Comparação da estabilidade postural entre jogadores de futsal com e sem história de entorse da tibiotársica

Introdução: A entorse da tibiotársica pode causar insuficiências no complexo articular do tornozelo, contudo o impacto de uma entorse prévia na estabilidade postural ainda é controverso. Objetivo: Comparar a estabilidade postural entre jogadores de futsal com e sem história de entorse da tibiotársica. Métodos: Foram recrutadas aleatoriamente 7 equipas seniores, amadoras, de futsal da região centro, Portugal, que participavam no campeonato distrital de Aveiro ou Coimbra na época 2013/14. Dos 83 jogadores que aceitaram participar no estudo, 12 tinham critérios para serem incluídos no grupo com entorse (GCE). Dos restantes, foram selecionados aleatoriamente 12 atletas para o grupo sem história de entorse (GSE). A estabilidade postural foi avaliada com os participantes em apoio unipodal, durante 30s, com os olhos abertos, usando uma plataforma de forças. Resultados: Não se observaram diferenças entre os grupos na idade (GSE, 25,8 ± 3,1 vs. GCE, 27,1 ± 4,3 anos, p>0,05), peso e altura. Relativamente à estabilidade postural apenas se observaram diferenças significavas entre grupos no deslocamento antero-posterior, sendo que o GCE apresentou um deslocamento superior ao GSE (4,72 ± 1,41 vs. 3,54 ± 0,23 cm, p<0,05). Não se registaram diferenças significativas no deslocamento medio-lateral, comprimento total, velocidade do deslocamento e área do centro de pressão. Conclusão: Neste estudo, os jogadores de futsal com história de entorse da tibiotársica apresentaram menor estabilidade postural, que se manifestou num maior deslocamento antero-posterior do centro de pressão.

Vasculitis, a Rare Presentation of a Post-Streptococcal Syndrome

Post-streptococcal vasculitis is not awell-recognized non-suppurative complication of Group A streptococcal infections. Seventeen-year-old male was admitted with palpable purpura in the limbs, ankle swelling, microscopic hematuria and elevated inflammation markers. After short remission period, an extensive exudative pleural effusion was identified. High anti-streptococcal antibodies titers were found. This report illustrates an atypical and rare presentation of a post-streptococcal syndrome.

Epidemiology of injuries in female high school soccer players.

Background: Sport is a compulsory activity in schools in South Africa. Female learners participating in soccer are more vulnerable to injuries than males. Objective: This study determined the epidemiology of injuries in female high school soccer players. Methods: A cross sectional survey captured the epidemiology of injuries in the players. The population included 200 players from 27 high schools in one district between the ages of 14 to 19 years. A self-administered questionnaire was used to collect data. Results: Only 85 scholars from 8 schools participated. From the 85 respondents, 31 (36.5%) sustained injuries. Only 61 injuries were reported by the injured players. The injury prevalence for the season was 36.5%. The rate of injury was 90 per 1000 athlete exposure hours during the season. The defenders and midfielders sustained the most injuries. Most injuries reported were contact in nature. More injuries occurred during training than during matches. The lower extremity (77.8%) was injured more than the upper extremity (22.2%). The knee (22.2%) and ankle (15.9%) were the most frequently injured body parts. Muscle injury was the most commonly reported followed by bruising. Conclusion: Prevalence of injuries was high with the lower limb, specifically the knee and ankle being commonly injured.

Measurement of the energy spectrum of cosmic rays above 10(18) eV using the Pierre Auger Observatory

We report a measurement of the flux of cosmic rays with unprecedented precision and Statistics using the Pierre Auger Observatory Based on fluorescence observations in coincidence with at least one Surface detector we derive a spectrum for energies above 10(18) eV We also update the previously published energy spectrum obtained with the surface detector array The two spectra are combined addressing the systematic uncertainties and, in particular. the influence of the energy resolution on the spectral shape The spectrum can be described by a broken power law E-gamma with index gamma = 3 3 below the ankle which is measured at log(10)(E-ankle/eV) = 18 6 Above the ankle the spectrum is described by a power law with index 2 6 followed by a flux suppression, above about log(10)(E/eV) = 19 5, detected with high statistical significance (C) 2010 Elsevier B V All rights reserved

