ABSTRACT Objective: This study aims to describe a kinematic gait assessment protocol and identify its main alterations in individuals with cervical spondylotic myelopathy (CSM) compared to healthy patients. Methods: In total, 14 patients diagnosed with CSM were enrolled and submitted to a three-dimensional gait analysis. The movement of patients was captured with infrared emission cameras that identified tracking markers placed on the lower limbs. Reference positions were used, and the patients walked along a rubberized walkway. The Gait Profile Score (GPS) and Movement Analysis Profile (MAP) were used to analyze variables. Results were subjected to a Student’s t-test at 95% confidence interval. The R Core Team (2016) software was used for statistical analysis, graphically comparing the study results with data from healthy patients. Results: When comparing the kinematic data bilaterally, no statistical differences were found. However, graphical analysis showed changes in the gait of patients with CSM compared to healthy individuals. There were differences in all movements, with a more significant discrepancy in hip and knee flexion and extension, dorsiflexion and plantar flexion, and internal and external hip rotation. Conclusion: We describe a protocol for gait kinematics assessment using GPS and MAP, and we presented the differences in gait kinematics in patients with CSM compared to healthy individuals. Level of Evidence II, Prospective study. Objective (CSM Methods total 1 threedimensional three dimensional limbs walkway (GPS MAP (MAP variables Students Student s ttest t test 95 interval 2016 (2016 bilaterally found However movements extension rotation Conclusion II 9 201 (201 20 (20 2 (2 (

RESUMO Objetivo: Descrever um protocolo de avaliação cinemática da marcha e identificar suas principais alterações, em indivíduos com mielopatia espondilótica cervical (MEC), em comparação com pacientes saudáveis. Métodos: 14 pacientes com diagnóstico de MEC foram incluídos e submetidos à análise tridimensional da marcha. Capturamos o movimento dos pacientes com câmeras de emissão infravermelha, que identificaram marcadores de rastreamento posicionados nos membros inferiores. Adquirimos sua posição de referência e os pacientes caminharam por uma passarela emborrachada. As variáveis foram analisadas pelo Gait Profile Score (GPS) e Movement Analysis Profile (MAP), sendo seus resultados analisados pelo teste t de Student com intervalo de confiança de 95%. Utilizamos o software R Core Team (2016) para análise estatística. Comparamos graficamente nossos resultados com dados de pacientes saudáveis. Resultados: Ao comparar os dados cinemáticos bilateralmente, não houve diferenças estatísticas. A análise gráfica evidenciou alterações na marcha do paciente em comparação a indivíduos saudáveis. Houve diferenças em todos os movimentos, com discrepância mais significativa na flexão e extensão do quadril e joelho, dorsiflexão e flexão plantar e rotação interna e externa do quadril. Conclusão: Descrevemos um protocolo de avaliação cinemática da marcha utilizando GPS e MAP e apresentamos as diferenças da marcha de pacientes com MEC, em comparação com indivíduos saudáveis. Nível de Evidência II, Estudo prospectivo. Objetivo , (MEC) saudáveis Métodos 1 infravermelha inferiores emborrachada (GPS MAP, (MAP) 95 95% 2016 (2016 estatística Resultados bilateralmente estatísticas movimentos joelho Conclusão II prospectivo (MEC (MAP 9 201 (201 20 (20 2 (2 (

