Neutral static alignment, normal movement and a satisfactory segmental interrelationship are described as significant factors in normal asymptomatic function and, when altered, increase the risk of lesions in the lower limbs. It is important to focus on the early identification of joint misalignments. Thus, the present study aims at developing, validating the content developed and confirming the reproducibility of the Dynamic Evaluation Method of Lower Limb Joint Alignment with Parallel Feet (MADAAMI-P), a simple video-based evaluation method using surface markers and a score sheet. The study was carried out in three stages: (1) the Dynamic Evaluation Method of Lower Limb Joint Alignment for dancers (MADAAMI) was adapted; (2) the content validity of the score sheet used in MADAAMI-P was checked; and (3) the intra- and inter-rater reproducibility were evaluated. Cohen's Kappa coefficient and the Intraclass Correlation Coefficient (ICC) were used in the statistical analysis to analyze the categories of the score sheet criteria and sum of the scores (a <0.05). The results showed that MADAAMI-P presents content validity satisfactory.

Introduction: The early evaluation of the spine in children is desirable because it is at this stage of development that the greatest changes in the body structures occur. Objective: To determine the test-retest, intra- and inter-rater reliability of the Flexicurve instrument for the evaluation of spinal curvatures in children. Method: Forty children ranging from 5 to 15 years of age were evaluated by two independent evaluators using the Flexicurve to model the spine. The agreement was evaluated using Intraclass Correlation Coefficients (ICC), Standard Error of the Measurement (SEM), and Minimal Detectable Change (MDC). Results: In relation to thoracic kyphosis, the Flexicurve was shown to have excellent correlation in terms of test-retest reliability (ICC2,2=0.87) and moderate correlation in terms of intra-(ICC2,2=0.68) and inter-rater reliability (ICC2,2=0.72). In relation to lumbar lordosis, it was shown to have moderate correlation in terms of test-retest reliability (ICC2,2=0.66) and intra- (ICC2,2=0.50) and inter-rater reliability (ICC=0.56). Conclusion: This evaluation of the reliability of the Flexicurve allows its use in school screening. However, to monitor spinal curvatures in the sagittal plane in children, complementary clinical measures are necessary. Further studies are required to investigate the concurrent validity of the instrument in order to identify its diagnostic capacity.

BACKGROUND: The adapted arcometer has been validated for use in adults. However, its suitability for use in children can be questioned given the structural differences present in these populations. OBJECTIVE: To verify the concurrent validity, repeatability, and intra- and inter-reproducibility of the adapted arcometer for the measurement of the angles of thoracic kyphosis and lumbar lordosis in children. METHOD: Forty children were evaluated using both sagittal radiography of the spine and the adapted arcometer. The evaluations using the arcometer were carried out by two trained evaluators on two different days. In the statistical treatment, the intraclass correlation coefficient (ICC), Pearson's product moment correlation, Spearman's rho, the paired t test, and Wilcoxon's test were used (α=.05). RESULTS: A moderate and significant correlation was found between the x-ray and the adapted arcometer regarding thoracic kyphosis, but no correlation was found regarding lumbar lordosis. Repeatability and intra-evaluator reproducibility of the thoracic kyphosis and lumbar lordosis were confirmed, which was not the case of inter-evaluator reproducibility. CONCLUSION: The adapted arcometer can be used to accompany postural alterations in children made by the same evaluator, while its use for diagnostic purposes and continued evaluation by different evaluators cannot be recommended. Further studies with the aim of adapting this instrument for use in children are recommended.

CONTEXTUALIZAÇÃO: A necessidade de identificação precoce de alterações posturais, sem expor as pessoas à radiação constante, tem estimulado a construção de instrumentos para medir as curvaturas da coluna vertebral. OBJETIVO: Verificar a validade, repetibilidade e reprodutibilidade dos ângulos das curvaturas sagitais da coluna vertebral, obtidos por meio de um arcômetro adaptado, comparando-os com os ângulos de Cobb (AC) das respectivas curvaturas, obtidos por meio de exames radiográficos. MÉTODOS: Cinquenta e dois indivíduos foram submetidos a dois procedimentos destinados a avaliar as curvaturas torácica e lombar: (1) exame de raios-X, a partir do qual os AC de ambas as curvaturas foram obtidos e (2) medição dos ângulos das curvaturas com o arcômetro (AA). Dois avaliadores coletaram os dados usando o arcômetro com as hastes sobre os processos espinhosos T1, T12, L1 e L5, de modo a permitir medidas que, com auxílio de trigonometria, forneceram os AA. RESULTADOS: Encontrou-se correlação muito forte e significativa entre AA e AC (r=0,94, p<0,01), sem diferença significativa (p=0,32) para a curvatura torácica, enquanto, para a curvatura lombar, encontrou-se uma forte e significativa correlação (r=0,71, p<0,01) entre AA e AC, sem diferença significativa (p=0,30). Existe uma correlação muito forte intra-avaliador e inter-avaliador nos AA. CONCLUSÃO: O arcômetro permitiu quantificar as curvaturas torácica e lombar, podendo-se considerar as medições válidas, fidedignas e objetivas para uso na avaliação de curvaturas da coluna vertebral no plano sagital.

