Development of a quantitative assessment system for correlation analysis of footprint parameters to postural control in children

Effectiveness of the Mat Pilates on the postural control, plantar pressure and plantar arch of school children: A randomized clinical trial

OBJECTIVE

To evaluate the effectiveness of Mat Pilates on postural control, plantar pressure and plantar arch (ALM) in schoolchildren.

DESIGN AND SETTING

The study was a randomized clinical trial, developed at the Early Childhood Education Institute, Londrina-PR. The participants were randomly assigned to groups: Pilates Group (PG) and Control Group (CG). Patients in the CG did not perform extra physical activity (Interventions).

PARTICIPANTS

43 children (eight to 12 years), no prior knowledge of the Pilates method, and no exercise training in the last six months.

INTERVENTION

The exercise program was based on the Mat Pilates method, twice weekly, 50 min each, 28 sessions.

OUTCOME MEASURES

Static balance (force platform), dynamic balance (the Reach Test), ALM (plantigraphy) and plantar pressure (baropodometry). The assessors were blinded to the allocation of participants.

RESULTS

Three children were excluded before randomization and 40 were randomized (PG n: 20; CG n:20).12 children were excluded during the protocol (PG n:7; CG n:5) and included in the intention to treat analysis. No significant difference between groups was observed for static and dynamic balance and ALM measures. There was a significant difference in the following outcomes for the PG: the plantar pressure on the right hemibody forefoot between pre-test 38.70 ± 14.38 and post-test 42.65 ± 15.63 (ES = 0.66; SRM = 0.50). The plantar pressure on the right hemibody rearfoot between pre-test 61.10 ± 14.18 and post-test 56.85 ± 19.39 (ES = 0.68; SRM = 0.53). No adverse or harmful events were reported in any group.

CONCLUSION

There were no differences in static and dynamic postural control and ALM between PG and CG. However, children GP showed improvement in some results of plantar pressure in relation CG.

CLINICAL TRIAL REGISTRATION NUMBER

Brazilian Registry of Clinical Trials (REBEC) (N_ RBR-8t5p7d).

The role of posturography on the initial stage of sports training

One of the main directions in the wrestlers training on the initial stage of sports training is the formation of the wrestler’s motion coordination abilities. Equilibrium function and anthropometric data including wrestler’s gender have essential differences in connection both with the child’s biological specialities and choosen athletic discipline special aspects. This research is focused on comparsion of variations in kinetic postural control affected by the lassitude among young athletes and non-athletes. 16 girl childs - freestyle wrestlers participates in this research. They are on initial stage of sports training. The control group consisted of 14 girl childs irrelevant to sports. There was made a hypothesis that the wrestlers lassitude can be measured subjectively (with the Borg scale) and objectively (with the stabilometrics), and that the wrestlers will better control their body position than the girls irrelevant to sports. Tecnobody Pro-Kin stabilometric platform was used to measure postural balance. There was determined statistically significant positive relationship of the investigated parameters changes between groups. As a result of the research we can make a conclusion that the offered method can provide reliable data concerning wrestler’s lassitude level. Analogues data are received with the rating of perceived exertion by Borg’s scale. As the result we can conclude that the offered postural balance research method is valid for the wrestler’s lassitude rating and can be used as a component of the complex athletes control system.

Influence of Children's Foot Type on Their Physical Motor Performance

BACKGROUND

This cross-sectional study aimed to determine whether normal, flat, or high-arched feet corresponded to better performance of certain motor tests in children.

METHODS

One hundred eighty-seven children (mean ± SD age, 11.15 ± 1.24 years) were recruited and divided into three groups: 96 with normal feet, 54 with high-arched feet, and 37 with low-arched feet. Nine motor trials were selected to assess motor performance: standing long jump, standing triple jump from each foot, standing vertical jump, shuttle run 10 × 5 m, standing-start 20-m sprint, static balance, dynamic balance on a beam of an inverted gym bench, and agility circuit.

RESULTS

There were no significant differences in the trial results between groups, although in eight of the nine trials participants in the high-arched group tended to perform better. Boys performed better than girls in all of the trials except those of balance.

CONCLUSIONS

These results suggest that children with a certain foot type did not achieve better motor performance in the nine trials tested.