RESUMO Objetivo: Comparar resultados clínicos de pacientes com escorregamento epifisário proximal do fêmur (EEPF) moderado e grave tratados com osteotomia basocervical e cervicoplastia com indivíduos saudáveis. Métodos: Coorte comparativa com 12 voluntários saudáveis e 12 pacientes (14 quadris) com EEPF moderado e grave submetidos à osteotomia basocervical e cervicoplastia entre 2007 e 2014. A média de idade na cirurgia foi de 13,3 ± 2,5 anos e o seguimento médio de 3,8 ± 2,2 anos. Avaliou-se nível de dor no quadril utilizando a escala visual analógica (EVA) e o teste de impacto anterior (TIA); nível de função usando o Harris Hip Score (HHS) e o 12-Item Short Form Health Survey (SF-12); amplitude de movimento (ADM) com goniometria e sinal de Drehmann; e força muscular do quadril com dinamômetro isocinético e sinal de Trendelenburg. Resultados: O nível de dor foi ligeiramente maior na coorte de EEPF comparado a quadris saudáveis (EVA, 0,8 ± 1,4 vs 0 ± 0, 0,007; TIA, 14% vs 0%, p = 0,06; respectivamente). Não foram observadas diferenças entre os grupos EEPF e controle para os escores funcionais (HHS, 94 ± 7 vs 100 ± 1, p = 0,135), exceto para ADM, com aumento da rotação interna (37,3º ± 9,4º vs 28,7º ± 8,2º, p < 0,001), e força, com diminuição do torque de abdução (75,5 ± 36,9 Nm/Kg vs 88,5 ± 27,6 Nm/Kg, p = 0,045), para o grupo EEPF. Conclusão: A osteotomia basocervical e a cervicoplastia restauraram o movimento do quadril e a força muscular, com exceção da força abdutora, a níveis próximos do normal, representando uma opção viável para o tratamento de EEPF moderado e grave. Nível de Evidência III, Estudo de Coorte Ambidirecional.

ABSTRACT Objective: To compare the clinical outcomes between patients with moderate and severe slipped capital femoral epiphysis (SCFE) treated with osteotomy at the base of neck and osteoplasty and with healthy individuals. Methods: Comparative cohort with 12 patients (14 hips) with moderate and severe SCFE who underwent osteotomy at the base of neck and osteoplasty between 2007 and 2014. The mean age at surgery was 13.3 ± 2.5 years and the mean follow-up was 3.8 ± 2.2 years. We assessed the level of hip pain by the visual analog scale (VAS) and anterior impingement test (AIT); the level of function using the Harris Hip Score (HHS) and 12-Item Short Form Health Survey (SF-12), the range of motion (ROM) by goniometry and Drehmann sign, and the hip muscular strength by isokinetic and Trendelenburg sign. Results: The level of pain was slightly higher in the SCFE cohort compared with healthy hips (VAS, 0.8 ± 1.4 vs 0 ± 0, 0.007; AIT, 14% vs 0%, p = 0.06; respectively). No differences were observed between the SCFE and control cohort for the functional scores (HHS, 94 ± 7 vs 100 ± 1, p = 0.135); except for ROM, with increased internal rotation (37.3º ± 9.4º vs 28.7º ± 8.2º, p < 0.001), and strength, with decreased abduction torque (75.5 ± 36.9 Nm/Kg vs 88.5 ± 27.6 Nm/Kg, p = 0.045) in the SCFE cohort. Conclusion: The osteotomy at the base of neck and the osteoplasty restored the hip motion and muscle strength, except for the abductor strength, to near normal levels, representing a viable option for the treatment of moderate and severe SCFE. Level of Evidence III, Ambidirectional Cohort Study.

Abstract Aims: To investigate the factors associated with shoulder rotational range of motion and its correlation with the self-reported function scale and functional assessment of the shoulder (closed kinetic chain upper extremity stability, peak torque of shoulder rotators, glenohumeral internal rotation deficit - GIRD, and pectoralis minor length index) in competitive water polo players. Methods: Thirty-four competitive water polo players (age: 15 +/- 1.6 years) participated in this study. The shoulder rotational range of motion, closed kinetic chain upper extremity stability, pectoralis minor length index, isokinetic torque of shoulder internal and external rotations, and self-reported upper limb function were assessed. The Pearson correlation coefficient was used to test the linear correlation before the multiple linear regressions, that were used to predict the variables associated with the external rotation and internal rotation range of motion ratio (ER/IR ratio) of the throwing limb. Results: A significant association was identified between the throwing limb ER/IR ratio and GIRD, and this observation allows us to infer that GIRD was responsible for 18.4% (p=0.01) of the variation. No associations between ER/IR ratio and the variables closed kinetic chain upper extremity stability, peak torque of shoulder internal rotation, and pectoralis minor length index were identified. Conclusion: Anatomical GIRD was the only factor associated with the ER/IR ratio in asymptomatic competitive water polo players from high school, indicating the beginning of the typical adaptations to increase performance without significantly altering the self-perception and functionality of their upper limbs.