Sílvia Maria Amado João

Postural assessment of girls between 7 and 10 years of age

UNLABELLED Postural alterations are often found in children and teenagers. In this stage of development, the posture undergoes many adjustments and adaptations due to changes of the body and to demanding psychosocial factors. PURPOSE To identify which postural alterations occur most often in students between 7 and 10 years of age, to identify preventive measures, and to provide information to parents and teachers about the problem of bad posture. METHODS Thirty three girls in each of 4 age groups between 7 and 10 years of age were assessed, resulting in a sample of 132 subjects. Photos of each girl in the sagittal and frontal planes were examined for postural deviations. RESULTS The main postural deviations found were knock-knee, medial rotation of the hip, antepulsion, pelvic anteversion, knee hyperextension, lumbar hyperlordosis, valgus ankle, imbalanced shoulders, lateral pelvic inclination, scoliosis, trunk rotation, thoracic hyperkyphosis, winged scapula, shoulder protraction, abducted scapula, medial rotation of shoulders, and head tilt. CONCLUSION High incidences of postural alterations occur in children of school age. Some of these reflect normal postural development, and get corrected during the childs growth. On the other hand, some alterations are asymmetries that can be caused by daily demands on the body and can result in negative impacts on the quality of life during childhood and adulthood. We emphasize the importance of providing information to parents and teachers about the problem of bad posture.

Reliability of photogrammetry in the evaluation of the postural aspects of individuals with structural scoliosis

PURPOSE The purpose of this study was to investigate the reliability of photogrammetry in the measurement of the postural deviations in individuals with idiopathic scoliosis. METHODS Twenty participants with scoliosis (17 women and three men), with a mean age of 23.1 ± 9 yrs, were photographed from the posterior and lateral views. The postural aspects were measured with CorelDRAW software. RESULTS High inter-rater and test-retest reliability indices were found. It was observed that with more severity of scoliosis, greater were the variations between the thoracic kyphosis and lumbar lordosis measures obtained by the same examiner from the left lateral view photographs. A greater body mass index (BMI) was associated with greater variability of the trunk rotation measures obtained by two independent examiners from the right, lateral view (r = 0.656; p = 0.002). The severity of scoliosis was also associated with greater inter-rater variability measures of trunk rotation obtained from the left, lateral view (r = 0.483; p = 0.036). CONCLUSIONS Photogrammetry demonstrated to be a reliable method for the measurement of postural deviations from the posterior and lateral views of individuals with idiopathic scoliosis and could be complementarily employed for the assessment procedures, which could reduce the number of X-rays used for the follow-up assessments of these individuals.

Postural Assessment of Lumbar Lordosis and Pelvic Alignment Angles in Adolescent Users and Nonusers of High-Heeled Shoes

OBJECTIVE The aims of this study were (1) to analyze the influence of wearing high-heeled shoes on lumbar lordosis and pelvic inclinations among adolescents aged between 13 and 20 years were users and nonusers of high-heeled shoes and (2) to correlate these postural angles with age. METHODS Fifty adolescents from the nonuser group (NUG) of high-heeled shoes and 50 from the user group (UG) were evaluated. Postural assessments were obtained by photogrammetry under 2 conditions-barefoot and with high-heeled shoes-and analyzed using the evaluation postural software. The measured angles included lumbar lordosis and the horizontal alignment of the pelvis. Descriptive analyses were carried out, with a significance level of 5%. RESULTS With high-heeled use, the NUG demonstrated rectification of the lumbar spine and pelvic retroversion, whereas the UG demonstrated hyperlordosis and pelvic anteversion. When barefoot, smaller lumbar lordosis angles for both groups were observed. However, the pelvic angles were lower for the UG group and higher for the NUG. The studied angles showed high reliabilities. Age was correlated with lumbar lordosis angles for the NUG in the barefoot condition and with pelvic alignments in both conditions for the UG. CONCLUSION For the subjects in this study, the use of high-heeled shoes is correlated with increased lumbar lordosis and pelvic anteversions. Lumbar lordosis angles are correlated with age for the NUG when barefoot.

Spinal postural alignment variance according to sex and age in 7- and 8-year-old children.