Evaluation of standing stability in individuals with flatfeet

OBJECTIVE

Flatfoot is one of the most common foot disorders, which not only influences the performance of the foot but also affects the alignments of the ankle, knee, and hip joints. The performance of the flat-arched individuals differs from that of normal individuals during walking. However, there is not enough information in the literature regarding their standing stability. Moreover, the influence of use of foot insole on standing stability has not been evaluated. Therefore, the aim of this study was to evaluate standing stability in individuals with flatfoot with and without insole.

METHODS

Two groups of normal and flat-arched individuals were recruited into this study. A Kistler force plate was used to measure the center of pressure (CoP), which is recognized as a good approximation of sway of center of gravity in a horizontal plane. Stability was determined by calculating the CoP excursions, path length, and velocity in the mediolateral and anteroposterior directions. The difference between stability in normal individuals and those with flatfoot was examined using the independent t test. The paired t test was used to determine the difference between stability in each group with and without insole. Significant P value was set at α ≤.05.

RESULTS

There was a significant difference between stability of flat-arched and normal individuals based on CoP velocity and total velocity. In addition, there was no direct correlation between the severity of flatfoot and instability during quiet standing. However, the mean values of CoP total velocity during standing with and without insole were significantly different (P < .001).

CONCLUSION

This study suggests that individuals with flatfoot are more unstable when compared with normal individuals during quiet standing. It seems that the foot insole improves the alignment of foot structure and reduces the forces applied on the ligament, thus, improving standing stability. Therefore, stability assessment in patients with flatfoot may be important, and the insole is a useful modality that can be used to improve stability in this patient group.

LEVELS OF EVIDENCE

Therapeutic, Level II: Prospective, comparative trial.

Flatfoot diagnosis by a unique bimodal distribution of footprint index in children

BACKGROUND

More than 1000 scientific papers have been devoted to flatfoot issue. However, a bimodal distribution of flatfoot indices in school-aged children has never been discovered. The purposes of this study were to establish a new classification of flatfoot by characteristic in frequency distribution of footprint index and to endue the classification with discrepancy in physical fitness.

METHODS/PRINCIPAL FINDINGS

In a longitudinal survey of physical fitness and body structure, weight bearing footprints and 3 physical fitness related tests were measured in 1228 school-aged children. Frequency distribution of initial data was tested by Kolmogorov-Smirnov test for normality and a unique bimodal distribution of footprint index was identified. The frequency distribution of footprint index manifests two distinct modes, flatfoot and non-flatfoot, by deconvolution and bootstrapping procedures. A constant intersection value of 1.0 in Staheli's arch index and 0.6 in Chippaux-Smirak index could distinguish the two modes of children, and the value was constant in different age, sex, and weight status. The performance of the one leg balance was inferior in flatfoot girls (median, 4.0 seconds in flatfoot girls vs. 4.3 seconds in non-flatfoot girls, p = 0.04, 95% CI 0.404-0.484).

DISCUSSION

The natural bimodality lends itself to a flatfoot classification. Bimodality suggests development of the child's foot arch would be a leap from one state to another, rather than a continuous growth as body height and weight. The underlying dynamics of the human foot arch and motor development will trigger research prospects.

Effects of whole body vibration training on balance in adolescents with and without Down syndrome

The present study aimed to determine whether a whole body vibration training program (WBV) is able to improve static standing balance in adolescents with and without Down syndrome (DS). Thirty adolescents with DS aged 11-20 years (DSG) and 27 adolescent, age/sex matched, without DS (CG) joined the study. Participants of each group were divided into two comparable groups, those who performed WVB (in DSG: VDSG; in CG: VCG) and those who did not perform WVB (in DSG: nVDSG; in CG: nVCG). Static-standing-balance under four conditions (C1: open-eyes/fixed-foot-support; C2: closed-eyes/fixed-foot-support; C3: open-eyes/compliant-foot-support; C4: closed-eyes/compliant-foot-support) was examine, before and after a 20-week WBV training program. For balance study, Postural-Parameters (PPs), based on center of pressure (COP) oscillations (anterior/posterior and medial/lateral COP excursion and COP mean velocity), and PPs ratios among the four conditions were calculated. After WBV training, no significant differences were found in any parameter in the VCG and nVCG and neither in the nVDSG, but there was a decrease of mean values in the analyzed PPs under C4, with significant differences in medial/lateral COP excursion and COP mean velocity, and a significant decrease in the ratio C4/C1 of the mean velocity in VDSG. Therefore, WBV training had positive effects in the balance of DS adolescents although only under specific conditions, with vision and somatosensory input altered. The positive results of this study are encouraging and open a wide field of research, looking for the most efficient program for this population.