Efectividad de la deslaminación mecánica con bisturí en la eliminación de helomas e hiperqueratosis

Introducción El motivo principal por el que acuden los pacientes a las consultas de podología es el dolor producido por los callos y callosidades plantares. El dolor producido por las callosidades y callos plantares provocan en el paciente cambios de presiones y alteraciones en el apoyo, dificultando la deambulación correcta. Existen numerosos estudios sobre la eliminación de callosidades en pacientes diabéticos, con AR, pero pocos en personas sanas. La eliminación de estos callos y callosidades se puede realizar mediante deslaminación mecánica con bisturí o mediante queratolíticos. Objetivos Objetivo principal Analizar el efecto de la deslaminación mecánica con bisturí de las callosidades y callos plantares sobre el dolor y la calidad de vida en sujetos sanos Objetivos secundarios Determinar la existencia de modificaciones en los parámetros de la marcha con la eliminación de callosidades y callos plantares Observar las diferencias y efectividad de tratamientos de la eliminación de callosidades plantares mediante la técnica de deslaminación mecánica con bisturí versus parches de ácido salicílico Comprobar los cambios producidos en los parámetros psíquicos y fiscos del paciente antes y después de las diferentes técnicas de eliminación de las callosidades empleadas Método Se realizan dos estudios: un estudio cuasi experimental aleatorizado no controlado, en el que a un grupo de 34 pacientes con callosidades plantares dolorosas se les mide el dolor con una escala visual analógica y para analizar los parámetros de la marcha, la paltaformaWin-Track, antes del tratamiento de deslaminación mecánica con bisturí y a las 24 horas. El segundo estudio es un ensayo clínico aleatorizado inscrito en Australian New ZelandClinicalstrials y aprobado por el Comité ético de la Universidad de Málaga, en el que 62 participantes con callosidades plantares dolorosas se dividieron en dos grupos de tratamiento. El grupo A recibió tratamiento con parche de ácido salicílico y el grupo B recibió tratmiento de deslaminación con bisturí. Se utilizó la escala visual analógica para la medida de dolor antes, inmediatamente después de la intervención, a las 2 semanas y a las 6 semanas. Para el dolor y la discapacidad funcional del pie se utilizó el cuestionario Manchester FootPain and Disability antes del tratamiento, a las 2 semanas y a las 6 semanas. Para medir la calidad de vida general se utilizó el cuestionario SF-12 Conclusiones La deslaminación mecánica con bisturí de los callos y callosidades plantares es efectiva para su eliminación a nivel de la sensación de dolor, aunque no tanto en lo que se refiere a la mejora de calidad de vida. No hay resultados significativos de que la eliminación mecánica con bisturí de callos y callosidades plantares modifican los parámetros de la marcha medido con la plataforma Win-track. Se observa como la deslaminación mecánica con bisturí para la eliminación de callos y callosidades plantares pueden ser más efectiva a corto plazo que la eliminación mediante parche con ácido salicílico. Se observa cómo se modifica los paramentos psíquicos en el grupo de tratamiento con parche con ácido salicílico, aunque con una significación baja. Bibliografía Balanowski, K. R., & Flynn, L. M. (2005). Effect of painful keratoses debridement on foot pain, balance and function in older adults. Gait & Posture, 22(4), 302-307. http://doi.org/10.1016/j.gaitpost.2004.10.006 Collins, S. L., Moore, R. A., &McQuay, H. J. (1997). The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain, 72(1-2), 95-97. Coughlin, M. J. (2000).Common Causes of Pain in the Forefoot in Adults. Journal of Bone & Joint Surgery, British Volume, 82-B(6), 781-790. Farndon, L. J., Vernon, W., Walters, S. J., Dixon, S., Bradburn, M., Concannon, M., & Potter, J. (2013). The effectiveness of salicylic acid plasters compared with «usual» scalpel debridement of corns: a randomised controlled trial. Journal of Foot and Ankle Research, 6(1), 40. http://doi.org/10.1186/1757-1146-6-40 Freeman, D. B. (2002). Corns and calluses resulting from mechanical hyperkeratosis. American FamilyPhysician, 65(11), 2277-2280. Gijon-Nogueron, G., Ndosi, M., Luque-Suarez, A., Alcacer-Pitarch, B., Munuera, P. V., Garrow, A., & Redmond, A. C. (2014). Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 23(2), 571-579. http://doi.org/10.1007/s11136-013-0507-5 Grouios, G. (2005). Footedness as a potential factor that contributes to the causation of corn and callus formation in lower extremities of physically active individuals. The Foot, 15(3), 154-162. http://doi.org/10.1016/j.foot.2005.05.003 Landorf, K. B., Morrow, A., Spink, M. J., Nash, C. L., Novak, A., Potter, J., &Menz, H. B. (2013). Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial. Trials, 14, 243. http://doi.org/10.1186/1745-6215-14-243 Lang, L. M. G., Simmonite, N., West, S. G., & Day, S. (1994). Salicylic acid in the treatment of corns. The Foot, 4(3), 145-150. http://doi.org/10.1016/0958-2592(94)90019-1 Luo, X., Lynn George, M., Kakouras, I., Edwards, C. L., Pietrobon, R., Richardson, W., & Hey, L. (2003). Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine, 28(15), 1739-1745. http://doi.org/10.1097/01.BRS.0000083169.58671.96 Ramachandra, P., Maiya, A. G., & Kumar, P. (2012). Test-retest reliability of the Win-Track platform in analyzing the gait parameters and plantar pressures during barefoot walking in healthy adults. Foot & Ankle Specialist, 5(5), 306-312. http://doi.org/10.1177/1938640012457680 Siddle, H. J., Redmond, A. C., Waxman, R., Dagg, A. R., Alcacer-Pitarch, B., Wilkins, R. A., &Helliwell, P. S. (2013). Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial. Clinical Rheumatology, 32(5), 567-574. http://doi.org/10.1007/s10067-012-2134-x

