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Souza IND, Figueiredo PHS, Silva KLS, Ávila MR, Oliveira LFFD, Almeida ILGI, Silva WT, Lacerda ACR, Mendonça VA, Costa HS. Factors associated with clinical severity in chronic venous disease: The role of functional parameters. J Bodyw Mov Ther 2024; 39:258-262. [PMID: 38876636 DOI: 10.1016/j.jbmt.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/26/2023] [Accepted: 03/06/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Chronic venous disease (CVD) is a highly prevalent disease that presents a wide spectrum of clinical expressions due to abnormalities in the venous system. Patients often have major functional changes that can limit daily activities. However, the functional factors associated with the severity of the disease remain poorly understood. OBJECTIVE To identify the functional factors associated with CVD severity. METHODS Seventy-five patients with CVD (92.0% females, 49.6 ± 13.3 years) were evaluated through clinical examination, lower limb perimetry, ankle range of motion (AROM), and lower limb muscle strength by the Heel Rise test, and Sit-to-stand test. Patients were stratified according to the disease severity as mild (telangiectasia, varicose veins, or edema in the lower limbs) or severe CVD (trophic changes or venous ulcer). RESULTS Patients with severe CVD (n = 13) were older (p = 0.002), predominantly male (p = 0.007), with reduced AROM in dorsiflexion (p = 0.028) and inversion (p = 0.009), reduced lower limb strength by the Heel Rise test (p = 0.040), and greater circumference of the calf (p = 0.020), ankle (p = 0.003), and plantar arch (p = 0.041) when compared to mild CVD (n = 62). Advanced age, male sex, lower ankle range of motion in dorsiflexion, and greater ankle and plantar arch circumferences were associated with CVD severity. However, the ankle circumference (OR 1.258, 95% CI: 1.008-1.570; p = 0.042), together with advanced age and male sex, was the only functional variable that remained independently associated with CVD severity. CONCLUSION The increased ankle circumference was a determinant of the CVD severity and may assist in risk stratification and guide treatment goals in this population.
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Affiliation(s)
- Iara Nepomuceno de Souza
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Keity Lamary Souza Silva
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Matheus Ribeiro Ávila
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Lucas Fróis Fernandes de Oliveira
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Igor Lucas Geraldo Izalino Almeida
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Whesley Tanor Silva
- Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Vanessa Amaral Mendonça
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Henrique Silveira Costa
- Physiotherapy Department, Biological and Health Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Postgraduate course in Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
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Barreto Rabelo D, Coelho Figueira Freire AP, Colen Milagres Brandão F, Oliveira Melo S, Ocarino JM, Saldanha Dos Anjos MT, Schleip R, Souza TR, Simoneau G, Zambelli Pinto R. Myofascial stiffness of plantar fascia and Achilles tendon in individuals with plantar fasciopathy: An observational cross-sectional study. Musculoskelet Sci Pract 2023; 66:102781. [PMID: 37290347 DOI: 10.1016/j.msksp.2023.102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Assessment of myofascial tissue stiffness have a role in identifying physical impairments in plantar fasciopathy (PF). It is still unclear which specific functional and tissue differences exist between individuals with PF. AIM To compare myofascial stiffness of plantar fascia, Achilles tendon, and triceps surae between symptomatic and asymptomatic limbs in individuals with PF and between individuals with and without PF. METHODS Thirty nine individuals diagnosed with PF and individuals with no history of PF were recruited. Myofascial stiffness of the plantar fascia, Achilles tendon, and triceps surae, range of motion, and clinical tests were performed. Mean difference (MD) and 95% confidence interval (CI) were calculated. RESULTS Individuals with PF showed lower mean stiffness in Achilles tendon insertion (MD = -1.00 N/mm; 95%CI: -1.80,-0.21) on the symptomatic limb compared to the corresponding symptomatic limb in control group, a lower mean stiffness in plantar fascia (MD = -0.16 N/mm; 95%CI: -0.30, -0.01) on the symptomatic limb compared to asymptomatic limb, and a lower mean stiffness in the region 3 cm above the Achilles tendon insertion (MD = -0.79; 95%CI: -1.59, -0.00) compared to control. Individuals with PF showed fewer repetitions in heel rise test (MD = -3.97 reps; 95%CI: -5.83, -2.12) and in the step-down test (MD = -5.23 reps; 95%CI: -7.02, -3.44) compared to control. CONCLUSIONS Individuals with PF present reduced stiffness in Achilles tendon insertion and plantar fascia. The reduced stiffness was more evident in Achilles tendon in individuals with PF compared to individuals without PF. Individuals with PF showed lower performance in clinical tests.
