HUBUNGAN BENTUK KAKI FLAT FOOT TERHADAP KESEIMBANGAN PADA ANAK USIA 7-10 TAHUN : NARRATIVE REVIEW

Latar Belakang : Keseimbangan adalah kemampuan tubuh menjaga keseimbangan saat melakukan gerakan atau aktivitas. Kemampuan keseimbangan anak pada usia perkembangan sangat penting untuk ditinjau, baik dari segi keseimbangan duduk, berdiri, dan saat berjalan. Salah satu penyebab keseimbangan terganggu yaitu gangguan muskuloskeletal berupa kelainan bentuk telapak kaki (flat foot). Anak-anak yang mudah terjatuh disebabkan rendahnya mempertahankan keseimbangan dan menandakan kondisi yang lebih serius hingga memiliki dampak yang bertahan lama. Tujuan : Tujuan narrative review ini adalah untuk mengetahui hubungan bentuk kaki flat foot terhadap keeimbangan pada anak usia 7-10 tahun. Metode Penelitian : Penyusunan skripsi ini menggunakan metode Narrative Review, yaitu mengumpulkan sebanyak sepuluh artikel penelitian, dengan langkah awal yaitu melakukan identifikasi kata kunci menggunakan rumus atau format PEOS (Population, Exsposure, Outcomes, Study Design) serta menetapkan kriteria inklusi dan ekslusi untuk menentukan artikel yang selanjutnya akan dipilih dan direview. Pencarian artikel-artikel penelitian dilakukan pada tiga database, yaitu PubMed, Google Scholar, Science Direct. Hasil Penelitian : Pencarian database 364 artikel setelah dilakukan penyaringan judul dan relevasi abstrak, didapatkan 10 artikel yang sesuai dengan tema. Kesimpulan : Beberapa artikel penelitian membuktikan hasil bahwa terdapat hubungan antara bentuk kaki flat foot terhadap keeimbangan pada anak usia 7-10 tahun. Tetapi tidak semua artikel penelitian memberikan hasil yang signifikan. Saran : Peneliti selanjutnya dapat meneliti mengenai tema ini dengan metode penelitian lain, seperti non eksperimental dengan jenis penelitian kuantitatif dengan desain penelitian deskriptif korelatif

What are the differences between subjects with and without flatfoot condition, with the aid of ultrasonography, kinematics, and kinetics in posture and gait?

O complexo do pé tem um papel importante na postura, equilíbrio, estabilidade e movimento, durante as posições estáticas e nos padrões gerais de movimento. Alterações estruturais ou funcionais no complexo do pé e no seu posicionamento podem afetar a postura e o movimento das estruturas distais e proximais. Comumente, indivíduos com pé plano desenvolvem restrições neurológicas ou musculares, frouxidão ligamentar ou articular, movimento excessivo e atividade muscular. Essa condição leva a maiores riscos de desenvolver lesões por sobrecarga mecânica nas articulações dos membros inferiores adjacentes. O objetivo é determinar se existem diferenças entre indivíduos com pé plano em comparação com indivíduos com pé neutro, em relação à postura e à análise do padrão de marcha. A amostra foi constituída por sujeitos com pé plano e neutro, alocados em dois grupos. Todos os sujeitos foram submetidos a procedimentos de avaliação para serem alocados em um dos grupos. Cada participante foi submetido à avaliação do padrão de marcha e postura, com auxílio de sistema MOCAP, e à avaliação da rigidez muscular com Ultrassonografia e, por fim, à avaliação da pressão plantar com uma plataforma de pressões. Os sujeitos com pé plano mostraram várias alterações e diferenças quando comparados aos participantes com pé neutro, de acordo com os principais resultados da análise da postura e do padrão de marcha. Considerando todos os estudos realizados e incluídos nesta tese, várias diferenças foram encontradas em indivíduos de pé plano. Porém, a maioria desses resultados são contraditórios com os resultados presentes na literatura, dando um crescimento da evidência científica sobre a condição de pé plano e a sua influência na postura, e no padrão de marcha. No entanto, em relação à falta de consenso sobre os resultados e condições de avaliação, vários estudos necessitam ser realizados para criar uma maior robustez da evidência científica. Porém, no que se refere ao rigor metodológico em relação a diferentes parâmetros, novos estudos precisam de abranger variáveis que foquem a avaliação geral da condição e não apenas do complexo do pé. Palavras-chave: POSTURA DE PÉ, PADRÕES DE MOVIMENTO, PÈ PLANO, BIOMECÂNICA.The foot complex has an important role in posture, balance, stability, and movement, during the static positions and in overall movements' patterns. Structural or functional alteration in the foot complex and foot posture may have an impact on posture and movement on distal and proximal structures. Commonly, subjects with flatfoot develop neurological or muscular restrictions, ligament or joint laxity, excessive motion, and muscle activity. This condition leads to higher risks of developing mechanical overloading injuries on adjacent lower-limb joints. The aim of this study is to determine if there are differences between flatfoot subjects compared to neutral foot subjects, regarding posture and gait pattern analysis. The sample was constituted by subjects with a flat and neutral foot, allocated in two groups. All subjects were submitted to assessment procedures to be allocated in one of the groups. Therefore, each participant was submitted to gait pattern and posture assessment, with the aid of a MOCAP system, and to muscle stiffness assessment with an ultrasound-based Shear- Wave Elastography and, finally to plantar pressure assessment with a baropodometric platform. Flatfoot subjects showed several alterations and differences when compared to neutral foot participants considering all principal outcomes along with posture and gait pattern. Considering all studies realized and included in this thesis, several differences were found in flatfoot subjects. Thus, most of those results are contradictory to those found in the literature, giving a growth of evidence relatively to foot posture condition and influence in posture and gait pattern. However, regarding the lack of consensus about the outcomes and assessment conditions, further studies need to be performed to create a more robust body of evidence. Although, regarding methodological deficiency regarding influencing aspects, further studies need to encompass methodological variables handling to focus on an overall evaluation of the condition and not only on the foot complex