Neural Modulation of Leg Stiffness in Response to Neuromuscular Fatigue

The spring-mass model is able to accurately represent hopping spring-like behavior (leg and joint stiffness), and leg and joint stiffness changes can reveal overall motor control responses to neural and muscular contributors of neuromuscular fatigue. By understanding leg stiffness modulation, we can determine which variables the nervous system targets to maintain motor performance and stability. The purpose of this study was to determine how neuromuscular fatigue affects hopping behavior by examining leg and joint stiffness before and after a single-leg calf raise fatiguing protocol. Post-fatigue, leg stiffness decreased for the exercised leg, but not for the non-exercised leg. Ankle and knee joint stiffness did not significantly change for either leg. This indicates that leg stiffness decreases primarily from muscular fatigue, but was not explained by ankle and knee joint stiffness. The decrease in leg stiffness may be an attempt to soften landing impact, while at the same time maintaining performance.

Biomechanical and morphological adaptations in women during pregnancy and the postpartum period in walking

A gravidez é uma fase especial da vida, com diversas alterações nos sistemas hormonais, anatómicos, e na composição corporal da mulher. No entanto, não é claro que alterações biomecânicas tridimensionais ocorrerem. Através do acompanhamento da mulher na gravidez e pós-parto, os objetivos da presente tese foram: 1) determinar os parâmetros temporais e espaciais do ciclo da marcha; 2) descrever a cinemática angular do membro inferior; 3) calcular os momentos e potências articulares do tornozelo, joelho e coxofemoral, utilizando o cálculo por dinâmica inversa; 4) descrever as magnitudes dos picos dos momentos e potências articulares dos membros inferiores; 5) identificar possíveis diferenças entre as fases de recolha relativamente aos parâmetros biomecânicos; 6) descrever longitudinalmente a composição corporal as alterações morfológicas; 7) analisar a influência das alterações antropométricas na cinética articular. Os resultados mostram que as mulheres mantêm os parâmetros temporais e espaciais da marcha. A cinemática angular do membro inferior tem o mesmo padrão, no entanto, a magnitude de alguns picos, especialmente na bacia e coxofemoral durante a fase terminal do apoio, pré-balanço e de balanço, apresentam alterações significativas. A coxofemoral é a articulação com mais alterações na cinética articular, com um aumento da carga interna associada aos momentos articulares da coxofemoral no plano transversal. No entanto, diversos momentos e potências articulares revelam uma diminuição significativa para o final da gravidez e/ou um aumento entre alguns trimestres da gravidez e o pós-parto. Como esperado, a maioria das variáveis associadas à composição corporal e às dimensões corporais tem um aumento significativo durante a gravidez e uma diminuição no pós-parto. Os modelos desenvolvidos para prever a carga interna aplicada ao membro inferior da grávida através de variáveis antropométricas, incluem quatro modelos com variáveis associadas à quantidade de gordura, quatro modelos com variáveis associadas à massa corporal global, três modelos que incluem a massa livre de gordura, e um modelo que inclui a forma do tronco. Os altos valores do R2 ajustado, mostram que as alterações na composição corporal e morfologia, determinam em grande parte a cinética articular da mulher nesta fase particular da vida.

