Rev. Esp. Pod. 2024; 35(1): 22-29 / DOI: 10.20986/revesppod.2024.1683/2023
Priscila Távara Vidalón, María José Manfredi Márquez
RESUMEN
Objetivos: Comprobar los cambios producidos en las presiones plantares del primer radio tras un programa de ejercicios de fortalecimiento del músculo peroneo largo.
Pacientes y métodos: En 24 sujetos con un primer radio dorsalfl exionado flexible, se valoró la dorsalflexión y plantarfl exión del primer radio, la extensión de la 1.ª articulación metatarsofalángica, la fuerza del peroneo largo, el FPI, y las presiones plantares de la cabeza del primer metatarsiano en dinámica. La muestra se dividió aleatoriamente en dos grupos. El grupo experimental realizó ejercicios para potenciar el peroneo largo con bandas elásticas durante 4 semanas.
Resultados: En el grupo de estudio se obtuvieron diferencias estadísticamente signifi cativas con un aumento en la plantarflexión del primer radio (p = 0.016), una disminución del porcentaje del tiempo de carga de la cabeza del primer metatarsiano (p = 0.036) y un aumento en el porcentaje del intervalo de tiempo en el que se produce su presión máxima (p = 0.008). Comparando ambos grupos, se encontraron diferencias significativas en la dorsalfl exión (p = 0.022) y plantarflexión del primer radio (p = 0.027) y en el valor máximo de presión de toda la fase de apoyo (p = 0.031).
Conclusiones: Los sujetos que realizaron el programa de ejercicios con bandas elásticas para potenciar el peroneo largo tras cuatro semanas presentaron un aumento del rango de movimiento de la plantarfl exión del primer radio, de la presión de la cabeza del primer metatarsiano durante la fase de apoyo y de su presión máxima en dinámica.
ABSTRACT
Objectives: To analyze the changes produced in the plantar pressures of the first ray after an exercise program to strengthen the peroneus longus muscle.
Patients and methods: In 24 subjects with a flexible dorsifl exed first ray, the dorsifl exion and plantarflexion of the fi rst ray, the dorsiflexion of the 1st metatarsophalangeal joint, the strength of peroneus longus, the FPI, and the plantar pressures under first metatarsal head were assessed. The sample was randomly divided into two groups. The experimental group performed exercises to strengthen the peroneus longus with elastic bands for 4 weeks.
Results: In the study group, statistically signifi cant diff erences were obtained with an increase in plantarflexion of the first ray (p = 0.016); a percentage decrease in fi rst metatarsal head loading time (p = 0.036); and an increase in the percentage of the time interval in which their maximum pressure occurs (p = 0.008). Comparing both groups, signifi cant diff erences were found in dorsiflexion (p = 0.022) and plantarfl exion of the first ray (p = 0.027); and in the maximum pressure value of the entire stance phase (p = 0.031).
Conclusion: The subjects who performed the exercise program with elastic bands to strengthen the peroneus longus after four weeks, presented an increase in the plantarfl exion of the first ray, in the first metatarsal head pressure during the stance phase and in its maximum pressure in dynamics.
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1. Munuera PV. El primer radio. Biomecánica y Ortopodología. 2.ª ed. Santander: Exa Editores SL; 2012.
2. Wong DW chi, Zhang M, Yu J, Leung AKL. Biomechanics of first ray hypermobility: an investigation on joint force during walking using finite element analysis. Med Eng Phys. 2014;36(11):1388-93.
3. Glasoe W, Yack HJ, Saltzman CL. Anatomy and biomechanics of the first ray. Phys Ther. 1999;79(9):854-9.
4. Root M, Orien W, Weed J. Normal and abnormal function of the foot, vol 2. Los Angeles: Clinical Biomechanics Corp; 1977.
5. Rueda M. Introducción a la biomecánica del pie (VI). Apunts Med Esport. 2005; 146:37-41.
6. Rico R. Biomecánica del Primer Radio. Deformidad en flexión plantar. Caso clínico. Rev Int Cienc Podol. 2008;3(1):53-66.
7. Bierman RA, Christensen JC, Johnson CH. Biomechanics of the first ray. Part III. Consequences of lapidus arthrodesis on peroneus longus function: A three-dimensional kinematic analysis in a cadaver model. J Foot Ankle Surg. 2001;40(3):125-31.