Screening for foot problems in children: is this practice justifiable?

Podiatry screening of children is a common practice, which occurs largely without adequate data to support the need for such activity. Such programs may be either formalised, or more ad hoc in nature, depending upon the use of guidelines or existing models. Although often not used, the well-established criteria for assessing the merits of screening programs can greatly increase the understanding as to whether such practices are actually worthwhile. This review examines the purpose of community health screening in the Australian context, as occurs for tuberculosis, breast, cervical and prostate cancers, and then examines podiatry screening practices for children with reference to the criteria of the World Health Organisation (WHO). Topically, the issue of paediatric foot posture forms the focus of this review, as it presents with great frequency to a range of clinicians. Comparison is made with developmental dysplasia of the hip, in which instance the WHO criteria are well met. Considering that the burden of the condition being screened for must be demonstrable, and that early identification must be found to be beneficial, in order to justify a screening program, there is no sound support for either continuing or establishing podiatry screenings for children.

Static standing balance in adolescents with Down syndrome

AIM

To analyse static-standing-balance of adolescents with Down syndrome (DS).

METHODS

Thirty-two adolescents with DS aged 10-19 years (DSG); 33 adolescents, age/sex-matched, without DS (CG). Static-standing-balance under four conditions (C1: open-eyes/fixed-foot-support; C2: closed-eyes/fixed-foot-support; C3: open-eyes/compliant-foot-support; closed-eyes/compliant-foot-support) was examined by means of time and frequency Postural-Parameters (PPs). To evaluate the contribution of each sensory system influencing postural control ratios among the four conditions were calculated. Mean values of all PPs were higher in the DSG than in the CG. Mean values of time PPs were higher in both groups on compliant-foot-support (with open and closed eyes) than on fixed-foot-support. Ratios C2/C1 were significantly lower in DSG than in CG; ratios C3/C1 presented higher values in DSG than in CG, with significant differences in length path and RMS-velocity; there were no differences in ratios C4/C1.

CONCLUSIONS

In our group of DS adolescents the shift from visual to multimodal control of stance had occurred and they showed similar postural control patterns than non-DS. Even though, they presented worse static balance than their peers without DS and they had more problems with altered somasosensory input. An adequate rehabilitation program insisting on somatosensory input could be a useful measure to improve balance.

Effect of awareness through movement on the head posture of bruxist children

The aim of this study was to evaluate the effectiveness of physiotherapy to improve the head posture and reduce the signs of bruxism in a group of bruxist children. A single-blind randomized clinical trial was performed. All the subjects were 3- to 6-year old, had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, a clinical, photographic and radiographic evaluation of the head and cervical posture were realized with standardized techniques. The children were randomized in an experimental (n = 13) and a control (n = 13) group. A physiotherapeutic intervention was applied to the children of the experimental group once a week, until 10 sessions were completed. Afterwards, the cephalogram and the clinical and photographic evaluation of the head posture were measured again. The data were analysed with the t-test and Mann-Whitney test. The subjects of the experimental group showed statistically significant improvement in the natural head posture. The physiotherapeutic intervention showed to be efficient to improve the head posture at the moment of measurement in the studied children. The relationship between bruxism and head posture, if exists, seems to be worthwhile to examine.

A distribuição da força plantar está associada aos diferentes tipos de pés?