Effects of roller massager on muscle performance, morphology, and oxygenation after exercise-induced muscle damage

This study determined roller massager (RM) effectiveness on ankle plantar flexors’ recovery after exercise-induced muscle damage (EIMD) stimulus. Two experiments were conducted. The first experiment (n=10) examined functional [i.e., ankle plantar flexion maximal voluntary isometric contraction (MVIC) and submaximal (30% of MVIC) sustained force; ankle dorsiflexion maximal range of motion and resistance to stretch; and pain pressure threshold] and morphological [medial gastrocnemius (MG) cross sectional area, thickness, fascicle length, and fascicle angle] variables, before and immediately, 1h, 24h, 48h, and 72 after EIMD. In the second experiment (n=10), changes in MG deoxyhemoglobin concentration kinetics (velocity and amplitude) during a submaximal sustained force test were observed before and 48h after EIMD. Participants performed both experiments twice, with and without (NRM) the application of a RM (6 × 45 seconds with 20 seconds rest between sets). RM intervention did not alter plantar flexors’ strength and flexibility impairment after EIMD, as well the MG morphology and oxygenation kinetics (p>0.05). On the other hand, a strong tendency for an acute (within 1 hour) change of ipsilateral (post-effects: RM=+19%, NRM=-5%, p=0.032) and contralateral (p=0.095) MG pain pressure threshold was observed. In conclusion, the present results suggest that a roller massager has no effect on muscular performance, morphology, and oxygenation recovery after EIMD, except for muscle pain pressure threshold (i.e., a soreness). Thus, RM may have potential application in recovery for people with increased muscle soreness, if performed immediately before a physical task.

Kinematic and electromyographic analysis of the overhead squat in individuals showing excessive medial knee displacement

Dynamic knee valgus is a multi-planar motion that has been associated with anterior cruciate ligament injuries and patellofemoral pain syndrome. Clinical assessment of dynamic knee valgus can be made by looking for the visual appearance of excessive medial knee displacement (MKD) in the double-leg squat (DLS). The purpose of this dissertation was to identify the movement patterns and neuromuscular strategies associated with MKD during the DLS. Twenty-four control subjects and eight individuals showing MKD during the DLS participated in the study. Significant differences were verified between subjects that demonstrated MKD and a control (CON) group for the eletromyographic amplitude of adductor magnus, biceps femoris, vastus lateralis and vastus medialis muscles (p < 0.05), during the descending phase of the DLS. During the ascending phase were found group differences for adductor magnus and rectus femoris muscles (p < 0.05). Results from kinematic analysis revealed higher minimum and maximum values of ankle abduction and knee internal rotation angles (p < 0.05) for the MKD group. Also, individuals showing excessive MKD had higher hip adduction/abduction excursion. Our results suggested that higher tibial internal rotation and knee internal rotation angles in the initial position of the DLS are associated with MKD. The neuromuscular strategies that contributed to MKD were higher adductor magnus activation, whereas biceps femoris, vastus lateralis and vastus medialis activated more to stabilize the knee in response to the internal rotation moment.

