Effects of Anteroposterior Talus Mobilization on Range of Motion, Pain, and Functional Capacity in Participants With Subacute and Chronic Ankle Injuries: A Controlled Trial.

Objective: The purpose of this study was to measure the acute (1 session) and chronic effects (6 sessions) and the follow-up (2 weeks) of anteroposterior articular mobilization of the talus, grade III of Maitland, on the dorsiflexion range of motion (ROM), pain, and functional capacity of individuals with subacute and chronic traumatic injuries of the ankle. Methods: Thirty-eight volunteers, men and women, with a mean age of 40.8 years, with subacute and chronic ankle injuries participated. The volunteers were blinded to the study purpose and were allocated into the experimental group (EG) or sham group (SG). Dorsiflexion ROM, pain, and functional capacity were measured using the universal goniometer, visual analog scale, and Foot and Ankle Ability Measure, respectively. Measurements were taken on 4 different occasions: (1) baseline, (2) after the first session, (3) after the sixth session, and (4) at follow-up. Articular anteroposterior mobilization of the talus grade III of Maitland was applied to the EG, whereas manual contact was applied to the SG. Three series of 30 seconds each with a 30-second rest interval between the series were conducted. Results: Significant increases in ankle dorsiflexion ROM were observed only for the EG after the first (EG: 9.5 ± 1.1; SG: 7.6 ± 1.1) and sixth (EG: 12.8 ± 1.2; SG: 8.4 ± 1.2) sessions and were maintained at follow-up (EG: 13.2 ± 1.1; SG: 9.3 ± 1.3). Decreases in pain and improvements in functional capacity (FC) were identified for both groups after the first and sixth sessions (Pain, EG: 1.3 ± 0.5; SG: 1.8 ± 0.6 and EG: 0.7 ± 0.3; SG: 0.7 ± 0.3; FC, EG: 64.6 ± 3.5; SG: 67.4 ± 4.4 and EG: 79.9 ± 3.3; SG: 86.2 ± 3.3) and remained at follow-up (Pain, EG: 0.3 ± 0.2; SG: 0.5 ± 0.3; FC, EG: 86.8 ± 2.7; SG: 89.8 ± 3.7). Conclusion: Articular grade III mobilization improved ankle dorsiflexion ROM, when compared with the SG. Changes in pain and functional capacity were similar in both groups.

Translation, cross-cultural adaptation and validity of the Brazilian version of the Foot and Ankle Ability Measure questionnaire.

PURPOSE: To translate and cross-culturally adapt the Foot and Ankle Ability Measure (FAAM) questionnaire and verify the psychometric properties of the Brazilian-Portuguese version of this instrument. METHODS: Analysis of validity was carried out by applying the Rasch model and evaluating correlations with the Short Form-36 (SF-36) Physical Function (PF) subscale. Test-retest reliability and internal consistency were analyzed with the intraclass correlation coefficient (ICC2,1) and Cronbach's alpha tests, respectively. RESULTS: Ninety subjects with various foot and ankle musculoskeletal disorders (age 37.05 SD 10.49 years) were included. The ICC2,1 was 0.88 and 0.82 with Cronbach's alphas of 0.93 and 0.90 for the "Activities of Daily Living" (ADL) and "Sports" subscales, respectively. Correlations with the SF-36 PF were 0.78 (p < 0.01, CI95: 0.62-0.87) and 0.65 (p < 0.01, CI95: 0.45-0.79) for the ADL and Sports subscales, respectively. Item reliability indices in Rasch analysis were 0.91 (ADL) and 0.84 (Sports). Three items from the ADL subscale (14.2%) did not match the expectations of the model. All items from the Sports subscale fit the model. CONCLUSIONS: There is evidence of validity and reliability of the FAAM-Brazil. Rasch analysis indicated that three items of the ADL subscale did not fit the model in the sample studied. Implications for Rehabilitation Self-report questionnaires are commonly used in both clinical practice and research because of their ability to efficiently collect information. If the instrument is created properly, the information collected can be used to interpret the effect of clinical conditions on physical function. The Foot and Ankle Ability Measure (FAAM) is an evaluative instrument that assesses functional limitations for those with foot- and ankle-related disorders. It was translated into four languages and has evidence of validity, reliability, and responsiveness. Evidence of validity and reliability is provided for the FAAM-Brazil when applied to subjects with a wide range of foot and ankle musculoskeletal disorders.

Immediate effect of a single anteroposterior talus mobilization on dorsiflexion range of motion in participants with orthopedic dysfunction of the ankle and foot.

OBJECTIVE: The purpose of this study was to determine the immediate effects of a single anteroposterior mobilization of the talus on the active dorsiflexion range of motion (ROM) in participants with different orthopedic foot and ankle injuries. METHODS: This study included 30 male and female participants aged 18 to 50 years with unilateral orthopedic foot and ankle dysfunction. All participants underwent 3 sets of active dorsiflexion ROM measurement in both ankles. Measurements included baseline, post-first treatment, and post-second treatment values. Participants received either joint mobilization or manual contact (control) on the affected ankle. Active dorsiflexion ROM was assessed using a biplanar goniometer with participants in the prone position and 90° of knee flexion. RESULTS: Both groups (joint mobilization and manual contact) showed increased active dorsiflexion ROM. However, the mean difference of dorsiflexion measurements before and after mobilization was greater than before and after control treatment. CONCLUSION: A single session of articular mobilization of the talus did not significantly increase dorsiflexion ROM in participants with orthopedic dysfunctions of the ankle and foot compared with a manual contact procedure.