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Affiliation(s)
- Daniel Barreto Rabelo
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | | | | | - Sabrina Oliveira Melo
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Juliana M Ocarino
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | | | - Robert Schleip
- Department of Sport and Health Sciences, Technical University of Munich, Germany.
| | - Thales R Souza
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Guy Simoneau
- Department of Physical Therapy, Marquette University, Milwaukee, WI, United States.
| | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
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Ferreira AP, Furtado SRC, Carceroni LL, Amâncio GPDO, Zuba PP, Pereira HMB, Pereira DAG. Variation in sociodemographic, clinical and functional characteristics of patients with chronic venous insufficiency in a single public health center. JOURNAL OF VASCULAR NURSING 2023; 41:72-76. [PMID: 37356873 DOI: 10.1016/j.jvn.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/16/2023] [Accepted: 05/03/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Describe and analyze the sociodemographic, clinical and functional characteristics of individuals with chronic venous insufficiency (CVI) and compare the clinical severity with levels of mobility. METHODS Exploratory cross-sectional study in a single public health center. The study cohort comprised 99 individuals. INTERVENTIONS Clinical, sociodemographic and physical activity level questionnaires were applied; we also evaluated ankle amplitude and sural triceps function. Descriptive statistics, independent t test and one-way ANOVA with post hoc Least Significant Difference (LSD) were performed. RESULTS Ninety-nine participants (87.9% woman) with an average age with an average age of 60.6 ± 14 years who where recruited to the study. The cohort was composed of individuals were moderately active, 80% exhibited symptoms of the disease and approximately 40% reported reduced mobility. Individuals who had reduced mobility and less physical activity showed reduced ankle amplitude and muscle function (p <0.05). CONCLUSION CVI impacts on functional capacity, even in individuals with less severe disease.
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Affiliation(s)
- Ana Paula Ferreira
- Universidade Federal de Minas Gerais - UFMG, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Belo Horizonte, MG, Brazil; Faculty of Medical and Health Sciences (SUPREMA), Juiz de Fora, MG, Brazil
| | - Sheyla Rossana Cavalcanti Furtado
- Universidade Federal de Minas Gerais - UFMG, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Belo Horizonte, MG, Brazil
| | | | | | - Priscila Penasso Zuba
- Multiprofessional Health Residency - Clinical Hospital, Universidade Federal de Minas Gerais - UFMG, MG, Brazil
| | | | - Danielle Aparecida Gomes Pereira
- Universidade Federal de Minas Gerais - UFMG, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Belo Horizonte, MG, Brazil.
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Carvalho ÍDC, Ferreira DKDS. Applicability of the step test for physical fitness assessment of women with chronic venous disease symptoms: a cross-sectional study. J Vasc Bras 2022. [DOI: 10.1590/1677-5449.202200922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract Background Chronic Venous Disease (CVD) can seriously impact physical fitness. Certain measures and aptitude tests can be employed to evaluate this condition in people with CVD that are simple, quick, and less expensive alternatives when compared to laboratory methods. Objectives To evaluate the applicability of the 4-minute step test, correlating its results with those of other measures and tests used with people with CVD symptoms. Methods Cross-sectional descriptive study carried out with 47 active women with CVD symptoms who participate in public physical exercise programs and were recruited by spontaneous demand. After clinical evaluation of disease stage, sociodemographic data were collected and calf circumference measurements, ankle goniometry, the tiptoe test, and the 4-minute step test were conducted. The women were already familiar with the apparatus used. Results The step test showed significant correlations (p<0.05) with calf measurements (r=0.31 and 0.32), flexibility (r=0.48 and 0.47), and the tiptoe test (r=0.33 for number of repetitions and 0.42 for speed of execution), in addition to an inverse correlation with disease severity (r=-0.29). Significant correlations were also found by age group (r=0.60 and 0.54, for calf circumference in the elderly) and by classification in tests and measurements (r=0.19 for the tiptoe test, and r=0 .29, for ankle flexibility). Conclusions The step test proved applicable and its use in conjunction with other aptitude tests offers a more complete evaluation of active women with CVD symptoms.
