A terhesség hatása a láb statikájára

Összefoglalás : Bevezetés: Kevés tanulmány foglalkozik a terhesség alatti talpi nyomásviszonyok vizsgálatával, illetve ezek nem veszik figyelembe az esetlegesen már a terhesség elõtt meglévõ statikai eltéréseket. Célunk volt feltérképezni a terhesség elsõ két trimeszterében a dinamikus talpnyomás-változásokat, továbbá objektíven vizsgálni, hogy a terhesség során jelentkezõ lábfájdalom hátterében a láb statikájának változása áll-e. Módszer: A felmérésben 8 várandós nõ vett részt (átlagéletkor: 30 év), közülük 5 fõnél tapasztaltunk már eredetileg is jelen lévõ pes planovalgus deformitást. A vizsgálatokat NOVEL 101B EMED SF típusú komputeres pedobarográffal végeztük. Mindkét láb adatait rögzítettük. A vizsgált paraméterek: a terhelt összfelület (cm2), maximális erõ (N), maximális nyomás (N/cm2), nyomás-idõ integrál (Ns/cm2). Meghatároztuk, hogy van-e különbség a láb statikájában a két trimeszterben, továbbá, hogy a kimutatott lábbetegség milyen mértékben nyilvánul meg a vizsgált paraméterekben. Az adatokat variancia analízissel értékeltük ki. Eredmények: A vizsgált paraméterekben az elsõ és második trimeszter között nem volt szignifikáns eltérés. Akiknél pes planovalgus kimutatható volt, szignifikánsan nagyobb volt a lábközép medialis részének területe és az arra esõ maximális erõ, mint akiknek a lábuk egészséges volt. A második trimeszterre a vizsgált paraméterek kisebb mértékû változása mutatkozott a lábbetegek esetében, a nem lábbetegekhez viszonyítva. Megbeszélés: A terhes nõk lábának statikája megváltozik a terhesség elõrehaladtával, de ez a változás az elsõ és második trimeszter között még nem szignifikáns a vizsgált paraméterek tekintetében. A kisebb mértékû változást a lábbetegek esetében befolyásolhatta a lúdtalpbetéttel történõ korrigálás. Eredményeink felhívják a figyelmet a terhesség során fellépõ mozgásszervi panaszok megelõzésének, illetve megfelelõ kezelésének fontosságára. További vizsgálatok szükségesek a láb statikájának feltérképezéséhez a harmadik trimeszterben és a szülés után. Summary : Introduction: There are few studies concerning plantar foot pressures of pregnant women, or these don't reckon with statical differences existing before pregnancy. The purpose of this study was to determine the changes in plantar pressure in the first and second trimester and to investigate, if changes in foot statics are responsible for pains in the foot during pregnancy. ACTA SANA 23 Method: 8 healthy pregnant women, mean age 30 years, were enrolled in the study. 5 of them have had pes planovalgus deformation for a longer time. Data collecting was performed with a NOVEL 101B EMED SF computerized pedobarograph. Both feet's data were recorded. Measured parameters: the area of the foot in contact with the measuring pressure plate (cm2), maximal force (N), peak pressure (N/cm2), pressure-time integral (Ns/cm2). Differences in the statics of the foot between the two trimesters were determined, and it was also assessed, how foot problems influence the measured parameters. Data were evaluated using analysis of variance. Results: There were no significant differences between the first and second trimester in measured data. The medial area of midfoot and the maximal force on it were significantly higher in pregnants with pes planovalgus, than in the women with healthy foot. During the two trimester, there were less changes in assessed parameters in women, who had foot problems, than in the group without it. Discussion: Consistent but not significant changes were seen in foot-statics during the first and second trimester. Correction with arch-support may be responsible for less changes in the case of foot problems. Our results suggest, that prevention and adequate treatment of locomotor complaints are very important during pregnancy. Further assessments are needed to investigate foot statics in the third trimester and after delivery

When does mechanical plantar stimulation promote sensory re-weighing: standing on a firm or compliant surface?