Achilles tendinosis: a morphometrical study in a rat model.

This study addresses the morphopathogenesis of Achilles tendinosis, using a rat model and presenting quantitative analysis of time-dependent histological changes. Thirty Wistar rats were used, randomly split in experimental and control groups. Animals of the experimental group were submitted to a treadmill running scheme. Five animals of each group were euthanized at four, eight and sixteen weeks. Achilles tendons were collected and processed routinely for histopath sections. Slides were stained by Hematoxylin-Eosin, Picrosirius Red, Alcian Blue, AgNOR, TUNEL and evaluated morphometrically. Cellular density decreased slightly along the time and was higher in the experimental group than in controls at fourth, eighth and sixteenth weeks. Fiber microtearing, percentual of reticular fibers and glycosaminoglycans content increased along the time and were higher in experimental group than in controls at all-time intervals. AgNOR labeling here interpreted as a marker of transcription activity was higher in the experimental groups than in controls at all-time intervals. Apoptotic cells were more frequent and diffusely distributed in tendinosis samples than in control groups. These results suggest that as mechanical overload is becoming chronic, cellular turnover and matrix deposition increases leading to tendinosis. The combination of staining techniques and morphometry used here to describe the evolution of lesions occurring in a rat model system has proved to be suited for the study of induced Achilles tendinosis.

Análise da influência da plataforma vibratória no desempenho do salto vertical em atletas de futebol: ensaio clínico randomizado / Analysis of the influence of the vibrating platform in vertical jump performance in soccer players: a randomized clinical trial

Objetivos: O objetivo deste estudo é analisar a influência da Plataforma Vibratória no desempenho do salto vertical de atletas de futebol. Materiais e métodos: A amostra foi composta de 30 atletas de futebol do sexo masculino,idade (18,57 ± 0,81 anos), peso (75,49 ± 7,463 kg), altura (1,79 ± 0,057 cm), percentual de gordura corporal (9.6 ± 1,327 por cento) e IMC (22,89 ± 1,354 kg/m2) alocados aleatoriamente em Grupo 1 (VCI) e Grupo 2 (CIQ). Valores de p ≤ 0,05 foram considerados estatisticamente significativos. Resultados: A altura do CMJSBB aumentou significativamente (p = 0,0001) após ambas as intervenções (VCI e CIQ), reduzindo também de forma significativa no período de follow-up (p = 0,0003). Não houve diferença significativa entre os grupos em todos os períodos (p = 0,524). No CMJCBB, houve um aumento significativo na altura do salto ao se comparar o grupo antes e depois das intervenções por VCI e CIQ (p = 0,001) e uma diminuição significativa comparando as medidas após as intervenções com o follow-up. Em relação aos tratamentos (G1 vs G2) não houve diferença estatística entre eles em todos os períodos (p = 0,675). Discussão: De acordo com os resultados, houve diferenças em relação ao fatortempo (pré, pós e follow-up). No entanto, não foram observadas mudanças em relação aos tratamentos propostos ao G1 e ao G2. O período de exposição de quatro semanas de VCI não produziu ganhos adicionais nas características morfológicas e/ou nas propriedades neuromusculares em longo prazo no G1 quando comparados como G2. Conclusão: O treinamento por VCI pode ser introduzido com fins complementares à rotina de treinamentode atletas de futebol, objetivando a melhora do desempenho muscular nos membros inferiores atribuídos deforma quantitativa na capacidade de saltar desses indivíduos.

Modelos experimentais de indução à tendinose por esforço repetitivo: revisão de literatura / Repetitive efforts induction experimental models of tendinosis: literature review

Objetivo: Revisar os modelos experimentais que buscaram induzir a tendinose em animais através de esforços repetitivos (overuse). Materiais e métodos: Foi realizada uma busca exaustiva e sistematizada no Pubmed/Medline, Cochrane/Bireme e PEDro limitada ao período de 01/01/1950 à 15/03/2007, no idioma inglês, em experimento animal e utilizando associações das palavras-chaves: tendinopaty, animal, tendon e overuse injury. Resultados: Nove artigos foram encontrados, sendo que quatro utilizaram modelos de indução através de contração ativa. Discussão: Os modelos que utilizaram contração induzida por eletro-estimulação apresentaram pouca similaridade à evolução da tendinose em humanos, uma vez que os animais estavam sob anestesia e todo o metabolismo se encontrava alterado. Por outro lado, os modelos que utilizaram contração ativa se assemelhavam, com maior fidedignidade, ao que realmente acontece no desenvolvimento clínico da tendinose, principalmente naqueles em que o tendão tem participação ativa durante a atividade imposta. Conclusão: Muito ainda falta para termos modelos experimentais padronizados e sistematizados para os diversos tendões. Futuros modelos devem levar em consideração à especificidade de cada tendão e procurar induzir a lesão da maneira similar ao que acontece em humanos.