Terminal interruption of relux source technique in the treatment of active venous ulcers

Introduction: The treatment for venous ulcers in most cases is unsatisfactory, with recurrences and poor healing. Objective: to evaluate adjuvant therapy in the treatment of active venous ulcers. Methods: We analyzed 20 patients with active venous ulcers attending the general Surgery outpatient clinic at the “Dr. José eleuterio gonzález” University Hospital from October 2012 to January 2013. they were randomly divided into 2 groups: group A (11 patients) underwent compression therapy and group B (9 patients) underwent compression therapy plus removal of the vein that gives terminal relux to the ulcer, guided by ultrasound (microphlebectomy). Patients were evaluated weekly (8 weeks). At each assessment, photographs and lesion measurements were taken and pain was evaluated using the visual analog scale. Results: No significant differences were found between the study groups in terms of age, weight, height, body mass index (BMi), ankle-brachial index, and baseline measurement of the ulcer (p>0.05). Group B showed a greater reduction in ulcer size and a statistically signiicant lower score on the visual analog pain scale (p<0.05) from the second and third week of treatment, respectively. Conclusions: the results obtained in patients with surgical procedure (group B) are consistent with the reported eficacy of chronic venous ulcer treatment with saphenectomy (conventional surgery), the difference is that in this study we used a minimally invasive procedure (microphlebectomy).

Térmitas como bioindicadores de qualidade de habitat na caatinga, Brasil: há uma sintonia entre as variáveis estruturais dos habitats e as taxocenoses amostradas?

The composition of termite assemblages was analyzed at three Caatinga sites of the Seridó Ecological Station, located in the municipality of Serra Negra do Norte, in the state of Rio Grande do Norte, Brazil. These sites have been subjected to selective logging, and cleared for pasture and farming. A standardized sampling protocol for termite assemblages (30h/person/site) was conducted between September 2007 and February 2009. At each site we measured environmental variables, such as soil granulometry, pH and organic matter, necromass stock, vegetation height, tree density, stem diameter at ankle height (DAH) and the largest and the smallest crown width. Ten species of termites, belonging to eight genera and three families, were found at the three experimental sites. Four feeding-groups were sampled: wood-feeders, soil-feeders, wood-soil interface feeders and leaf-feeders. The wood-feeders were dominant in number of species and number of encounters at all sites. In general, the sites were not significantly different in relation to the environmental variables measured. The same pattern was observed for termite assemblages, where no significant differences in species richness, relative abundance and taxonomic and functional composition were observed between the three sites. The agreement between the composition of assemblages and environmental variables reinforces the potential of termites as biological indicators of habitat quality

Three-dimensional kinetic adaptations of gait throughout pregnancy and postpartum

Biomechanical adaptations that occur during pregnancy can lead to changes on gait pattern. Nevertheless, these adaptations of gait are still not fully understood. The purpose was to determine the effect of pregnancy on the biomechanical pattern of walking, regarding the kinetic parameters. A three-dimensional analysis was performed in eleven participants. The kinetic parameters in the joints of the lower limb during gait were compared at the end of the first, second, and third trimesters of pregnancy and in the postpartum period, in healthy pregnant women. The main results showed a reduction in the normalized vertical reaction forces, throughout pregnancy, particularly the third peak. Pregnant women showed, during most of the stance phase, medial reaction forces as a motor response to promote the body stability. Bilateral changes were observed in hip joint, with a decrease in the participation of the hip extensors and in the eccentric contraction of hip flexors. In ankle joint a decrease in the participation of ankle plantar flexors was found. In conclusion, the overall results point to biomechanical adjustments that showed a decrease of the mechanical load of women throughout pregnancy, with exception for few unilateral changes of hip joint moments.

L’analyse biomécanique du sprint sur ergomètre non-motorisé : interaction entre les asymétries cinétiques et cinématiques lors d’un sprint de 40 verges