The purpose of this study was to investigate the effect of different types of mechanical stimulation of the sole on standing postural stability in healthy, young adults. Fifty subjects (34 women, 16 men; mean age 23 +/- 2 (mean +/- SE)) stood barefoot on fixed force plates both with open and closed eyes on firm surface and then on compliant surface (foam). A modified Clinical Test of Sensory Interaction on Balance protocol was employed to assess the center of gravity (COG) excursions along anteroposterior (AP) and mediolateral (ML) axes on each surface and visual condition. After the baseline measurement, a stimulation was applied with an elastic spiked layer topped to the firm and then foam surface, and the COG excursions were measured during the stimulation, and then at least 30 min after the stimulation of the spiked layer, we used 10 min of manual static and glide pressure applied to the plantar surface of both feet. Immediately after manual stimulation, static balance parameters were measured again. Results showed that after manual stimulation, the sway path with closed eyes decreased significantly on the AP and ML directions on firm surface conditions. The spiked layer caused significantly decreased sway path on firm platform in both directions, but it was ineffective on compliant surface. Our results established that the activation of plantar mechanoreceptors by 10-min manual stimulation can partially compensate subjects for the absence of visual input and the lack of accurate pressure information from the supporting surface, too

Postural control in degenerative diseases of the hip joint

BACKGROUND: Few studies investigated the postural control in patients with hip joint impairments; in some cases, balance impairments have been found, while other researchers have seen no significant changes. The goal of this study was to characterize postural stability in patients suffering from unilateral osteoarthritis or rheumatoid arthritis in different balance tasks and to reveal potential differences between the two diseases in this respect. METHODS: Ten patients with hip osteoarthritis (mean age: 62.3years), 10 patients with rheumatoid arthritis (mean age: 55.4years) and 10 healthy control subjects (mean age: 54.3years) took part in the study. Displacement of centre of pressure was measured with a force plate in mediolateral and anteroposterior directions during two-leg standing on firm and compliant surfaces with eyes opened and closed. FINDINGS: Standing on a firm surface sway path increased significantly in the anteroposterior direction in both patient groups and in the mediolateral direction in all groups with eyes closed as compared to eyes opened condition. Standing on a compliant surface, sway paths increased significantly in both directions in all groups with eyes closed as compared to eyes opened condition; furthermore, sway paths were significantly longer with eyes closed in patients with rheumatoid arthritis in comparison with control and osteoarthritis groups. INTERPRETATION: Our data revealed that the manipulation of both visual and somatosensory information can reveal subtle impairments in balance control. Thus, this paradigm can unmask the effects of decreased proprioception due to joint capsule lesion in patients with rheumatoid arthritis

Quantitative characterization of a repeated acute joint inflammation model in rats.

1. Chronic pain owing to arthritis is a major clinical problem worldwide. To study the underlying pathological mechanisms of chronic pain and the effectiveness of different treatments, a number of experimental models have been developed over the years. 2. We introduced a new subchronic inflammatory model by repeated unilateral administration of carrageenan into the ankle joint of rats, and investigated the degree and the time-course of the oedema, and thermal and mechanical hyperalgesia. 3. Carrageenan (450 microg) was injected on three occasions (on days 1, 4 and 7), and the resulting oedema, thermal hyperalgesia (paw withdrawal test) and weight load were characterized in voluntarily walking rats daily for 15 days. The effect of diclofenac sodium (3 mg/kg orally daily for 15 days) was also determined. 4. Repetitive administration of carrageenan caused fluctuating oedema and pain responses, which did not normalize within 3 days. Exacerbated inflammatory oedema was observed after the second and third injections. Oedema and a decreased weight load of the inflamed paw were observed throughout the investigation period, and paw withdrawal thresholds to noxious thermal stimuli returned to baseline pre-carrageenan values from Day 13. 5. Oral diclofenac (3 mg/kg daily for 15 days) significantly decreased oedema within a few days (Day 3), whereas its anti-allodynic effect developed only several days later (Day 9). However, diclofenac at the applied dose did not influence the thermal hyperalgesia. 6. The results suggest that the repeated administration of carrageenan might be a suitable model for determining the effects of long-lasting treatment