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[PMID]:28449699
[Au] Autor:Munteanu SE; Landorf KB; McClelland JA; Roddy E; Cicuttini FM; Shiell A; Auhl M; Allan JJ; Buldt AK; Menz HB
[Ad] Endereço:Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, 3086, Australia. s.munteanu@latrobe.edu.au.
[Ti] Título:Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis (the SIMPLE trial): study protocol for a randomised controlled trial.
[So] Source:Trials;18(1):198, 2017 Apr 27.
[Is] ISSN:1745-6215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This article describes the design of a parallel-group, participant- and assessor-blinded randomised controlled trial comparing the effectiveness of shoe-stiffening inserts versus sham shoe insert(s) for reducing pain associated with first metatarsophalangeal joint (MTPJ) osteoarthritis (OA). METHODS: Ninety participants with first MTPJ OA will be randomised to receive full-length shoe-stiffening insert(s) (Carbon Fibre Spring Plate, Paris Orthotics, Vancouver, BC, Canada) plus rehabilitation therapy or sham shoe insert(s) plus rehabilitation therapy. Outcome measures will be obtained at baseline, 4, 12, 24 and 52 weeks; the primary endpoint for assessing effectiveness being 12 weeks. The primary outcome measure will be the foot pain domain of the Foot Health Status Questionnaire (FHSQ). Secondary outcome measures will include the function domain of the FHSQ, severity of first MTPJ pain (using a 100-mm Visual Analogue Scale), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 and EuroQol (EQ-5D-5L™) questionnaires), use of rescue medication and co-interventions, self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention-to-treat principle. Economic analysis (cost-effectiveness and cost-utility) will also be performed. In addition, the kinematic effects of the interventions will be examined at 1 week using a three-dimensional motion analysis system and multisegment foot model. DISCUSSION: This study will determine whether shoe-stiffening inserts are a cost-effective intervention for relieving pain associated with first MTPJ OA. The biomechanical analysis will provide useful insights into the mechanism of action of the shoe-stiffening inserts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000552482 . Registered on 28 April 2016.
[Mh] Termos MeSH primário: Protocolos Clínicos
Órtoses do Pé
Articulação Metatarsofalângica/fisiopatologia
Osteoartrite/terapia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Análise Custo-Benefício
Seres Humanos
Osteoartrite/reabilitação
Avaliação de Resultados (Cuidados de Saúde)
Cooperação do Paciente
Sapatos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13063-017-1936-1


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[PMID]:28450898
[Au] Autor:Wyndow N; Crossley KM; Vicenzino B; Tucker K; Collins NJ
[Ad] Endereço:School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072 QLD Australia.
[Ti] Título:A single-blinded, randomized, parallel group superiority trial investigating the effects of footwear and custom foot orthoses versus footwear alone in individuals with patellofemoral joint osteoarthritis: a phase II pilot trial protocol.
[So] Source:J Foot Ankle Res;10:19, 2017.
[Is] ISSN:1757-1146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patellofemoral joint osteoarthritis is a common condition, yet information regarding conservative management is lacking. Foot orthoses are an effective intervention for improving pain and function in younger individuals with patellofemoral pain and may be effective in those with patellofemoral osteoarthritis. This pilot study will seek to establish the feasibility of a phase III randomised controlled trial to investigate whether foot orthoses worn in prescribed motion controlled footwear are superior to prescribed motion control footwear alone in the management of patellofemoral osteoarthritis. METHODS/DESIGN: This phase II pilot clinical trial is designed as a randomized, single-blind, parallel group, two arm, superiority trial. The trial will recruit 44 participants from Queensland and Tasmania, Australia. Volunteers aged 40 years and over must have clinical symptoms and radiographic evidence of patellofemoral osteoarthritis to be eligible for inclusion. Those eligible will be randomized to receive either foot orthoses and prescribed motion control shoes, or prescribed motion control shoes alone, to be worn for a period of 4 months. The feasibility of a phase III clinical trial will be evaluated by assessing factors such as recruitment rate, number of eligible participants, participant compliance with the study protocol, adverse events, and drop-out rate. A secondary aim of the study will be to determine completion rates and calculate effect sizes for patient reported outcome measures such as knee-related symptoms, function, quality of life, kinesiophobia, self-efficacy, general and mental health, and physical activity at 2 and 4 months. Primary outcomes will be reported descriptively while effect sizes and 95% confidence intervals will be calculated for the secondary outcome measures. Data will be analysed using an intention-to-treat principle. DISCUSSION: The results of this pilot trial will help determine the feasibility of a phase III clinical trial investigating whether foot orthoses plus motion control footwear are superior to motion control footwear alone in individuals with patellofemoral osteoarthritis. A Phase III clinical trial will help guide footwear and foot orthoses recommendations in the clinical management of this disorder. TRIAL REGISTRATION: Retrospectively registered with the Australian New Zealand Clinical Trials Registry: ACTRN12615000002583. Date registered: 07/01/15.