The Effect of Fatigue on Lower Extremity Biomechanics and Balance in Anterior Cruciate Ligament Reconstructed Individuals

The purpose of this study was to investigate the effects of fatigue on balance in females with ACLR. A total of 14 female ACLR participants (age= 19.64±1.5 years; height = 163.52±6.18cm; weight = 62.6±13.97kg) were used in this study. All participants completed a balance task, before and again after a fatigue protocol that consisted of a stationary squatting task. There was a significant difference in COP velocity and COP sway path between the pre-fatigue and post-fatigue conditions as COP velocity and COP sway path significantly increased from pre-fatigue to post-fatigue. Results indicate that female ACLR individuals have significantly greater COP velocity and COP area after fatigue.Master of Art

The effect of aging on movement characteristics and postural control during stooping and crouching tasks

Stooping and crouching (SC) postures are integral to many daily tasks, such as retrieving objects from the floor and reaching to low shelves, yet nearly one in four community-dwelling older adults (24%) report having difficulty or being completely unable to perform SC movements. While limited research has identified physical (e.g., lower extremity strength and joint immobility) and behavioural (e.g., obesity and balance confidence) determinants of SC difficulty, little is known about how aging affects the manner in which SC tasks are performed. The objective of this thesis was to describe age-related differences in movement kinematics and balance control during stooping and crouching tasks. Healthy younger (n = 12) and older (n = 12) participants performed a series of object-retrieval tasks – varying in initial lift height, precision required, and duration – that required them to bend over or reach toward the floor. In addition to kinematic and postural control measures describing the movements, measures of lower limb isometric strength, passive range of motion (ROM), and balance confidence were obtained for each participant. Compared to younger, older participants moved slower into and out of self-selected postures, which were characterized by higher whole-body centre of mass (COM) vertical positions. Specifically, older adults exhibited lower vertical COM linear velocities and lower hip, knee, and ankle joint angular velocities during transitions, and higher COM heights achieved through comparatively less flexion in the hip, knee, and ankle joints during object retrieval. Older participants also displayed smaller, more centralized anterior-posterior (AP) COM excursions and lower COM velocities, but higher centre of pressure (COP) activity compared to younger participants, demonstrated through increased COP velocity (relative to COM velocity) and more frequent COP adjustments aimed at regulating COM position. Changing task constraints (i.e., lower initial lift height or longer duration) elicited greater postural changes in younger compared to older participants, potentially reflecting a diminished ability in older adults to make appropriate task-specific adaptations. In particular, younger participants were 4 times more likely than older participants to use a lower to the floor, forefoot crouching posture, especially during longer duration tasks. Older participants also had decreased leg strength and less passive range of motion compared to younger participants. Overall, the results of this thesis demonstrate that despite moving slower through shorter distances, older adults displayed higher COP activity, which may have reflected a heightened effort to control COM position, during SC tasks. This compliments existing works describing age-related differences in movement strategies and balance control during lifting and sit-to-stand tasks. Further work exploring relationships between specific physiological and behavioural factors and SC task performance measures is needed to inform therapeutic intervention strategies

Pes planus in children: its implications and the influencing factors on its development