BACKGROUND: The need for early identification of postural abnormalities without exposing patients to constant radiation has stimulated the development of instruments aiming to measure the spinal curvatures. OBJECTIVE: To verify the validity, repeatability and reproducibility of angular measures of sagittal curvatures of the spine obtained using an adapted arcometer, by comparing them with Cobb angles of the respective curvatures obtained by using X-rays. METHODS: 52 participants were submitted to two procedures designed to evaluate the thoracic and lumbar curvatures: (1) X-ray examination from which the Cobb angles (CA) of both curvatures were obtained, and (2) measuring the angles with the arcometer (AA). Two evaluators collected the data using the arcometer, with the rods placed at T1, T12, L1 and L5 spinous processes levels in a way as to permit linear measurements which, with aid of trigonometry, supplied the AA. RESULTS: There was a very strong and significant correlation between AA and CA (r=0.94; p<0.01), with no-significant difference (p=0.32), for the thoracic curvature. There was a strong and significant correlation for the lumbar curvature (r=0.71; p<0.01) between AA and CA, with no-significant difference (p=0.30). There is a very strong correlation between intra-evaluator and inter-evaluator AA. CONCLUSION: It was possible to quantify reliably the thoracic and lumbar curvatures with the arcometer and it can thus be considered valid and reliable and for use in evaluating spinal curvatures in the sagittal plane.

CONTEXTUALIZAÇÃO: A análise da mecânica externa dos exercícios de Pilates e da biomecânica das articulações pode subsidiar a prescrição de exercícios na reabilitação. OBJETIVOS: Avaliar o comportamento do torque de resistência (ΓR) do exercício de extensão de quadril (EQ) realizado no Cadillac; realizar uma análise biomecânica a partir do comportamento do ΓR e das distâncias perpendiculares médias ponderadas (DPMPs) para estimar a força muscular resultante (FM R) dos extensores e flexores e propor critérios mecânicos para progressão do exercício de EQ realizado no Cadillac. MÉTODOS: Catorze praticantes de Pilates realizaram EQ no aparelho Cadillac em quatro situações em ordem aleatorizada - usando duas molas (vermelha e azul) fixadas em duas posições (alta e baixa). As posições angulares foram coletadas por meio de eletrogoniometria. Para o cálculo do ΓR, torque muscular (ΓM) e da FM R foram usados diagramas de corpo livre e equações de movimento. Os valores de DPMP dos músculos flexores e extensores do quadril foram quantificados usando dados da literatura. RESULTADOS: O ΓR e a FM R apresentaram comportamentos semelhantes em todas as situações, entretanto os valores máximos de ΓR não ocorrem na mesma posição articular que a FM R máxima. A DPMP dos flexores de quadril apresentou um comportamento crescente-decrescente, com máximo próximo aos 55º de flexão, enquanto os extensores de quadril apresentaram comportamento semelhante, com máximo próximo aos 25º de flexão. CONCLUSÃO: A análise biomecânica do exercício e a avaliação das características mecânicas associadas à articulação do quadril podem ser usadas como critérios objetivos de prescrição e progressão do exercício de EQ no Pilates.

BACKGROUND: The understanding of the external mechanics of Pilates exercises and the biomechanics of the joints may guide the prescription of rehabilitation exercises. OBJECTIVES: To evaluate the resistance torque (ΓR) during hip extension (HE) exercises performed on the Pilates Cadillac. To perform a biomechanic analysis of the ΓR and the weighted mean moment arm (WMMA) in order to calculate the resultant muscle force (FM R) of the hip extensors and flexors. To present a mechanical criteria for progression of HE exercise on the Pilates Cadillac. METHODS: Fourteen participants performed HE exercises on the Cadillac in four randomly assigned situations - using two springs (blue and red), which were attached in two positions (high and low). Angular positions were measured using an electrogoniometer. In order to calculate ΓR, the muscle torque (ΓM) and FM R, free-body diagrams and movement equations were used. The WMMA of the hip extensors and flexors were estimated from the literature. RESULTS: The ΓR and FM R presented a similar behavior during all situations; however, the maximum ΓR values did not occur at the same joint position as the FM R maximum values. The WMMA of the hip flexors presented an increased- decreased behavior with greatest values around 55º of flexion, while the hip extensors presented a similar behavior with greatest values around 25º of flexion. CONCLUSION: Biomechanic analysis of HE exercises and the evaluation of mechanical features in relation to the hip joint may be used as an objective criteria for the prescription and progression of HE exercise in Pilates.