Au sprint 100 mètres et dans de nombreux sport de puissance, la phase d’accélération est un déterminant majeure de la performance. Toutefois, les asymétries cinétiques et cinématiques peuvent avoir une incidence sur la performance. L’objectif de cette étude était d’identifier la présence d’interaction entre différentes variables cinétiques et cinématiques angulaires aux membres inférieures (MI) d’un sprint de haute intensité sur un ergomètre non-motorisé avec résistance (NMR). Suite à une rencontre de familiarisation, 11 sujets ont exécuté des sprints de 40 verges. Les données cinétiques ont été obtenues par l’entremise de plateformes de force intégrées aux appuis de l’ergomètre NMR à 10 Hz et les données cinématiques ont été amassées à l’aide du système Optitrack et du logiciel Motive Tracker à 120Hz. Nous avons effectué un test de corrélation linéaire (Corrélation linéaire de Pearson) pour déterminer la relation entre les données cinétiques et cinématiques (p < 0,05). L’analyse des données a révélée (1) une corrélation positive entre la moyenne d’amplitude articulaire à la cheville et la moyenne des pics de puissance développés (W/kg) lors de la phase de maintien (r = 0,62), (2) une corrélation négative entre l’extension maximale moyenne (calculé à partir de l’angle de flexion le plus petit) à la hanche et la moyenne de pics de puissance développées en fin de poussée lors de la totalité et de la phase de maintien (r = -0,63 et r = -0,69 respectivement), et finalement (3) une corrélation négative entre la différence de dorsiflexion maximale à la cheville et la différence des pics de puissance développés aux MI lors du contact du pied au sol en phase de maintien ( r = -0,62). Les résultats obtenus dans cette étude permettront d’améliorer l’intervention des préparateurs physiques et la pratique des athlètes de sport de puissance en plus d’aider au développant de nouvelles technologies et outils d’entrainement complémentaire au sprint et particulièrement à la phase d’accélération.

Eficacia de la infiltración de Plasma Rico en Plaquetas (PRP) en pacientes diagnosticados del Síndrome de la Fascia Plantar (SFP) desde el punto de vista clínico y funcional

On the basis of the knowledge that the entheses between the plantar fascia and the calcaneus may exhibit a varied pathology, we considered the need to value the pathological factors by illustrating the anatomical changes in the Plantar Fascia Syndrome (PFS) with easy-to-obtain images which allowed us to substantiate our claims. Accordingly, we analized the anatomical (Orts Llorca, 1977; Llusá, 2007; Sobotta, 2007; Domenech Mateu, 2012; Rodriguez Baeza 2012) and biomechanical (Arandes, 1956; Viladot 1979; Caturla, 2001; Safe, 2001) literature in order to better know the location of the pathology and also to assess the functional reasons that could favor this disease. A study of the affected area by Nuclear Magnetic Resonance (NMR) revealed the presence of bone affections such as bone edema, subchondral lesions and several other bone pathologies together with fascia intrinsic injuries such as myxoid degeneration, intrasubstance fissures and perifascial edematous lesions (Larroca, 2013; Conejero, 2014). Injuries not properly treated during the acute phase can evolve into chronic processes which, month after month, become ever more difficult to resolve. In addition, as seen throughout this study, there are changes in the anatomical normality of the foot usually associated with pathological conditions of the plantar fascia. Once the pathological aspects of PFS are identified and their location is established, clinical manifestations should be registered in order to define this syndrome. Pain is the main symptom in patients with PFS and is associated, in many occasions, with tightness or stiffness of the plantar area, limited mobility of the arch of the ankle and, inevitably, a progressive functional deterioration. Thus, that sharp and stabbing pain felt when one puts the foot on the floor after a period of rest located in the front lower face of the heel and irradiating and/or projecting to the middle of the sole of the foot would be synonymous with Plantar Fascia Syndrome (PFS)...

Three-dimensional kinetic adaptations of gait throughout pregnancy and postpartum

Biomechanical adaptations that occur during pregnancy can lead to changes on gait pattern. Nevertheless, these adaptations of gait are still not fully understood. The purpose was to determine the effect of pregnancy on the biomechanical pattern of walking, regarding the kinetic parameters. A three-dimensional analysis was performed in eleven participants. The kinetic parameters in the joints of the lower limb during gait were compared at the end of the first, second, and third trimesters of pregnancy and in the postpartum period, in healthy pregnant women. The main results showed a reduction in the normalized vertical reaction forces, throughout pregnancy, particularly the third peak. Pregnant women showed, during most of the stance phase, medial reaction forces as a motor response to promote the body stability. Bilateral changes were observed in hip joint, with a decrease in the participation of the hip extensors and in the eccentric contraction of hip flexors. In ankle joint a decrease in the participation of ankle plantar flexors was found. In conclusion, the overall results point to biomechanical adjustments that showed a decrease of the mechanical load of women throughout pregnancy, with exception for few unilateral changes of hip joint moments.