Název: Pes planus u dětí - důsledky a faktory ovlivňující jeho rozvoj Pozadí Plochá noha je jednou z nejčastějších diagnóz v pediatrii; převažuje flexibilní typ ploché nohy. Tento vývojový typ je u malých dětí běžným nálezem, růstem a vývojem spontánně vymizí a zůstává asymptomatický. Nehledě na to je vysoký výskyt u dospívajících a také je často mnoho případů ploché nohy v dospělosti prezentováno jako přetrvávající pozůstatek z dětství. Faktory, které ovlivňují výskyt ploché nohy během vývoje dítěte, mají také kapacitu na změnu jejího průběhu a pomáhají v diagnostice, léčbě a prevenci ploché nohy. Účel Cílem této rešeršní práce bylo zlepšit znalosti o přetrvávání podmínek vzniku ploché nohy v dětské populace zjištěním vývoje ploché nohy v dětství s nástinem dopadu na držení těla a chůzi a identifikaci faktorů, které přispívají k výskytu a progresi deformity. Metodika Byla prohledána elektronická databáze ke získání článků z vhodných odborných časopisů (od začátku roku 2012 do poloviny roku 2013). Byly vybrány pouze plnotextové články, s několika vyjímkami. Další informace byly shromážděny z on-line učebnic a také byly kontrolovány citace v pracích za účelem získání dalších článků. Výsledky Mnohé studie nalezly, prokázaly a korelovaly faktory, které jsou významné pro vývoj ploché nohy. Jsou však...Background Pes planus is one of the most common diagnoses in the pediatric field; flexible flat foot being the most prevalent. This developmental type of flatfoot is a normal finding in young children, seen to resolve spontaneously with growth and development and also remain asymptomatic. Despite this, there is still a large incidence of flat feet in adolescence and many cases of adult flatfeet are frequently presented as residual pediatric flatfeet. The factors that influence the prevalence of flatfeet during a child's development have also the capacity to altering its course and gaining insight on what they are and their influence aids in diagnosing, treating and preventing flat feet. Purpose The aim of this literature review was to enhance knowledge on the persistence of the flat feet condition in the pediatric population by determining the development of flat feet in children with an outline of its affect on posture and gait and identifying contributing factors that affect the incidence and progression of the deformity. Methodology An electronic database search was conducted to obtain articles from relevant journals (from early 2012 to mid 2013). Only full text English articles were obtained, with a few exceptions. Further information was collected from online textbooks and the reference lists of the...FyzioterapieFaculty of Physical Education and SportFakulta tělesné výchovy a sport

A Comparison of Postural Stability during Upright Standing between Normal and Flatfooted Individuals, Based on COP-Based Measures

Aging causes foot arches to collapse, possibly leading to foot deformities and falls. This paper proposes a set of measures involving an entropy-based method used for two groups of young adults with dissimilar foot arches to explore and quantize postural stability on a force plate in an upright position. Fifty-four healthy young adults aged 18–30 years participated in this study. These were categorized into two groups: normal (37 participants) and flatfooted (17 participants). We collected the center of pressure (COP) displacement trajectories of participants during upright standing, on a force plate, in a static position, with eyes open (EO), or eyes closed (EC). These nonstationary time-series signals were quantized using entropy-based measures and traditional measures used to assess postural stability, and the results obtained from these measures were compared. The appropriate combinations of entropy-based measures revealed that, with respect to postural stability, the two groups differed significantly (p < 0.05) under both EO and EC conditions. The traditional commonly-used COP-based measures only revealed differences under EO conditions. Entropy-based measures are thus suitable for examining differences in postural stability for flatfooted people, and may be used by clinicians after further refinement

A Comparison of Postural Stability during Upright Standing between Normal and Flatfooted Individuals, Based on COP-Based Measures

Aging causes foot arches to collapse, possibly leading to foot deformities and falls. This paper proposes a set of measures involving an entropy-based method used for two groups of young adults with dissimilar foot arches to explore and quantize postural stability on a force plate in an upright position. Fifty-four healthy young adults aged 18–30 years participated in this study. These were categorized into two groups: normal (37 participants) and flatfooted (17 participants). We collected the center of pressure (COP) displacement trajectories of participants during upright standing, on a force plate, in a static position, with eyes open (EO), or eyes closed (EC). These nonstationary time-series signals were quantized using entropy-based measures and traditional measures used to assess postural stability, and the results obtained from these measures were compared. The appropriate combinations of entropy-based measures revealed that, with respect to postural stability, the two groups differed significantly (p < 0.05) under both EO and EC conditions. The traditional commonly-used COP-based measures only revealed differences under EO conditions. Entropy-based measures are thus suitable for examining differences in postural stability for flatfooted people, and may be used by clinicians after further refinement