[Mh] Termos MeSH primário: Órtoses do Pé
Osteoartrite do Joelho/terapia
Síndrome da Dor Patelofemoral/terapia
Sapatos
[Mh] Termos MeSH secundário: Adulto
Idoso
Continuidade da Assistência ao Paciente
Desenho de Equipamento
Estudos de Viabilidade
Feminino
Nível de Saúde
Seres Humanos
Masculino
Registros Médicos
Meia-Idade
Articulação Patelofemoral
Cooperação do Paciente
Projetos Piloto
Queensland
Consulta Remota
Autoeficácia
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13047-017-0200-y


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[PMID]:28448898
[Au] Autor:Eek MN; Zügner R; Stefansdottir I; Tranberg R
[Ad] Endereço:Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Box 21062, SE-418 04 Gothenburg, Sweden. Electronic address: meta.nystrom-eek@vgregion.se.
[Ti] Título:Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole.
[So] Source:Gait Posture;55:150-156, 2017 Jun.
[Is] ISSN:1879-2219
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. RESULTS: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe+sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole.
[Mh] Termos MeSH primário: Paralisia Cerebral/fisiopatologia
Órtoses do Pé
Transtornos Neurológicos da Marcha/fisiopatologia
Desigualdade de Membros Inferiores/fisiopatologia
Desigualdade de Membros Inferiores/reabilitação
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Criança
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:29201147
[Au] Autor:Edwards K; Borthwick A; McCulloch L; Redmond A; Pinedo-Villanueva R; Prieto-Alhambra D; Judge A; Arden N; Bowen C
[Ad] Endereço:Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
[Ti] Título:Evidence for current recommendations concerning the management of foot health for people with chronic long-term conditions: a systematic review.
[So] Source:J Foot Ankle Res;10:51, 2017.
[Is] ISSN:1757-1146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Research focusing on management of foot health has become more evident over the past decade, especially related to chronic conditions such as diabetes. The level of methodological rigour across this body of work however is varied and outputs do not appear to have been developed or translated into clinical practice. The aim of this systematic review was to assess the latest guidelines, standards of care and current recommendations relative to people with chronic conditions to ascertain the level of supporting evidence concerning the management of foot health. Methods: A systematic search of electronic databases (Medline, Embase, Cinahl, Web of Science, SCOPUS and The Cochrane Library) for literature on recommendations for foot health management for people with chronic conditions was performed between 2000 and 2016 using predefined criteria. Data from the included publications was synthesised via template analysis, employing a thematic organisation and structure. The methodological quality of all included publications was appraised using the Appraisal for Research and Evaluation (AGREE II) instrument. A more in-depth analysis was carried out that specifically considered the levels of evidence that underpinned the strength of their recommendations concerning management of foot health. Results: The data collected revealed 166 publications in which the majority (102) were guidelines, standards of care or recommendations related to the treatment and management of diabetes. We noted a trend towards a systematic year on year increase in guidelines standards of care or recommendations related to the treatment and management of long term conditions other than diabetes over the past decade. The most common recommendation is for preventive care or assessments (e.g. vascular tests), followed by clinical interventions such as foot orthoses, foot ulcer care and foot health education. Methodological quality was spread across the range of AGREE II scores with 62 publications falling into the category of high quality (scores 6-7). The number of publications providing a recommendation in the context of a narrative but without an indication of the strength or quality of the underlying evidence was high (79 out of 166). Conclusions: It is clear that evidence needs to be accelerated and in place to support the future of the Podiatry workforce. Whilst high level evidence for podiatry is currently low in quantity, the methodological quality is growing. Where levels of evidence have been given in in high quality guidelines, standards of care or recommendations, they also tend to be strong-moderate quality such that further strategically prioritised research, if performed, is likely to have an important impact in the field.
