Abstract Context In the elderly, weak lower limb muscles impair functional tasks' performance. Objective To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method 50 women (68.0 ± 4.6 years old) and 50 men (72.7 ± 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30°/s. Peak torque, total work, and coefficient of variation were analyzed. Results Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.

OBJECTIVE: The aims of this study were to evaluate the anteroposterior displacement behavior of the center of pressure without any visual reference and determine its relationship with knee muscle strength and reports of falls in postmenopausal women. Among those with osteoporosis, the specific objective was to evaluate the correlation of thoracic kyphosis and vitamin D with center of pressure displacement. METHODS: This was a cross-sectional observational study without intervention. The assessments were performed on 126 postmenopausal women (aged 55-65 years) who were grouped according to their lumbar bone density into osteoporosis and control groups. Center of pressure was evaluated on a force platform (100 Hz frequency and 10 Hz filter), with the subjects standing on both feet with eyes closed for 60 seconds. Knee muscle strength was evaluated using an isokinetic dynamometer in concentric/concentric mode at a velocity of 60°/s. In the osteoporosis group, vitamin D was assayed, and the thoracic spine was radiographed. RESULTS: In the control group, there was a correlation between the center of pressure and knee strength (r = 0.37; p<0.003). Reports of falls were not associated with center of pressure displacement (p = 0.056). In the osteoporosis group, thoracic kyphosis and vitamin D levels were not correlated with the center of pressure. CONCLUSION: Anteroposterior center of pressure displacement without visual influence was not associated with falls, thoracic kyphosis or vitamin D in the osteoporosis group. Only knee muscle strength was associated with center of pressure displacement in the control group.

OBJECTIVE: To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up. METHOD: This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6 ±11.8 years (range: 25-68 years), 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly. RESULTS: At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster. CONCLUSION: Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment.

Trata-se de ensaio clínico com o objetivo de verificar a eficiência da massagem para diminuir a lombalgia ocupacional e sua influência no desempenho das atividades laborais e de vida, na equipe de Enfermagem. A amostra foi composta por 18 funcionários, que receberam de 7 a 8 sessões após o plantão. Pela escala numérica de dor, houve melhora significante estatisticamente entre a 3ª e 1ª avaliação (p=0,000) e entre 3ª e 2ª (p=0,004), pelo teste de Wilcoxon. Sobre a avaliação funcional de Owestry, no teste T pareado, observou-se diferença estatística (p=0,02) entre o primeiro momento, com média de 21,33% e o segundo (18,78%), e se manteve entre a segunda e terceira avaliação (16,67%). Foram encontrados 18 pontos (médio risco) para escala de avaliação do risco na movimentação e transferência. Conclui-se que a massagem foi eficiente na diminuição da lombalgia ocupacional, assim como trouxe melhoria nas atividades de trabalho e vida. Clinical Trials Identifier: NCT01315197.

This is a clinical trial which aims to evaluate the efficiency of massage in the reduction of occupational low back pain, and its influence on the performance of work and life activities for the nursing team. The sample consisted of 18 employees who received seven to eight sessions after their work period. From the Numerical Pain Rating Scale, significant improvements were found between the 3rd and 1st evaluations (p=0.000) and between the 3rd and 2nd (p=0.004), using the Wilcoxon test. Regarding the Oswestry Disability Index, the paired t test showed a statistical difference (p=0.02) between the baseline, with a mean of 21.33% and the second evaluation (18.78%), which was also seen between the second and third evaluation (16.67%). The score for the Handling and Transfer Risk Evaluation Scale was 18 points (medium risk). It is concluded that massage was effective in reducing occupational low back pain, and provided improvement in activities of work and life. Clinical Trials Identifier: NCT01315197.