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Carvalho ÍDC, Ferreira DKDS. Aplicabilidade do teste do degrau na avaliação da aptidão física de mulheres com sintomas de doença venosa crônica: estudo transversal. J Vasc Bras 2022; 21:e20220092. [DOI: 10.1590/1677-5449.202200921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/03/2022] [Indexed: 12/12/2022] Open
Abstract
Resumo Contexto A doença venosa crônica (DVC) pode impactar a aptidão física dos indivíduos. Algumas medidas e testes de aptidão são aplicados para avaliar essa condição em pessoas com DVC, sendo alternativas simples, rápidas e menos dispendiosas de avaliação comparadas a métodos laboratoriais. Objetivos Avaliar a aplicabilidade do teste do degrau de 4 minutos, correlacionando seus resultados com os de outras medidas e testes aplicados a pessoas com sintomas de DVC. Métodos Estudo descritivo transversal realizado com 47 mulheres ativas com sintomas de DVC, participantes de programas públicos de exercícios físicos e recrutadas por demanda espontânea. Foi realizada avaliação clínica da doença, e foram coletados dados sociodemográficos, medidas de perimetria de panturrilha e goniometria de tornozelo, teste ponta do pé e teste do degrau de 4 minutos. As mulheres já eram familiarizadas com o implemento utilizado. Resultados O teste do degrau apresentou correlações significativas (p < 0,05) com as medidas de panturrilha (r = 0,31 e 0,32), flexibilidade (r =0,48 e 0,47) e teste ponta do pé (r = 0,33 para n.º de repetições e 0,42 para velocidade de execução), além de correlação inversa com a gravidade da doença (r = -0,29). Correlações significativas também foram encontradas por faixa etária (r = 0,60 e 0,54, para perimetria de panturrilha em idosos) e por classificação nos testes e medidas (r = 0,19 para o teste ponta do pé e r = 0,29 para flexibilidade de tornozelo). Conclusões O teste do degrau se mostra aplicável, e sua utilização, em conjunto com outros testes de aptidão, permite uma avaliação mais completa de mulheres ativas com sintomas de DVC.
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Pereira DAG, Furtado SRC, Amâncio GPDO, Zuba PP, Coelho CC, de Lima AP, Carvalho MLV, Monteiro DP. Association between heel-rise test performance and clinical severity of chronic venous insufficiency. Phlebology 2020; 35:631-636. [PMID: 32408796 DOI: 10.1177/0268355520924878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Peripheral pump dysfunction is important in identifying manifestations of chronic venous insufficiency. The association with disease severity may define better treatment strategies. OBJECTIVE To evaluate the association between peripheral muscular pump performance by heel-rise test, age, physical activity, use of compression stockings, and chronic venous insufficiency clinical severity. METHODS Subjects with chronic venous insufficiency were enrolled in the study (n = 172) and evaluated by clinical-etiology-anatomy-pathophysiology severity and heel-rise test. RESULTS In model 1 of logistic regression, number of heel-rise test repetitions, age, and physical activity explained 47% of clinical-etiology-anatomy-pathophysiology severity (p = 0.0001), physical activity contributed the most. In model 2, heel-rise test repetition rate, age, and physical activity explained 46.4% of clinical-etiology-anatomy-pathophysiology severity (p = 0.0001), repetition rate contributed the most. Conclusion: There was an inverse association between muscular pump performance and physical activity with clinical-etiology-anatomy-pathophysiology severity, muscular pump repetition rate contributed to a less severe outcome.
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Affiliation(s)
| | | | | | - Priscila Penasso Zuba
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cristiane Cenachi Coelho
- Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Paula de Lima
- Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Monteiro DP, Britto RR, Fregonezi GADF, Dias FAL, Silva MGD, Pereira DAG. Reference values for the bilateral heel-rise test. Braz J Phys Ther 2017; 21:344-349. [PMID: 28709587 PMCID: PMC5628365 DOI: 10.1016/j.bjpt.2017.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/16/2016] [Accepted: 11/16/2016] [Indexed: 12/02/2022] Open
Abstract
Bilateral HRT reference values were established, stratified by age and gender. Bilateral HRT reference values may be used as a basis for research and clinical practice.
Background The bilateral heel-rise test is an instrument that evaluates the performance of the triceps surae. Normative parameters need to be established for the use of the heel-rise test in clinical practice. Objective To determine the reference values for the bilateral heel-rise test. Methods This cross-sectional study assessed healthy subjects using the bilateral heel-rise test. We analyzed the number of repetitions, time (in seconds), and repetition rate (repetitions/second) during execution of the heel-rise test, until the point of voluntary fatigue. The estimates were stratified by age and gender. Multiple linear regression was performed to define the reference equation for the bilateral heel-rise test. Results A total of 147 individuals were included. The median age was 37 years (IQR 28–46). It was observed that the number of repetitions decreases with age, with a higher number of repetitions in male participants compared to female participants. Gender, body mass index, and maximum activity scores predict 14% of the number of plantar flexions performed in the bilateral heel-rise test. Age and adjusted activity scores predict 18% of the repetition rate in the bilateral heel-rise test. Conclusion The bilateral heel-rise test reference values for an adult population were defined as scores above the 25th percentile for number of repetitions, time, and repetition rate. The number of heel-rise test repetitions that corresponds to the 25th percentile, according to age and gender, is as follows: age 20–29, 65 repetitions for men and 45.5 for women; age 30–39, 62.75 men and 41.5 women; age 40–49, 67.25 men and 45 women; and age 50–59, 54 men and 39.25 women.
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Affiliation(s)
- Débora Pantuso Monteiro
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Raquel Rodrigues Britto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | - Marconi Gomes da Silva
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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