PURPOSE Childrens postural alignment undergoes many adjustments due to the changes in body proportions during the stages of growth. The objective of this study was to quantitatively characterize and analyze spinal postural standards in 7- and 8-year-old children to verify which of the differences found were correlated to age and sex. METHODS Two hundred thirty public school students (Amparo, São Paulo, Brazil) aged 7 to 8 years were divided into groups according to postural alignment, which were further subdivided by sex and age, for comparison. Digital photos of upright subjects were analyzed to evaluate posture. Lumbar and thoracic curvature, pelvic inclination, head posture, and lateral spine deviation were measured using CorelDraw (Ottawa, Canada) software guidelines and bone landmarks. Descriptive statistics and analysis of variance data analysis were utilized to verify differences among the groups. This was a cross-sectional, descriptive study. RESULTS Mean values for the variables analyzed were calculated. For lumbar lordosis, 7-year-old boys showed 38.49 degrees +/- 15.32 degrees in comparison to all other groups (42.29 degrees +/- 7.13 degrees ). For thoracic kyphosis, the 7-year-old children presented 28.07 degrees +/- 7.73 degrees , and the 8-year-olds 30.32 degrees +/- 7.73 degrees . Pelvic inclination presented a mean value of 15.82 degrees +/- 5.46 degrees and single lateral spine deviation mean value of 3.48 degrees +/- 2.12 degrees . CONCLUSION For the sample studied, differences based on sex and age were found for some of the body segments analyzed. The values found in this study may contribute to improved physiotherapeutic treatment when associated with other aspects of the clinical assessment and symptomatology.

Reeducação postural global e alongamento estático segmentar na melhora da flexibilidade, força muscular e amplitude de movimento: um estudo comparativo

Exercicios de alongamento sao usados para aumentar a flexibilidade e amplitude de movimento (ADM). Entre os metodos existentes, destacam-se a reeducacao postural global (RPG), que promove o alongamento global das cadeias musculares, e o alongamento segmentar, que alonga um musculo ou grupo muscular especifico. Este estudo visou comparar o alongamento segmentar e o global pela tecnica de RPG quanto ao ganho de flexibilidade, ADM e forca muscular. Trinta mulheres foram distribuidas aleatoriamente em tres grupos (n=10 em cada): o grupo global fez alongamento de cadeias musculares; o grupo segmentar realizou alongamento segmentar; e o grupo controle nao fez alongamento. Antes e depois do tratamento, em todos os grupos, foram avaliadas a ADM de extensao da perna, flexibilidade pelo teste 3o dedo-solo e forca isometrica de flexao da perna em 45° e 90°. Os dois grupos experimentais realizaram oito sessoes de alongamento de 30 minutos cada, duas vezes por semana. Toda a analise estatistica foi realizada com p<0,05. Os resultados dos grupos global e segmentar foram semelhantes entre si e superiores aos do grupo controle na ADM, flexibilidade e forca muscular em 45° e 90° (p<0,05). Na avaliacao intra-sessoes, os dois grupos tambem tiveram desempenhos semelhantes, com ganho relativo da ADM maior nas primeiras e decrescendo ao longo das sessoes. Ambas as tecnicas de alongamento foram pois igualmente eficientes no aumento de flexibilidade, ADM e forca muscular.

Reliability and Validity of the Photogrammetry for Scoliosis Evaluation: a Cross-Sectional Prospective Study

OBJECTIVE The purpose of this study was to investigate the reliability and validity of photogrammetry in measuring the lateral spinal inclination angles. METHODS Forty subjects (32 female and 8 males) with a mean age of 23.4 +/- 11.2 years had their scoliosis evaluated by radiographs of their trunk, determined by the Cobb angle method, and by photogrammetry. The statistical methods used included Cronbach alpha, Pearson/Spearman correlation coefficients, and regression analyses. RESULTS The Cronbach alpha values showed that the photogrammetric measures showed high internal consistency, which indicated that the sample was bias free. The radiograph method showed to be more precise with intrarater reliabilities of 0.936, 0.975, and 0.945 for the thoracic, lumbar, and thoracolumbar curves, respectively, and interrater reliabilities of 0.942 and 0.879 for the angular measures of the thoracic and thoracolumbar segments, respectively. The regression analyses revealed a high determination coefficient although limited to the adjusted linear model between the radiographic and photographic measures. It was found that with more severe scoliosis, the lateral curve measures obtained with the photogrammetry were for the thoracic and lumbar regions (R = 0.619 and 0.551). CONCLUSIONS The photogrammetric measures were found to be reproducible in this study and could be used as supplementary information to decrease the number of radiographs necessary for the monitoring of scoliosis.

Rearfoot alignment and medial longitudinal arch configurations of runners with symptoms and histories of plantar fasciitis

OBJECTIVE: To evaluate and compare rearfoot alignment and medial longitudinal arch index during static postures in runners, with and without symptoms and histories of plantar fasciitis (PF). INTRODUCTION: PF is the third most common injury in runners but, so far, its etiology remains unclear. In the literature, rearfoot misalignment and conformations of the longitudinal plantar arch have been described as risk factors for the development of PF. However, in most of the investigated literature, the results are still controversial, mainly regarding athletic individuals and the effects of pain associated with these injuries. METHODS: Forty-five runners with plantar fasciitis (30 symptomatic and 15 with previous histories of injuries) and 60 controls were evaluated. Pain was assessed by a visual analogue scale. The assessment of rearfoot alignment and the calculations of the arch index were performed by digital photographic images. RESULTS: There were observed similarities between the three groups regarding the misalignments of the rearfoot valgus. The medial longitudinal arches were more elevated in the group with symptoms and histories of PF, compared to the control runners. CONCLUSIONS: Runners with symptoms or histories of PF did not differ in rearfoot valgus misalignments, but showed increases in the longitudinal plantar arch during bipedal static stance, regardless of the presence of pain symptoms.