[Mh] Termos MeSH primário: Doença Crônica/terapia
Doenças do Pé/terapia
/patologia
Podiatria/normas
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença Crônica/epidemiologia
Complicações do Diabetes/prevenção & controle
Diabetes Mellitus/terapia
Gerenciamento Clínico
Prática Clínica Baseada em Evidências
Doenças do Pé/epidemiologia
Doenças do Pé/patologia
Órtoses do Pé/provisão & distribuição
Úlcera do Pé/terapia
Seres Humanos
Guias de Prática Clínica como Assunto/normas
Padrão de Cuidado
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.1186/s13047-017-0232-3


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[PMID]:28465224
[Au] Autor:Cambron JA; Dexheimer JM; Duarte M; Freels S
[Ad] Endereço:Department of Research, National University of Health Sciences, Lombard, IL. Electronic address: jcambron@nuhs.edu.
[Ti] Título:Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial.
[So] Source:Arch Phys Med Rehabil;98(9):1752-1762, 2017 09.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To investigate the efficacy of shoe orthotics with and without chiropractic treatment for chronic low back pain compared with no treatment. DESIGN: Randomized controlled trial. SETTING: Integrative medicine teaching clinic at a university. PARTICIPANTS: Adult subjects (N=225) with symptomatic low back pain of ≥3 months were recruited from a volunteer sample. INTERVENTIONS: Subjects were randomized into 1 of 3 treatment groups (shoe orthotic, plus, and waitlist groups). The shoe orthotic group received custom-made shoe orthotics. The plus group received custom-made orthotics plus chiropractic manipulation, hot or cold packs, and manual soft tissue massage. The waitlist group received no care. MAIN OUTCOME MEASURES: The primary outcome measures were change in perceived back pain (numerical pain rating scale) and functional health status (Oswestry Disability Index) after 6 weeks of study participation. Outcomes were also assessed after 12 weeks and then after an additional 3, 6, and 12 months. RESULTS: After 6 weeks, all 3 groups demonstrated significant within-group improvement in average back pain, but only the shoe orthotic and plus groups had significant within-group improvement in function. When compared with the waitlist group, the shoe orthotic group demonstrated significantly greater improvements in pain (P<.0001) and function (P=.0068). The addition of chiropractic to orthotics treatment demonstrated significantly greater improvements in function (P=.0278) when compared with orthotics alone, but no significant difference in pain (P=.3431). Group differences at 12 weeks and later were not significant. CONCLUSIONS: Six weeks of prescription shoe orthotics significantly improved back pain and dysfunction compared with no treatment. The addition of chiropractic care led to higher improvements in function.
[Mh] Termos MeSH primário: Dor Crônica/terapia
Órtoses do Pé
Dor Lombar/terapia
Manipulação Quiroprática/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Dor Crônica/fisiopatologia
Terapia Combinada
Feminino
Seres Humanos
Dor Lombar/fisiopatologia
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:28984769
[Au] Autor:Chen W; Liu X; Pu F; Yang Y; Wang L; Liu H; Fan Y
[Ad] Endereço:aKey Laboratory of Rehabilitation Technical Aids, Ministry of Civil Affair, School of Biological Science and Medical Engineering, Beihang University bState Key Laboratory of Virtual Reality Technology and Systems, Beihang University cNational Research Center for Rehabilitation Technical Aids dRokab Pedorthic Center, Beijing, P.R. China.