OBJETIVO: Quantificar as forças e mensurar o arco longitudinal medial em pés de escolares. MÉTODOS: Estudo transversal envolvendo escolares da primeira série do ensino fundamental de uma escola pública de Guaratinguetá (SP). Para identificar a distribuição das pressões plantares, foram utilizadas duas plataformas de força e a impressão plantar em papel para mensurar o arco longitudinal medial. Compararam-se as forças plantares da porção medial e lateral e as forças plantares da região anterior e posterior dos pés. Os pés, depois de classificados, foram comparados quanto às médias das forças plantares de cada sensor. A aquisição da atividade baropodométrica foi coletada três vezes seguidas para cada sensor e realizada na posição ortostática. Os valores médios foram comparados através dos testes t de Student e ANOVA. RESULTADOS: Participaram do estudo 57 escolares com idade média de 7,5 anos sem qualquer queixa ou indício de doença ortopédica e/ou neurológica. As forças plantares foram significativamente maiores da região medial do pé esquerdo (p=0,003) e em ambos os retropés (p<0,001). A amostra apresentou prevalência significativamente maior de pés planos, com 59,4%, pés normais com 32,1% e pés cavos com 8,5%. CONCLUSÕES: Foi possível quantificar as forças plantares, classificar os tipos de pés e associar a distribuição plantar ao tipo de pé, demonstrando que há associação entre o padrão de pé e a distribuição das forças plantares.

Crime Scene Reconstruction Using a Fully Geomatic Approach

This paper is focused on two main topics: crime scene reconstruction, based on a geomatic approach, and crime scene analysis, through GIS based procedures. According to the experience of the authors in performing forensic analysis for real cases, the aforesaid topics will be examined with the specific goal of verifying the relationship of human walk paths at a crime scene with blood patterns on the floor. In order to perform such analyses, the availability of pictures taken by first aiders is mandatory, since they provide information about the crime scene before items are moved or interfered with. Generally, those pictures are affected by large geometric distortions, thus - after a brief description of the geomatic techniques suitable for the acquisition of reference data (total station surveying, photogrammetry and laser scanning) - it will be shown the developed methodology, based on photogrammetric algorithms, aimed at calibrating, georeferencing and mosaicking the available images acquired on the scene. The crime scene analysis is based on a collection of GIS functionalities for simulating human walk movements and creating a statistically significant sample. The developed GIS software component will be described in detail, showing how the analysis of this statistical sample of simulated human walks allows to rigorously define the probability of performing a certain walk path without touching the bloodstains on the floor.

Head posture and dental wear evaluation of bruxist children with primary teeth

The aim of the present study was to compare the head position and dental wear of bruxist and non-bruxist children with primary dentition.

METHODS

All the subjects had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist or non-bruxist according to their anxiety level, bruxism described by their parents and signs of temporomandibular disorders. The dental wear was drawn in dental casts and processed in digital format. Physiotherapeutic evaluation and a cephalometric radiograph with natural head position were also performed for each child to evaluate the cranio-cervical position for the bruxist group (n = 33) and the control group (n = 20). The variables of the two groups were compared, using the Student t-test and Mann-Whitney U-test.

RESULTS

A more anterior and downward head tilt was found in the bruxist group, with statistically significant differences compared with the controls. More significant dental wear was observed in the bruxist children.

CONCLUSIONS

Bruxism seems to be related to altered natural head posture and more intense dental wear. Further studies are necessary to explore bruxism mechanisms.

Comparison of standing balance between female collegiate dancers and soccer players

STUDY DESIGN

This study was designed as a comparison study of two cohorts.

OBJECTIVES

The hypothesis of this study was that soccer players and dancers have different balance abilities and that these differences could be objectively measured using center of pressure measurements.

BACKGROUND

Center of pressure (COP) measurements are reproducible and have been validated in the literature for assessing standing balance. The literature does not provide sensitive enough techniques for discriminating between two groups of athletes with excellent standing balance.

METHODS AND MEASURES

A Matscan pressure mat (Tekscan, Boston, MA) was used to compare COP change variability between 32 female collegiate soccer players and 32 dancers. COP was used to calculate sway index, center acquisition time, sway path length and sway velocity as measures of standing balance.

RESULTS

The dancers had significantly better balance scores (p<0.05) in 5 of 20 balance tests. Results for the remaining 15 balance tests were not significantly different.

CONCLUSION

These data show that standing balance characteristics of dancers and soccer players can be objectively measured using COP data. Dancers have certain standing balance abilities that are better than those of soccer players. The COP measurements in this study can be used as a tool in future studies investigating standing balance in different groups of athletes.