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      Correlações entre as estruturas dos membros inferiores Translated title: Correlations between lower limb structures

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          Abstract

          A literatura sugere que mudanças no ângulo Q podem alterar o arco plantar longitudinal e que um mau alinhamento do retropé poderia também modificar a postura do antepé. Contudo, não foram encontrados estudos que correlacionem quantitativamente, na postura ortostática bipodal, todos esses segmentos. Assim, o propósito deste estudo foi avaliar quantitativamente e verificar eventuais correlações entre o ângulo Q, arco plantar longitudinal, alinhamento frontal do tendão do calcâneo e antepé, na postura ortostática bipodal, por meio de fotogrametria. Foram avaliados 30 indivíduos jovens (60 membros inferiores) de ambos os sexos, com idade entre 18 e 24 anos. Foi feita captura fotográfica digital no plano frontal anterior de joelho e antepé; no plano frontal posterior, do tendão do calcâneo; e da impressão plantar exposta no podoscópio. Os dados foram analisados estatisticamente e o nível de signficância fixado em 5%. Foram obtidas as seguintes correlações entre: ângulo Q X arco plantar, r=0,29 (p=0,021); ângulo Q X antepé, r=0,23 (p=0,092); ângulo Q X tendão do calcâneo, r=0,06 (p=0,627); arco plantar X antepé, r=0,09 (p=0,464); arco plantar X tendão do calcâneo, r=-0,05 (p=0,680); e antepé X tendão do calcâneo, r=-0,02 (p=0,857). A única correlação significativa encontrada, embora fraca, foi entre o ângulo Q e o arco plantar longitudinal medial, o que sugere cautela ao se inferirem correlações entre estruturas dos membros inferiores.

          Translated abstract

          Literature often reports that changes in the Q angle may alter the longitudinal plantar arch and that a misalignment of the rearfoot might also modify forefoot position. However, no studies could be found that quantitatively establish correlations between those lower limb segments in orthostatic bipedal posture. The goal of this study was to quantitatively assess possible correlations between the Q angle, longitudinal plantar arch, frontal forefoot and rearfoot alignment in bipedal orthostatic position, by means of photogrammetry. Thirty individuals (60 lower limbs) of both sexes, aged 18 to 24 years old, were photographed at knee and forefoot anterior frontal plane, rearfoot posterior frontal plane (calcanean tendon), and footprint (by electronic high-resolution podoscopy). Data were statistically analysed and the significance level set at 5%. The following correlations were found: Q angle X plantar arch, r=0.29 (p=0.021); Q angle X forefoot, r=0.23 (p=0.092); Q angle X calcanean tendon, r=0,06 (p=0.627); plantar arch X forefoot, r=0.09 (p=0.464); plantar arch X calcanean tendon, r=-0.05 (v=0.680); and forefoot X calcanean tendon, r=-0,02 (p=0,857). The only significant correlation found, although weak, was between the Q angle and longitudinal medial plantar arch, which suggests cautiousness when inferring correlations between lower limb structures.

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          Most cited references54

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          The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model.

          D Tiberio (1986)
          Excessive compression of the lateral articular surfaces is frequently a major component of patellofemoral dysfunction. Many subjects exhibiting symptoms of this disorder have structural deviations throughout the lower extremity which combine to produce malalignment of the patellofemoral joint. Included in these malalignment factors is excessive pronation of the subtalar joint. Excessive rotation of the lower leg which accompanies subtalar joint pronation has been cited as a major contributor to patellofemoral dysfunction. Although the excessive rotation of the lower leg will disrupt the normal mechanics of the tibiofemoral joint, the specific link between tibial rotation and patellofemoral symptoms has not been established. This paper presents a theoretical model which describes the compensation that can occur at the tibiofemoral joint to deal with the excessive tibial rotation. The link between the tibiofemoral compensation and increased patellofemoral compression is delineated. Factors which determine whether this increased compression becomes symptomatic are discussed. J Orthop Sports Phys Ther 1987;9(4):160-165.
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            Pes cavus and pes planus. Analyses and treatment.

            The arch of the foot serves as an adaptable, supportive base for the entire body. This article discusses how the arch of the foot affects the normal biomechanics of the lower limb. An anatomical overview of the three components of the arch of the foot is presented, identifying the medial longitudinal arch as the arch mainly responsible for related structural problems throughout the lower limb. Deviations in the normal structure of the medial longitudinal arch produce unbalanced, functionally unstable conditions of the foot such as pes cavus or pes planus. Specific evaluation criteria for both pes cavus and pes planus are discussed, in addition to the adverse effects these two disorders have on weight bearing, force dissipation, and normal gait. Compensatory pronation associated with pes planus is one of the most common lower extremity disorders seen currently by physical therapists working in sports medicine, and its causes and related lower limb disorders are discussed. Most of these structural deformities can be corrected through the use of various orthotic devices. Specific guidelines are presented for using both soft and permanent orthoses, which offer the foot increased shock absorption and proper structural alignment.
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              The quadriceps angle: a review of the literature.

              Previous investigations of the quadriceps (Q) angle and its relationship to knee disorders have yielded equivocal results. The purpose of this paper is to present a review of the current literature on the Q angle and to examine the differences in Q angles when measured: 1) under differing measurement protocols; 2) between asymptomatic and symptomatic populations; 3) between male and female samples; and 4) from side to side within subjects. Little scientific evidence exists to support the commonly held assumptions that Q angles are larger in symptomatic vs. asymptomatic or that they are equal in the right vs. left lower limb. However, larger mean values are consistently observed in groups of young adult females vs. young adult males.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                fp
                Fisioterapia e Pesquisa
                Fisioter. Pesqui.
                Universidade de São Paulo (São Paulo )
                2316-9117
                September 2009
                : 16
                : 3
                : 205-210
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade Federal de Alfenas
                [3 ] Universidade de São Paulo Brazil
                Article
                S1809-29502009000300003
                10.1590/S1809-29502009000300003
                a01b96e3-1b91-40b1-bea6-dd684a78ef36

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1809-2950&lng=en
                Categories
                ORTHOPEDICS
                REHABILITATION

                Orthopedics,Physiotherapy
                Lower extremity,Photogrammetry,Posture,Extremidade inferior,Fotogrametria,Postura

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