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Benefícios da aplicação de palmilhas posturológicas na biomecânica, parâmetros baropodométricos e estabilométricos de corredores de rua com calcâneo valgo
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Introdução: A Podoposturologia é uma técnica que tem crescido na sua indicação e prescrição junto a fisioterapeutas, médicos, e educadores físicos. Esta é uma técnica que realiza o estudo da postura através dos pés, e que utiliza as palmilhas posturais como mecanismo de reprogramação tónico muscular, visando o ajuste não somente a modificação da distribuição plantar, mas através de tal modificação alinhar as assimetrias posturais. Objetivo: O objetivo deste trabalho foi analisar a influência das palmilhas posturológicas na postura, na biomecânica e nos parâmetros baropodométricos e estabilométricos em corredores de rua portadores de calcâneo valgo. Metodologia: Foi realizado um ensaio clínico randomizado controlado simples cego. Foram recrutados 20 indivíduos atletas amadores, corredores de rua, com idades compreendidas entre os 18 e os 60 anos. Os mesmos foram divididos em 2 grupos: o primeiro grupo, controlo, foi composto por indivíduos que usaram palmilhas termomoldadas (GC) (n=20), o segundo grupo, experimental, com indivíduos que utilizaram palmilhas termomoldadas e peças podais (GPP) (n=20). Todos os atletas dos grupos GC e GPP utilizaram as palmilhas associadas a sapatilhas de corrida de pisada neutra. Resultados: foram encontrados resultados que sugerem que parece existir influência do estímulo podal na postura e nos parâmetros baropodométricos e estabilométricos em corredores de rua portadores de calcâneo valgo. E houve relevância estatística no comparativo final entre o GC e o GPP, no nivelamento da cintura pélvica (p=0,003); no alinhamento do tendão do calcâneo a esquerda (p=0,015), a direita (p=0,022); no alinhamento do ângulo Q do joelho esquerdo (p=0,002), e direito (p=0,007); no ponto de pressão máxima do retropé esquerdo (p=0,019); e na distribuição de carga estática do retropé esquerdo (p=0,046), e antepé esquerdo (p=0,046). Conclusão: Encontramos valores que nesta amostra parecem demonstrar que o uso de palmilha termodeladas com peças podais alcançam o nivelamento pélvico, alinham o valgismo do tendão do calcâneo, e do ângulo Q do joelho, assim como influenciam no pico de pressão plantar e na distribuição percentual pressórica na baropodometria. Vale ressaltar que também ocorreram modificações nas varíaveis analisadas na estabilometria demonstrando estímulo ao controle postural, mesmo que as mesmas não tenham encontrado relevância estatística.
Introduction: Podoposturology is a technique that has grown in its indication and prescription among physiotherapists, doctors, and physical educators. This is a technique that performs the study of the posture through the feet, and that uses the postural insoles as a mechanism of reprogramming muscle tone, aiming not only to modify the plantar distribution, but through such a modification to align the posture asymmetries. Methods: Was performed a blinded randomized clinical trial. Were recruited 20 amateurs’ athletes, street runners, with ages between 18 and 60 years. They are divided into 2 groups: the control group, was composed by individuals that used thermoformed insoles; the experimental group, with individuals that used thermoformed insoles with foot pieces. All athletes from both groups used the insoles, associated with running shoes with neutral tread. Results: Results found seem to suggest that there is influence of the podal stimulus in posture and the baropodometric and stabilometric parameters in street runners with calcaneus valgus. We found changes in practically all variables in the experimental group after 3 months. And there was statistical significance in the final comparison between CG (Control Group) and EG (Experimental Group), in pelvic girdle levelling (p = 0.003); in the left calcaneal tendon alignment (p = 0.015), the right (p = 0.022); in the Q-angle alignment of the left knee (p = 0.002), and right (p = 0.007); at the maximum pressure point of the left rearfoot (p = 0.019); and in the static load distribution of the left rearfoot (p = 0.046), and the left forefoot (p = 0.046). Conclusion: We found values that demonstrated that the use of a thermodelated insole with foot pieces reach the pelvic level, align the valgus of the calcaneal tendon, and the Q angle of the knee, as well as influence the peak of plantar pressure and the percentage pressure distribution in baropodometry. It is worth mentioning that there were also changes in the variables analysed in the stabilometry demonstrating the stimulus to postural control, even though they did not find statistical relevance. However, as described by authors cited in this study, the association of different physiotherapeutic techniques, especially those involving therapeutic exercises has a positive effect when associated with insoles.
Introduction: Podoposturology is a technique that has grown in its indication and prescription among physiotherapists, doctors, and physical educators. This is a technique that performs the study of the posture through the feet, and that uses the postural insoles as a mechanism of reprogramming muscle tone, aiming not only to modify the plantar distribution, but through such a modification to align the posture asymmetries. Methods: Was performed a blinded randomized clinical trial. Were recruited 20 amateurs’ athletes, street runners, with ages between 18 and 60 years. They are divided into 2 groups: the control group, was composed by individuals that used thermoformed insoles; the experimental group, with individuals that used thermoformed insoles with foot pieces. All athletes from both groups used the insoles, associated with running shoes with neutral tread. Results: Results found seem to suggest that there is influence of the podal stimulus in posture and the baropodometric and stabilometric parameters in street runners with calcaneus valgus. We found changes in practically all variables in the experimental group after 3 months. And there was statistical significance in the final comparison between CG (Control Group) and EG (Experimental Group), in pelvic girdle levelling (p = 0.003); in the left calcaneal tendon alignment (p = 0.015), the right (p = 0.022); in the Q-angle alignment of the left knee (p = 0.002), and right (p = 0.007); at the maximum pressure point of the left rearfoot (p = 0.019); and in the static load distribution of the left rearfoot (p = 0.046), and the left forefoot (p = 0.046). Conclusion: We found values that demonstrated that the use of a thermodelated insole with foot pieces reach the pelvic level, align the valgus of the calcaneal tendon, and the Q angle of the knee, as well as influence the peak of plantar pressure and the percentage pressure distribution in baropodometry. It is worth mentioning that there were also changes in the variables analysed in the stabilometry demonstrating the stimulus to postural control, even though they did not find statistical relevance. However, as described by authors cited in this study, the association of different physiotherapeutic techniques, especially those involving therapeutic exercises has a positive effect when associated with insoles.
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Keywords
Palmilhas Posturologia Podoposturologia Pelve Joelho Baropodometria Estabilometria Calcâneo valgo Corredores de rua Insoles Posturology Podoposturology Pélvis Knee Baropodometry Stabilometry Calcaneus valgus Street runners