Se trata de ensayo clínico con el objetivo de verificar la eficiencia del masaje para apocar la lumbalgia ocupacional y su influencia en el desempeño de las actividades laborales y de vida, en el equipo de Enfermería. La muestra fue compuesta por 18 empleados, que recibieron de 7 a 8 sesiones después del plantón. Por la escala numérica de dolor, hubo mejora significante estadísticamente entre la 3ª y 1ª evaluación (p=0,000) y entre la 3ª y 2ª (p=0,004), por la prueba de Wilcoxon. Sobre la evaluación funcional de Owestry, en la prueba T pareado, se observó diferencia estadística (p=0,02) entre el primer momento, con media del 21,33% y el según (18,78%), y se mantuvo entre la segunda y tercera evaluación (16,67%). Fueron encontrados 18 puntos (medio riesgo) para escala de evaluación del riesgo en el movimiento y transferencia. Se concluye que el masaje fue eficiente en la disminución de la lumbalgia ocupacional, así como trajo mejoría en las actividades de trabajo y vida. Clinical Trials Identifier: NCT01315197.

This is a clinical trial which aims to evaluate the efficiency of massage in the reduction of occupational low back pain, and its influence on the performance of work and life activities for the nursing team. The sample consisted of 18 employees who received seven to eight sessions after their work period. From the Numerical Pain Rating Scale, significant improvements were found between the 3rd and 1st evaluations (p=0.000) and between the 3rd and 2nd (p=0.004), using the Wilcoxon test. Regarding the Oswestry Disability Index, the paired t test showed a statistical difference (p=0.02) between the baseline, with a mean of 21.33% and the second evaluation (18.78%), which was also seen between the second and third evaluation (16.67%). The score for the Handling and Transfer Risk Evaluation Scale was 18 points (medium risk). It is concluded that massage was effective in reducing occupational low back pain, and provided improvement in activities of work and life. Clinical Trials Identifier: NCT01315197.

Se trata de ensayo clínico con el objetivo de verificar la eficiencia del masaje para apocar la lumbalgia ocupacional y su influencia en el desempeño de las actividades laborales y de vida, en el equipo de Enfermería. La muestra fue compuesta por 18 empleados, que recibieron de 7 a 8 sesiones después del plantón. Por la escala numérica de dolor, hubo mejora significante estadísticamente entre la 3ª y 1ª evaluación (p=0,000) y entre la 3ª y 2ª (p=0,004), por la prueba de Wilcoxon. Sobre la evaluación funcional de Owestry, en la prueba T pareado, se observó diferencia estadística (p=0,02) entre el primer momento, con media del 21,33% y el según (18,78%), y se mantuvo entre la segunda y tercera evaluación (16,67%). Fueron encontrados 18 puntos (medio riesgo) para escala de evaluación del riesgo en el movimiento y transferencia. Se concluye que el masaje fue eficiente en la disminución de la lumbalgia ocupacional, así como trajo mejoría en las actividades de trabajo y vida. Clinical Trials Identifier: NCT01315197.

Trata-se de ensaio clínico com o objetivo de verificar a eficiência da massagem para diminuir a lombalgia ocupacional e sua influência no desempenho das atividades laborais e de vida, na equipe de Enfermagem. A amostra foi composta por 18 funcionários, que receberam de 7 a 8 sessões após o plantão. Pela escala numérica de dor, houve melhora significante estatisticamente entre a 3ª e 1ª avaliação (p=0,000) e entre 3ª e 2ª (p=0,004), pelo teste de Wilcoxon. Sobre a avaliação funcional de Owestry, no teste T pareado, observou-se diferença estatística (p=0,02) entre o primeiro momento, com média de 21,33% e o segundo (18,78%), e se manteve entre a segunda e terceira avaliação (16,67%). Foram encontrados 18 pontos (médio risco) para escala de avaliação do risco na movimentação e transferência. Conclui-se que a massagem foi eficiente na diminuição da lombalgia ocupacional, assim como trouxe melhoria nas atividades de trabalho e vida. Clinical Trials Identifier: NCT01315197.

