El tobillo en el baile flamenco Gloria Elena Moreno Novelo Hernández; José Manuel Castillo-López; Desiderio Mateos-Martínez ...
Revista del Centro de Investigacion Flamenco Telethusa,
04/2020, Volume:
13, Issue:
15
Journal Article
Open access
The main aim of this paper is to evaluate if there are significant statistical differences in ankle range of motion and stability between flamenco dancers and a control group of non-dancers. Injuries ...in dancers are generally associated with different factors, such as shoe characteristics, heel height and physical requirements. The ankle joint is the most susceptible when loads are not handled properly. This study involved 48 subjects divided into two groups of 24 (30.77 ± 13.379 years old). Clinical differences were observed, but not statistically significant in the left Anterior Drawer Test between both groups (p <0.122). In relation to the right Anterior Drawer Test, no difference was observed as it was negative. According to the results obtained, the research concludes that the practice of flamenco dance does not modify ankle range of motion nor does it increase ankle instability when there has been a previous sprain compared to non-dancers.
The Zadek osteotomy is a therapeutic option in Haglund’ syndrome for patients with a X/Y ratio measurement of the calcaneus under 2.5. We hypothesized that Zadek osteotomy would lead to improvement ...in ankle dorsiflexion and functional scores.
Twenty-two patients (mean age: 48.5 years) with Haglund’s syndrome underwent a Zadek osteotomy and were enrolled in a prospective study investigating the proposed hypothesis. Radiological measurements included the X/Y ratio and the pitch angle. Measurements of the dorsiflexion of the ankle, using a hand-made frame, were performed twice by 2 independent observers. Inter and intra classes correlations were calculated. Functional results were assessed using AOFAS, EFAS and EFAS sport. Correlation between ankle dorsiflexion and functional scores were determined using linear regression curves.
Our hypothesis was validated with a mean improvement of dorsiflexion of 7.27° (54.98% improvement from pre-operative measurement) (p < 0.0001). Ankle dorsiflexion measurements were highly reproducible with an interclass correlation coefficient(ICC)> 0.95 (0.98–0.99). All mean values of functional scores were significantly improved(p < 0.05) AOFAS (61.95–94), EFAS (14–21.82), EFAS sport (7.68–13.69) and were strongly correlated to the dorsiflexion values with a coefficient of determination of 0.82 for AOFAS and EFAS and of 0.86 for EFAS sport, respectively. The mean values of X/Y ratio and pitch angle improved from pre to postoperative conditions, 2.18–2.75 and 28.95–19.77° (p < 0.05), respectively.
The angle correction obtained from modifiying the shape of the calcaneus, due to the Zadek osteotomy, confirms it as a safe and reliable treatment, with improvements of both ankle dorsiflexion and functional scores.
Purpose
To describe a crossing technique of stenotic/occluded and tortuous highly calcific ankle vessels during complex percutaneous limb salvage intervention in diabetic patients with ischaemic foot ...ulcers (Rutherford 5 and 6).
Technique
We propose a simple technique to achieve “straightening” of the tortuous vessel and allow safe devices passage into the foot arteries, Patients were asked to hold their foot in plantar or dorsal flexion, accordingly to the treated artery. If unable to do so, an equipe member executed the manoeuvre on their behalf.
Results
The technique was applied in 148 cases, with a success rate of 81% (120/148). No complications related to the manoeuvre were observed.
Conclusion
Crossing of tortuous distal crural vessels can be challenging in diabetic patients; in our experience, this technique can be a useful tool to obtain a successful recanalization in complex procedures with high risk of failure.
El presente estudio muestra un caso clínico de reversión de una artrodesis con un implante total a una paciente de 63 años que había sido intervenida en dos ocasiones de artrodesis fallidas. La ...paciente presentaba dolor persistente a nivel de la articulación de Chopart, así como a nivel del maléolo externo, en especial durante la marcha, dolor a la palpación directa a nivel de los ligamentos laterales del tobillo y dolor a nivel de articulación astrágalo-escafoidea y calcáneo-cuboidea cuando realizaba inversión forzada. En el presente artículo se introduce un método de tratamiento para revertir una artrodesis de la primera articulación metatarso-falángica mediante la colocación de un implante total tipo Toefit-Plus™ para devolver la movilidad de la articulación. Se consiguió alivio del dolor con una movilidad de la primera articulación metatarso-falángica dentro de límites normales, con un primer radio ligeramente insuficiente, siendo necesario un tratamiento posquirúrgico con soportes plantares para mejorar la funcionalidad. En el examen clínico de rango de movimiento activo se lograron 40̊ de dorsiflexión, y en cuanto a la funcionalidad del extensor largo del primer dedo, volvió a su estado natural después de la intervención. El mayor conocimiento de las ventajas y desventajas de esta técnica nos permitiría que más pacientes pudieran verse favorecidos ante situaciones desfavorables con artrodesis metatarso-falángicas que no han dado el resultado esperado, por lo que es necesario profundizar en el estudio de más casos.