[Ti] Título:Conservative treatment for equinus deformity in children with cerebral palsy using an adjustable splint-assisted ankle-foot orthosis.
[So] Source:Medicine (Baltimore);96(40):e8186, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A novel splint, the assisting ankle-foot orthoses (AFO), was developed to provide adjustable sustained stretching to improve conservative treatment for equinus deformities in children with cerebral palsy (CP). The treatment effect was validated by follow-up visits. METHODS: This study involved subjects between 2 and 12 years old, including 28 CP children treated with splint-assisted AFO correction, 30 CP children treated with static AFO correction, and 30 normal children with typical development (TD). Quantitative pedobarographic measurements were taken to evaluate the effect of splint-assisted AFO correction. The heel/forefoot ratio was introduced to indicate the degree of the equinus deformity during treatment. RESULTS: The results showed that the heel/forefoot ratios were 1.41 ±â€Š0.26 for the TD children; 0.65 ±â€Š0.41, 1.02 ±â€Š0.44, and 1.24 ±â€Š0.51 for the splint-assisted AFO correction before and after 6-month and 12-month treatments; 0.59 ±â€Š0.37, 0.67 ±â€Š0.44, and 0.66 ±â€Š0.42 for the static AFO correction before and after 6-month and 12-month treatments. CONCLUSIONS: This study suggests that correction with the adjustable splint-assisted AFO is an effective treatment for equinus deformity in CP Children.
[Mh] Termos MeSH primário: Paralisia Cerebral/complicações
Tratamento Conservador/instrumentação
Pé Equino/terapia
Órtoses do Pé
Contenções
[Mh] Termos MeSH secundário: Tornozelo/fisiopatologia
Estudos de Casos e Controles
Criança
Pré-Escolar
Tratamento Conservador/métodos
Pé Equino/etiologia
Pé Equino/fisiopatologia
Desenho de Equipamento
Feminino
/fisiopatologia
Calcanhar/fisiopatologia
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008186


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[PMID]:28858119
[Au] Autor:Shirai Y; Wakabayashi K; Wada I; Tsuboi Y; Ha M; Otsuka T
[Ad] Endereço:aDepartment of Orthopaedic Surgery bDepartment of Rehabilitation Medicine, Nagoya City University Graduate School of Medicine, Nagoya, Aichi, Japan.
[Ti] Título:Flatfoot in the contralateral foot in patients with unilateral idiopathic clubfoot treated using the foot abduction brace.
[So] Source:Medicine (Baltimore);96(35):e7937, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:While the foot abduction brace (FAB) plays an important role in the Ponseti method, the true function of the FAB in the treatment of idiopathic clubfoot remains unknown. In our clinical experience, we have noted that many patients with unilateral idiopathic clubfoot developed significant flatfoot in the contralateral foot during brace treatment. The purpose of this study was to investigate the natural history of the contralateral foot development during and after brace wear. We also discuss the effect of the FAB on the contralateral foot.We retrospectively reviewed 21 contralateral feet of 21 patients with unilateral idiopathic clubfoot who were treated using the Ponseti method and were conservatively followed up until the FAB was taken off (6 years of age or older). We evaluated flatfoot indicators of the contralateral foot on standing radiographs during and after brace wear and compared them against the normal reference ranges. We also evaluated the changes in the flatfoot indicators of the contralateral foot during and after brace wear.Although there was a significant difference in the flatfoot indicators between the contralateral foot and normal reference ranges during brace wear, there was no significant difference in the flatfoot indicators after brace wear. While there was no significant improvement in flatfoot indicators of the contralateral foot during brace wear, there was a significant improvement or a trend to improve after brace wear. There was no significant correlation between the contralateral flatfoot and original joint laxity.Significant flatfoot deformity was observed in the contralateral foot during brace wear. The contralateral flatfoot persisted during brace wear and improved to within normal reference ranges after brace wear. Our findings suggest that the FAB may influence the development of the contralateral foot, leading to the flatfoot.