INTRODUCTION: There is still no consensus among different specialists on the subject of kinematic variation during the hemiparetic gait, including the main changes that take place during the gait cycle and whether the gait velocity changes the patterns of joint mobility. One of the most frequently discussed joints is the knee. OBJECTIVES: This study aims to evaluate the variables found in the angular kinematics of knee joint, and to describe the alterations found in the hemiparetic gait resulting from cerebrovascular injury. METHODS: This study included 66 adult patients of both genders with a diagnosis of either right or left hemiparesis resulting from ischemic cerebrovascular injury. All the participants underwent three-dimensional gait evaluation, an the angular kinematics of the joint knee were selected for analysis. RESULTS: The results were distributed into four groups formed based on the median of the gait speed and the side of hemiparesis. CONCLUSIONS: The relevant clinical characteristics included the important mechanisms of loading response in the stance, knee hyperextension in single stance, and reduction of the peak flexion and movement amplitude of the knee in the swing phase. These mechanisms should be taken into account when choosing the best treatment. We believe that the findings presented here may aid in preventing the occurrence of the problems found, and also in identifying the origin of these problems.

OBJETIVO: O objetivo deste estudo foi avaliar as variáveis resultantes da alteração do mecanismo de resposta à carga por análise tridimensional da cinemática angular da articulação do joelho durante a marcha hemiparética oriunda de acidente vascular cerebral. MÉTODO: Estudo retrospectivo com 66 pacientes adultos de ambos os sexos (33 masculino e 33 feminino), com idade 45,4 ± 8,5 anos, com diagnóstico de acidente vascular cerebral isquêmico com hemiparesia em lado direito ou esquerdo. Todos os pacientes foram submetidos ao protocolo de realização do exame tridimensional computadorizado de marcha por meio de VICON/PEAK® 370. Os valores da cinemática angular do joelho foram selecionados para análise. RESULTADOS: Não foram encontradas diferenças estatisticamente significantes (teste de Kruskal Wallis) entre os sujeitos para as variáveis: posição angular e pico de flexão do joelho (p<0,05). As caracterísitcas clínicas relevantes encontradas foram: aumento da flexão do joelho no contato inicial e amplitude de movimento abaixo do esperado nesta fase do ciclo de marcha, estas são as que devem ser levadas em conta na seleção do melhor tratamento, pois são as que apresentam alterações importantes no mecanismo de resposta à carga na totalidade dos pacientes. DISCUSSÃO: O mecanismo de resposta à carga é fundamental para o andar porque tem como objetivo reduzir o impacto no membro inferior e suavizar o deslocamento do centro de massa no espaço reduzindo assim o consumo energético. Esta capacidade necessita ser compreendida para ser então melhor tratada e reabilitada. A dificuldade é que ainda não há consenso entre os diversos estudiosos do tema sobre as variáveis cinemáticas das articulações durante a marcha hemiparética.

PURPOSE: The aims of this study were to evaluate the variables found in the alteration of the load-response mechanism on 3-dimensional kinematic analysis of the knee joint during hemiparetic gait following stroke. METHODS: We evaluated 66 adult patients (33 men and 33 women), aged 45.4 ± 8.5 years (mean ± SD), with a diagnosis of ischemic cerebrovascular accident either right or left hemiparesis and brachial prevalence. All the participants underwent 3-dimensional gait evaluation with a Vicon 370, and the values of the angular kinematics of the knee joint were selected for analysis. RESULTS: There were no statistically significant differences (by the Kruskal-Wallis test) between the subjects regarding the following variables: angular knee position at initial contact and time of peak knee flexion in the stance. The clinically relevant characteristics found were: an increase in knee joint flexion during the initial contact and a movement amplitude below that anticipated in this phase of the walking cycle. These should be taken into account when choosing the best treatment, because they are the ones which exhibit the most important alteration in the load-response mechanism in all patients. CONCLUSION: There is still no consensus among the different specialists regarding the variations in kinematics during the hemiparetic gait. One of the most frequently discussed joints is the knee-the way the main changes take place during the gait cycle and whether the gait velocity changes the patterns of joint mobility.