We present a clinical case of revision of failed arthrodesis of the first metatarsophalangeal joint with conversion to a total metatarsophalangeal prothesis. The patient was a 63 years old woman who underwent two previous failed interventions due to hallux rigidus with arthrodesis at the first metatarsophalangeal articulation. The patient had persistent pain at Chopart's joint and at the external malleolus that worsened with gait. She referred pain at the lateral ligaments of the ankle with direct palpation and pain on the talonavicularis and calneus-cuboid joints with forced inversion of the foot. The present paper describes a novel technique to reverse an arthrodesis of the first metatarsophalangeal joint to a total joint replacement with Toefit-Plus™ implant thus restoring joint mobility. Pain relief was achieved and mobility of the first metatarsophalangeal joint was restored within its normal range of motion with a hypermobility of the first ray that required post-surgical treatment with plantar orthoses to improve functionality. At clinical evaluation patient presented active range of motion up to 40̊of dorsiflexion, achieved due to the restoration of functionality of the extensor hallucis longus after the intervention. A better knowledge of advantages and disadvantages of this surgical technique would allow an improved selection of the patients who would benefit from this technique after a failed arthrodesis of first metatarsophalangeal joint. Further studies are needed for a better understanding of the beneficts of this surgery through more clinical studies.
Intramuscular pressure (IMP) is of major importance in blood flow and is often taken as a good estimate of muscular tension. However, its measurement remains invasive. The aims of the present work ...were: (1) to re-examine the possibility of evaluating IMP and muscular tension changes by means of surface electromyographic recordings, and (2) to clarify the influence of elastic compressive stockings (ECS). Surface EMG of muscles tibialis anterior (TA), soleus, gastrocnemius, and IMP from the anterior tibial compartment (ATC), deep posterior compartment (DPC), superficial posterior compartment (SPC) of the right leg, were simultaneously recorded in nine healthy subjects. Subjects performed series of voluntary concentric TA contractions (right ankle dorsal flexions) and TA isometric contractions, with or without elastic ECS, in a decubitus posture.
Rest IMP mean values, measured over 60 s, ranged between 12.3 and 26.6 mmHg, i.e. in the range or slightly higher than those reported in the literature. When ECS were applied, mean IMP increase was 6.4 mmHg in ATC, 8.7 mmHg in DPC and 21.0 mmHg in SPC, while the corresponding EMG amplitude decreased.
In ankle dorsal flexion movements, instantaneous values of TA-EMG amplitudes were linearly correlated to ATC-IMP instantaneous values, over the whole of the EMG rising part of every movement. When ECS were applied, the relationships between TA-EMG amplitude and ATC-IMP amplitude remained linear but where shifted towards higher IMP, in agreement with the increase in rest IMP. Because of antagonist co-contractions, IMP from DPC and SPC were also linearly correlated with ATC-IMP but with low coefficients of proportionality.
As in TA concentric contractions, TA-EMG amplitudes were linearly correlated to ATC-IMP instantaneous values in isometric contractions, but the slopes of the latter were always greater. This result is explained by the relationship between muscle tension and shortening velocity.
Al the results showed that: (1) instantaneous changes in surface EMG amplitude may provide a good estimate of IMP changes during the rising part of isometric, but also of concentric voluntary contractions; (2) elastic compressive stockings do not impair subjects relaxation capacity but actually increase the ratio IMP/muscle activation. As a consequence, ECS may actually increase the venous return during voluntary contractions.
This article describes the intervention for improvement of the limitation of range of ankle dorsal flexion. A limited range of ankle dorsal flexion is caused by shortening of antagonist musde or ...joint capsule, decrease of joint play and disorder of the axis of dorsal flexion. Especially, a disorder of the joint axis is the most important finding among all causes. Disorder of the joint axis has a close relation with shortening of the soft tissue around the ankle joint. Especially, there are some typical parts, in which shortening of the soft tissue is related to disorder of the ankle motion axis. These parts were identified as the D-point (Daikuya's normalizing point for ankle axis). Compression and stretching to the D-point normalized ankle axis disorder. Normalizing the ankle axis is an important strategy in physical therapy for the limitation of the range of ankle dorsal flexion, because normal soft tissue is loosened and shortened tissue is untouched in physical therapy for an abnormal ankle axis.
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