[Mh] Termos MeSH primário: Braquetes/efeitos adversos
Pé Torto Equinovaro/terapia
Pé Chato/etiologia
Órtoses do Pé/efeitos adversos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Pé Torto Equinovaro/complicações
Pé Chato/diagnóstico por imagem
Seguimentos
Seres Humanos
Lactente
Radiografia
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007937


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[PMID]:28704464
[Au] Autor:Rosenberg M; Steele KM
[Ad] Endereço:Department of Mechanical Engineering, University of Washington, Seattle, Washington, United States of America.
[Ti] Título:Simulated impacts of ankle foot orthoses on muscle demand and recruitment in typically-developing children and children with cerebral palsy and crouch gait.
[So] Source:PLoS One;12(7):e0180219, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Passive ankle foot orthoses (AFOs) are often prescribed for children with cerebral palsy (CP) to assist locomotion, but predicting how specific device designs will impact energetic demand during gait remains challenging. Powered AFOs have been shown to reduce energy costs of walking in unimpaired adults more than passive AFOs, but have not been tested in children with CP. The goal of this study was to investigate the potential impact of powered and passive AFOs on muscle demand and recruitment in children with CP and crouch gait. We simulated gait for nine children with crouch gait and three typically-developing children with powered and passive AFOs. For each AFO design, we computed reductions in muscle demand compared to unassisted gait. Powered AFOs reduced muscle demand 15-44% compared to unassisted walking, 1-14% more than passive AFOs. A slower walking speed was associated with smaller reductions in absolute muscle demand for all AFOs (r2 = 0.60-0.70). However, reductions in muscle demand were only moderately correlated with crouch severity (r2 = 0.40-0.43). The ankle plantarflexor muscles were most heavily impacted by the AFOs, with gastrocnemius recruitment decreasing 13-73% and correlating with increasing knee flexor moments (r2 = 0.29-0.91). These findings support the potential use of powered AFOs for children with crouch gait, and highlight how subject-specific kinematics and kinetics may influence muscle demand and recruitment to inform AFO design.
[Mh] Termos MeSH primário: Paralisia Cerebral/reabilitação
Marcha/fisiologia
Músculo Esquelético/fisiopatologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Fenômenos Biomecânicos
Paralisia Cerebral/fisiopatologia
Criança
Desenvolvimento Infantil
Simulação por Computador
Desenho de Equipamento
Feminino
Órtoses do Pé
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180219


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[PMID]:28614253
[Au] Autor:Xing F; Lu B; Kuang MJ; Wang Y; Zhao YL; Zhao J; Sun L; Wang Y; Ma JX; Ma XL
[Ad] Endereço:aBiomechanics Labs of Orthopedics Institute, Tianjin Hospital bTianjin Medical University cDepartment of Orthopedics, Tianjin Hospital, Tianjin, People's Republic of China.
[Ti] Título:A systematic review and meta-analysis into the effect of lateral wedge arch support insoles for reducing knee joint load in patients with medial knee osteoarthritis.