The effects of plantar fasciitis and pain on plantar pressure distribution of recreational runners

BACKGROUND Plantar fasciitis is the third most frequent injury in runners. Despite its high prevalence, its pathogenesis remains inconclusive. The literature reports overload as the basic mechanism for its development. However, the way that these plantar loads are distributed on the foot surface of runners with plantar fasciitis and the effects of pain on this mechanical factor has not yet been investigated. Therefore, the aim of this study was to evaluate and compare the plantar pressure distributions during running in runners with symptom or history of plantar fasciitis and runners without the disease. METHODS Forty-five recreational runners with plantar fasciitis (30 symptomatic and 15 with previous history of the disease) and 60 runners without plantar fasciitis (control group) were evaluated. Pain was assessed by a visual analogue scale. All runners were evaluated by means of the Pedar system insoles during running forty meters at a speed of 12(5%) km/h, using standard sport footwear. Two-way ANOVAS were employed to investigate the main and interaction effects between groups and plantar areas. FINDINGS No interaction effects were found for any of the investigated variables: peak pressure (P = 0.61), contact area (P = 0.38), contact time (P = 0.91), and the pressure-time integral (P = 0.50). INTERPRETATION These findings indicated that the patterns of plantar pressure distribution were not affected in recreational runners with plantar fasciitis when compared to control runners. Pain also did not interfere with the dynamic patterns of the plantar pressure distributions.

Estratégias para ensino de hábitos posturais em crianças: história em quadrinhos versus experiência prática

Este estudo experimental verificou os efeitos de um programa de educacao postural comparando duas estrategias de ensino, a utilizacao de uma historia em quadrinhos (HQ) e a experiencia pratica de posturas corretas e incorretas (EP). O programa de educacao postural foi aplicado em tres encontros com escolares das 2a e 3a series, com idades entre 7 e 11 anos; 40 meninas e 40 meninos foram divididos igualmente em dois grupos, cada um submetido a uma estrategia de ensino: GHQ e GEP. O conhecimento dos habitos posturais foi verificado por meio de questionarios aplicados antes e apos 6 meses do termino das sessoes. Foram ensinadas as posturas corretas em pe, sentado, de transportar mochilas, de abaixar, de mudar objetos de lugar e jeito de dormir. Os resultados do estudo indicaram que, para todas as variaveis estudadas houve aumento significativo no aprendizado e memorizacao dos habitos posturais corretos em ambos os grupos, e que nao houve diferenca significativa entre as duas estrategias educativas. Nao foram detectadas diferencas no aprendizado e memorizacao dos habitos posturais corretos em criancas de ambos os sexos submetidas as duas metodologias de ensino.

Effects of phonophoresis with Arnica montana onto acute inflammatory process in rat skeletal muscles: An experimental study

This study aimed at verifying the effects of phonophoresis associated with Arnica montana on the acute phase of an inflammatory muscle lesion. Forty Wistar male rats (300+/-50 g), of which the Tibialis Anterior muscle was surgically lesioned, were divided into four groups (n=10 each): control group received no treatment; the ultrasound group (US) was treated in pulsed mode with 1-MHz frequency, 0.5 W/cm(2) intensity (spatial and temporal average - SATA), duty cycle of 1:2 (2 ms on, 4 ms off, 50%), time of application 3 min per session, one session per day, for 3 days; the phonophoresis or ultrasound plus arnica (US+A) group was treated with arnica with the same US parameters plus arnica gel; and the arnica group (A) was submitted to massage with arnica gel, also for 3 min, once a day, for 3 days. Treatment started 24h after the surgical lesion. On the 4th day after lesion creation, animals were sacrificed and sections of the lesioned, inflamed muscle were removed for quantitative (mononuclear and polymorphonuclear cell count) and qualitative histological analysis. Collected data from the 4 groups were statistically analyzed and the significance level set at p<0.05. Results show higher mononuclear cell density in all three treated groups with no significant difference between them, but values were significantly different (p<0.0001) when compared to control groups. As to polymorphonuclear cell density, significant differences were found between control group (p=0.0134) and US, US+A and A groups; the arnica group presented lesser density of polymorphonuclear cells when compared (p=0.0134) to the other groups. No significant difference was found between US and US+A groups. While the massage with arnica gel proved to be an effective anti-inflammatory on acute muscle lesion in topic use, these results point to ineffectiveness of Arnica montana phonophoresis, US having seemingly checked or minimized its anti-inflammatory effect.