CONTEXTUALIZAÇÃO: Apesar do amplo uso do Pilates na Fisioterapia, há poucos estudos que avaliaram a ativação elétrica dos músculos nos exercícios. OBJETIVO: Verificar a influência de diferentes regulagens de mola e posições do indivíduo sobre a ativação elétrica dos multífidos (MU) e oblíquos externos (OE) durante a flexoextensão do quadril (FEQ) no Cadillac. MÉTODOS: Oito mulheres praticantes de Pilates por seis meses realizaram 10 repetições de FEQ nas situações: mola baixa (MB), mola fixada a 30 cm do nível em que estava o indivíduo; mola alta (MA), mola fixada a 90 cm do nível em que estava o indivíduo; posição próxima (PP), distância de 10 cm da fixação da mola; posição distante (PD), distância de 30 cm da fixação da mola. Dados cinemáticos e de eletromiografia (EMG) foram coletados sincronizadamente, e os músculos monitorados bilateralmente foram os OE e os MU. Cada movimento de FEQ foi recortado em duas fases (extensão e flexão). O sinal de EMG foi calculado e normalizado usando a contração voluntária máxima (CVM). O Wilcoxon test foi usado para investigar diferenças entre as situações (p<0,05). RESULTADO: Os músculos MU apresentaram valores de ativação muscular de 10 a 20% da CVM, sendo os maiores valores observados na MA e na PD. Para os OE, valores de ativação de 20 a 45% da CVM foram encontrados, com os maiores valores obtidos na MB e na PP. CONCLUSÃO: Os músculos OE e MU apresentaram uma ativação elétrica distinta durante as diferentes regulagens de mola e posições dos indivíduos avaliados.

BACKGROUND: Despite of the widepread use of Pilates in Physical Therapy, there are few studies that have assessed the muscle electrical activation during Pilates exercises. OBJECTIVE: Verify the influence of different spring adjustments and individual positions on the electrical activation of multifidus (MU) and oblique external (OE) muscles during hip flexion-extension (HFE) exercise on the Cadillac. METHODS: Eight women practicing Pilates exercises for at least six months performed 10 repetitions of HFE in the following situations: Lower Spring, spring fixed at 30 cm in relation to level which the individuals were positioned. Higher Spring, spring fixed at 90 cm in relation to level which the individuals were positioned. Near Position, distance of 10 cm from the fixed spring. Distant Position, distance of 30 cm from the fixed spring. Kinematic and eletromyographic data (EMG) were collected simultaneously and the MU and OE muscles were monitored. Each movement of HFE was splitted in two phases (extension and flexion). The EMG signal was calculated and normalized using the maximal voluntary contraction (MVC). The Wilcoxon test was used to investigate differences between the situations (p<0.05). RESULTS: MU muscle presented muscle activation values ranging from 10 to 20 % MVC, and the highest muscle activation in the lower spring and in the near position. OE muscles presented muscle activation values ranging from 20 to 45% MVC, and the highest values in the higher spring and in the distant position. CONCLUSION: MU and OE muscles presented a distinct electrical activation during different available spring adjustments and individual positions.

Estimar a força dos músculos do ombro e compreender o quanto cada músculo contribui para produção do torque em determinado movimento articular torna-se indispensável para a compreensão do movimento humano, bem como para o planejamento da reabilitação de pacientes com disfunções no ombro. Neste sentido, o presente estudo tem como principal objetivo estimar a força muscular e analisar a contribuição dos músculos Infra-espinhoso, Redondo Menor, Supra-espinhoso, Deltóide Posterior e Deltóide Médio no torque de rotação externa dinâmico do ombro no plano transverso. Para isso, um modelo de otimização gerado no software MATLABâ 7.0 (MathWork Inc, Massachusetts - USA), capaz de estimar a produção de força e torque de cada um dos músculos rotadores externos do ombro foi utilizado.Os músculos Infra-espinhoso e Redondo Menor apresentaram um pico de torque de 22Nm em 20º e 6Nm em 28º, respectivamente, quando o ombro encontrava-se em rotação interna. A magnitude máxima de força alcançada por estes músculos foi de 996N para o Infraespinhoso e 306N para o Redondo Menor. Os músculos Supra-espinhoso, Deltóide Posterior e Deltóide Médio praticamente não produziram torque e obtiveram magnitudes pequenas de força. Estes resultados apontam que os músculos Infra-espinhoso e Redondo Menor são preferencialmente recrutados para o gesto de rotação externa do ombro.

Estimate the shoulder muscles forces and understand how much each muscle the moment production during joint movement is indispensable for the knowledge of the human movement, as well as, for the rehabilitation planning of patients with shoulder dysfunction. For this reason, the goal of the present study is to estimate the muscle force and to analyze the contribution of the following muscles: Infraspinatus, Teres Minor, Supraspinatus, Deltoideus Posterior and Deltoideus Medialis during dynamic external rotation of the shoulder in the transverse plane. So, an optimization model structured in the software MATLAB 7.0 (MathWork Inc., Massachusetts - the USA) was used to estimate the force and moment production of each the shoulder external rotators muscles. The muscles Infraspinatus and Teres Minor reached the following peak moment, respectively: 22 Nm (20º of internal rotation) and 6 Nm (28º of internal rotation). The force magnitudes reached by these muscles were 996 N for the Infraspinatus and 306 N for the Teres Minor, both at 31° of internal rotation. The muscles Supraspinatus, Deltoideus Posterior and Deltoideus Medialis presented low magnitudes for external rotation moment and force. These results suggested Infraspitatus and Teres Minor muscles are preferentially recruited during external rotation of the shoulder.