[So] Source:Medicine (Baltimore);96(24):e7168, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to evaluate the immediate effects of lateral wedge arch support insoles (LWAS) on reducing the knee joint load in patients with medial knee osteoarthritis (OA) compared with an appropriate control. METHODS: Databases including Medline, EMBASE, Web of Science, Wiley Online Library, Cochrane library, and Google Scholar were searched with no limits on study date or language, from the earliest available date to October 31, 2016. The included studies had to have the aim of reducing knee load and have an appropriate control. The main measured values were the first and second peak external knee adduction moments (EKAM) and the knee adduction angular impulse (KAAI). The random-effects model was used for analyzing the eligible studies. RESULTS: Nine studies met the inclusion criteria with a total of 356 participants of whom 337 received LWAS treatment. The risk of methodological bias scores (quality index) ranged from 21 to 27 of 32. Treatment with LWAS resulted in statistically significant reductions in the first peak EKAM (P = .005), the second peak EKAM (P = .01), and the KAAI (P = .03). However, among trials in which the control treatment was control shoes, the LWAS showed no associations on the first peak EKAM (P = .10) or the KAAI (P =  .06); among trials in which the control treatment was neutral insoles, the LWAS showed no associations on the second peak EKAM (P = .21) or the KAAI (P = .23). At the same time, the LWAS showed no statistically significant reduction on the first peak EKAM (P = .39) when compared with flat insoles. CONCLUSION: Although meta-analysis outcomes of all studies indicated statistically significant associations between LWAS and reductions of the first peak EKAM, second peak EKAM and KAAI in people with medial knee OA while walking, different results existed in subgroups using various control conditions for comparison. These findings do not support the use of LWAS insoles for reducing knee load. An optimal LWAS treatment should provide the appropriate height of arch support and amount of lateral wedging. Further research should investigate the best combination of these 2 parameters to achieve efficacy without altered comfort.
[Mh] Termos MeSH primário: Órtoses do Pé
Osteoartrite do Joelho/fisiopatologia
Osteoartrite do Joelho/terapia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007168


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[PMID]:28267118
[Au] Autor:Bleau Lavigne M; Reeves I; Sasseville MJ; Loignon C
[Ad] Endereço:Maude Bleau Lavigne, MScN, RN, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada. Isabelle Reeves, PhD, RN, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada. Marie-Josée Sasseville, PhD, Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada. Christine Loignon, PhD, Family Medicine Department, Faculty of Medicine, Université de Sherbrooke, Québec, Canada.
[Ti] Título:Development of a Survey to Explore Factors Influencing the Adoption of Best Practices for Diabetic Foot Ulcer Offloading.
[So] Source:J Wound Ostomy Continence Nurs;44(2):129-137, 2017 Mar/Apr.
[Is] ISSN:1528-3976
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The primary purpose of this study was to develop 2 survey tools to explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in primary health care settings. One survey was intended for the patients receiving care for a diabetic foot ulcer in primary health care settings and the other was intended for the health professionals providing treatment. The second purpose of this study was to evaluate the psychometric properties of the 2 surveys. DESIGN: Development and validation of survey instruments. METHODS: Two surveys were developed using a published guide. Following review of pertinent literature and identification of variables to be measured, a bank of items was developed and pretested to determine clarity of the item and responses. Psychometric testing comprised measurement of content validity index (CVI) and intraclass correlation coefficient (ICC). Only items obtaining satisfactory CVI and ICC scores were included in the final version of the surveys. RESULTS: The final version of the patient survey contained 41 items and the final version of the survey for health care professionals contained 21 items. The patient-intended survey's items demonstrate high content validity scores and satisfactory test-retest reliability scores. The overall CVI score was 0.98. Forty of the 49 items eligible for testing obtain satisfactory ICC scores. One item's test-retest reliability could not be tested but it was retained based on its high CVI. The health professional-intended survey, an overall CVI score of 0.91 but items had lower ICC scores (63%, 31 of the 49 items), did not achieve a satisfactory ICC score for inclusion in the final instrument. CONCLUSION: This project led to development of 2 instruments designed to identify and explore factors influencing adoption of best practices for diabetic foot ulcer offloading treatment in the primary health care setting. Future research and testing is required to translate these French surveys into English and additional languages, in order to reach a broader population.
[Mh] Termos MeSH primário: Pé Diabético/terapia
Órtoses do Pé/normas
Guias de Prática Clínica como Assunto/normas
Psicometria/normas
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Canadá
Complicações do Diabetes/prevenção & controle
Diabetes Mellitus
Pé Diabético/etiologia
Pé Diabético/prevenção & controle
Seres Humanos
Psicometria/instrumentação
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.1097/WON.0000000000000310



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