RESUMO
RESUMO As mudanças morfológicas, biomecânicas e funcionais nos pés podem aumentar o risco de queda nos idosos. Os idosos institucionalizados apresentam menor mobilidade e maior risco de queda. O objetivo deste trabalho é verificar as relações das características dos pés com a mobilidade e quedas de idosos institucionalizados e ativos da comunidade. Participaram deste estudo 15 idosos institucionalizados e 15 idosos ativos da comunidade, que foram avaliados quanto à incidência de quedas e por meio do Timed Up and Go Test; presença de hálux valgo e pico de força muscular de flexores do hálux e dos artelhos pela plataforma de pressão. utilizou-se a análise de variância para comparar os grupos. Como resultado, os idosos comunitários apresentaram maior força muscular de flexores dos artelhos que os idosos institucionalizados (p<0,05) e melhor mobilidade funcional. Observou-se risco de queda nos idosos institucionalizados. O hálux valgo grau leve foi a deformidade mais comum. O teste de Pearson não mostrou correlação entre as variáveis analisadas e a incidência de quedas. Conclui-se que a força muscular de flexores dos artelhos é maior nos idosos comunitários, assim como a mobilidade funcional, quando comparados com idosos institucionalizados.
RESUMEN Las alteraciones morfológicas, biomecánicas y funcionales en los pies pueden aumentar el riesgo de caída en las personas mayores. Las que están institucionalizadas presentan menor movilidad y mayor riesgo de caída. El propósito de esta investigación es comprobar la relación entre las características de los pies con la movilidad y la caída de personas mayores institucionalizadas y activas en la comunidad. Del estudio, participaron 15 personas mayores institucionalizadas y 15 personas mayores activas en la comunidad, de las cuales se evaluaron la incidencia de caídas mediante el Timed Up and Go Test; la presencia de Hallux valgus y el punto máximo de fuerza muscular de los flexores del Hallux y de los dedos del pie mediante la plataforma de presión. Se utilizó el análisis de varianza para comparar los grupos. Los resultados demuestran que las personas mayores comunitarias presentaron una fuerza muscular de los flexores de los dedos del pie mayor que las institucionalizadas (p<0,05) y también una mejor movilidad funcional. En las personas mayores institucionalizadas se observó riesgo de caída. El Hallux valgus con deformidad leve fue la más común. El test de Pearson no demostró correlación entre las variables evaluadas y la incidencia de caídas. Se concluye que la fuerza muscular de los flexores de los dedos del pie es mayor en las personas mayores comunitarias, así como la movilidad funcional, en comparación a las institucionalizadas.
ABSTRACT Morphological, biomechanical and functional changes in the feet may increase the risk of fall in older adults. Institutionalized older adults have less mobility and greater risk of falling. The aim of this study is to check the relationship of the feet's characteristics with the mobility and falls of institutionalized or active community-dwelling older adults. A total of 15 institutionalized and 15 community-dwelling older adults participated in this study. They were assessed considering the incidence of falls and through the Timed Up and Go Test; presence of hallux valgus; and strength peak of the muscles of the hallux and toes measured by a pressure platform. The variance analysis was used to compare the groups. As a result, the community-dwelling older adults showed greater muscle strength of the toe flexor muscles than institutionalized older adults (p<0.05) and better functional mobility. We observed the risk of fall in institutionalized older adults. Hallux valgus of mild degree was the most common deformity. The Pearson's correlation coefficient showed no correlation between the analyzed variables and incidence of falls. We concluded that the strength of toe flexor muscles is greater in community-dwelling older adults, as well as the functional mobility, when compared with institutionalized older adults.
RESUMO
This paper aimed to analyze, from both a kinetic and kinematic perspective, the postural control of children with cerebral palsy (CP) able to independently perform the sit-to-stand (STS) task (ICP) and children who needed support (SCP) typically developing children during the STS; and also investigate the influence of seats heights and foot placement positions on postural control of these children. Fourteen children with CP and fourteen typically developing controls were recruited. Based on the Gross Motor Function Classification System (GMFCS) the children with CP were divided into ICP (level I) and SCP (levels II and III). Balance was assessed using the Pediatric Balance Scale. Motor function was rated using the GMFCS. Kinematic and kinetic data were recorded and analyzed during the STS task at two different seat heights and foot placement positions. The SCP exhibited significantly less balance according to the PBS and smaller displacement of their center of pressure (COP) in anteroposterior (COPAP) and mediolateral (COPML) direction relative to the other two groups. ICP demonstrated significant greater in the COPML displacement than the other groups. Children with CP required more time to complete the STS than controls. Those in the SCP group had lower linear displacement of the shoulder and knee than others during the STS task. During the high bench condition, the linear displacements of the shoulder and knee were reduced also. We conclude that the SCP has less COPAP and COPML oscillation, what means the better postural control during STS than the other two groups, which may be related to the support provided. The ICP exhibited greater COPML oscillations than controls, suggesting that they utilized different strategies in the frontal plane during the STS task. The seat height and foot placement did not influence postural control in children with CP, at least in terms of kinetic parameters. Seat height influenced the kinematic variables, with a high bench reducing linear displacement of the shoulder (vertical and horizontal) and knee (vertical) both in children with CP and control children.
