 1cm in diameter] under the conditions of eyes open and eyes closed. Two-way analysis of variance was employed for the statistical analysis, with the level of significance set at 5% (p<.05). The results revealed statistically significant differences between tests when barefoot and when wearing high-heeled shoes as well as with eyes open and eyes closed (p<.01). With the use of high-heeled shoes, there was a significant increase in mediolateral oscillation with eyes closed (p<.01). The present study demonstrates that the use of seven-cm high heels altered static balance in the healthy young women analyzed, increasing the oscillation of the center of pressure, regardless of visual restriction.

Influence of high-heeled shoes on venous function in young women.

BACKGROUND: Walking with high-heeled shoes is a common cause of venous complaints such as pain, fatigue, and heavy-feeling legs. The aim of the study was to clarify the influence of high-heeled shoes on the venous return and test the hypothesis that women wearing different styles of high-heeled shoes present an impaired venous return when compared with their values when they are barefoot. METHODS: Thirty asymptomatic women (mean age, 26.4 years) wearing appropriately sized shoes were evaluated by air plethysmography (APG), a test that measures changes in air volume on a cuff placed on the calf, while they performed orthostatic flexion and extension foot movements and altered standing up and lying down. The test was repeated in four situations: barefoot (0 cm), medium heels (3.5 cm), stiletto high heels (7 cm), and platform high heels (7 cm). The APG values of venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) were divided into four groups according to heel height and compared by repeated-measures analysis of variance. RESULTS: RVF was increased in the groups wearing high heels (stiletto and platform) compared with the barefoot group (P < .05). RVF was increased in the medium-heel group (3.5 cm) compared with the barefoot group (P < .05), and despite the lack of statistical significance, the medium-heel group showed lower values of RVF compared with the two high-heel groups. The EF parameter followed the opposite tendency, showing higher values for the barefoot group compared with the other three groups (P < .05). Values for VFI were similar in the three situations evaluated. CONCLUSIONS: High heels reduce muscle pump function, as demonstrated by reduced EF and increased RVF values. The continuous use of high heels tends to provoke venous hypertension in the lower limbs and may represent a causal factor of venous disease symptoms.

The relationship between wearing incorrectly sized shoes and foot dimensions, foot pain, and diabetes.

CONTEXT: Wearing inappropriate shoes can cause biomechanical imbalance, foot problems, and pain and induce falls. OBJECTIVE: To verify the prevalence of wearing incorrectly sized shoes and the relationship between incorrectly sized shoes and foot dimensions, pain, and diabetes among older adults. DESIGN: A cross-sectional study. PARTICIPANTS: 399 older adults (227 women and 172 men) age 60 to 90 y. MAIN OUTCOME MEASURES: The participants were asked about the presence of diabetes, pain in the lower limbs and back, and pain when wearing shoes. Foot evaluations comprised the variables of width, perimeter, height, length, first metatarsophalangeal angle, the Arch Index, and the Foot Posture Index. The data analysis was performed using a 2-sample t test and chi-square test. RESULTS: The percentage of the participants wearing shoe sizes bigger than their foot length was 48.5% for the women and 69.2% for the men. Only 1 man was wearing a shoe size smaller than his foot length. The older adults wearing the incorrect shoe size presented larger values for foot width, perimeter, and height than those wearing the correct size, but there were no significant differences between the groups with respect to the Arch Index and the Foot Posture Index. Incorrectly sized shoes were associated with ankle pain in women but not with diabetes. Men were more likely to wear incorrectly fitting shoes. The use of correctly sized shoes was associated with back pain in women. CONCLUSIONS: The use of incorrectly sized shoes was highly prevalent in the population studied and was associated with larger values for foot width, perimeter, and height and with ankle pain.

Educação em pé diabético / Education for diabetic foot

Objetivo: O objetivo desta investigação foi determinar a estratificação de risco em um grupo de pacientes diabéticos apresentando-se pela primeira vez um uma clínica para pé diabético, determinar as medidas preventivas tomadas pela equipe de saúde local e avaliar o nível de conscientização dos pacientes em relação à morbidade associada ao pé diabético. Métodos: Cinquenta pacientes diabéticos adultos foram encaminhados a uma Clínica para Pé Diabético de um Hospital Público Municipal para este estudo observacional. A consulta inicial foi considerada como a primeira intervenção relacionada ao envolvimento desses pacientes em relação ao potencial desenvolvimento de morbidades. Os pacientes haviam sido diagnosticados como sendo diabéticos, em média, há cinco anos. Rresultados: No momento da consulta, 94% do grupo não estava usando sapatos apropriados. Os pulsos pediosos (dorsalis pedis e/ou tibial posterior) foram palpados em 76% dos pacientes. Trinta indivíduos (60%) apresentavam evidências de neuropatia periférica. Vinte e um deles (42%) tinham deformidade clínica. Houve correlação positiva entre história de úlcera no pé, a presença de neuropatia periférica e a presença de deformidade do pé (p < 0.004 em cada correlação). Cconclusões: A informação e a educação, não apenas dos pacientes, como também de todos os interessados no assunto e nesses problemas, tornam-se pontos básicos nos resultados favoráveis neste cenário.

Familial gingival hyperplasia: a case of pseudo-Laband syndrome.

Three siblings with familial gingival hyperplasia and abnormal feet are reported. Despite the resemblance to the Laband syndrome, where there are anomalies of the terminal phalanges, the abnormalities of the feet in these children were caused by the persistent wearing of "flip-flop" sandals. Care is required in the conduct of history and examination.

Exostosis subungueal del dedo gordo del pie / Subungueal exostosis of the big toe

Se define muy bien el cuadro clínico de la exostosis subungueal del dedo gordo del pie, se establecen las pautas para llegar a su diagnóstico, se describe la anatomía patológica haciendo la diferenciación con el osteocondroma convencional y se discute la etiopatogenia cuya exacta naturaleza y causa aún permanece en la oscuridad. Después de analizar la causa de la recidiva del dolor en los pacientes operados por exostosis subungueal, describimos la técnica quirúrgica que empleamos y que consiste en la resección de la mitad distal de la segunda falange con conservación de las partes blandas y la matriz ungueal, mostrando finalmente los buenos resultados obtenidos con este procedimiento.

Exostosis subungueal del dedo gordo del pie / Subungueal exostosis of the big toe

Se define muy bien el cuadro clínico de la exostosis subungueal del dedo gordo del pie, se establecen las pautas para llegar a su diagnóstico, se describe la anatomía patológica haciendo la diferenciación con el osteocondroma convencional y se discute la etiopatogenia cuya exacta naturaleza y causa aún permanece en la oscuridad. Después de analizar la causa de la recidiva del dolor en los pacientes operados por exostosis subungueal, describimos la técnica quirúrgica que empleamos y que consiste en la resección de la mitad distal de la segunda falange con conservación de las partes blandas y la matriz ungueal, mostrando finalmente los buenos resultados obtenidos con este procedimiento. (AU)