8. Johnson CH, Christensen JC. Biomechanics of the first ray Part I. The effects of peroneus longus function: A three-dimensional kinematic study on a cadaver model. J Foot Ankle Surg. 1999;38(5):313-21.
9. Roca-Dols A, Losa-Iglesias ME, Sánchez-Gómez R, López-López D, Becerro-de-Bengoa-Vallejo R, Calvo-Lobo C. Electromyography comparison of the effects of various footwear in the activity patterns of the peroneus longus and brevis muscles. J Mech Behav Biomed Mater. 2018;82:126-32.
10. Dullaert K, Hagen J, Klos K, Gueorguiev B, Lenz M, Richards RG, et al. The influence of the Peroneus Longus muscle on the foot under axial loading: A CT evaluated dynamic cadaveric model study. Clin Biomech. 2016;34:7-11.
11. Choi Y, Lee J. Effect of peroneus longus muscle release on abductor hallucis muscle activity and medial longitudinal arch before toe-tap exercise in participants with flexible pes planus. Healthcare. 2021;10(44):1-9.
12. Duchenne G. Physiologie des Mouvements. Philadelphia: Lippincott Williams and Wilkins; 1867.
13. Sánchez Gómez R, De Benito González S, Gómez Martín B, Álvarez-Calderón Iglesias O, Rico Teixeira R. Maniobra de fiabilidad para el Músculo Peroneo Lateral Largo: Hipermobilidad del Primer Radio. Rev Int Cienc Podol. 2009;3(1):35-44.
14. Cornwall MW, Fishco WD, McPoil TG, Lane CR, O’Donnell D, Hunt L. Reliability and validity of clinically assessing first-ray mobility of the foot. J Am Podiatr Med Assoc. 2004;94(5):470-6.
15. Wang H, Yu H, Kim YH, Kan W. Comparison of the effect of resistance and balance training on isokinetic eversion strength, dynamic balance, hop test, and ankle score in ankle sprain. Life. 2021;11(4)1-13.
16. Song SH, Park JH, Song GD, Lee SG, Jo YH, Jin MK, et al. Usability of the Thera-Band® to improve foot drop in stroke survivors. NeuroRehabilitation. 2018;42(4):505-10.
17. Spencer Cain M, Ban RJ, Chen YP, Geil MD, Goerger BM, Linens SW. Four-week ankle-rehabilitation programs in adolescent athletes with chronic ankle instability. J Athl Train. 2020;55(8):801-10.
18. Kaminski TW, Buckley BD, Powers ME, Hubbard TJ. Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. Br J Sports Med. 2003;37(5):410-5.
19. Begg C, Cho M, Eastwood S, Horton R, Olkin I. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276(8):637-9.
20. Munuera-Martínez PV, Távara-Vidalón P, Monge-Vera MA, Sáez-Díaz A, Lafuente-Sotillos G. The validity and reliability of a new simple instrument for the measurement of first ray mobility. Sensors. 2020;20(8):1-16.
21. Távara-Vidalón P, Lafuente-Sotillos G, Munuera-Martínez PV. Movimiento del primer dedo en sujetos con hallux limitus vs. sujetos con pies normales. Rev Esp Podol. 2021;32(2):116-22. DOI: 10.20986/revesppod.2021.1621/2021.
22. Távara-Vidalón P, Lafuente-Sotillos G, Manfredi-Márquez MJ, Munuera-Martínez PV. Movilidad normal del primer radio en los planos sagital y frontal. Rev Esp Podol. 2021;32(1):27-35. DOI: 10.20986/revesppod.2021.1600/2021.
23. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech. 2006;21(1):89-98.
24. Martínez-Nova A, Sánchez-Rodríguez R, Cuevas-García JC, Sánchez-Barrado E. Estudio baropodométrico de los valores de presión plantar en pies no patológicos. Rehabilitación. 2007;41(4):155-60.
25. Martínez-Nova A, Cuevas-García JC, Sánchez-Rodríguez R, Pascual-Huerta J, Sánchez-Barrado E. Estudio del patrón de presiones plantares en pies con hallux valgus mediante un sistema de plantillas instrumentadas. Rev Esp Cir Ortop Traumatol. 2008;52(2):94-8.
26. Cain MS, Ban RJ, Chen YP, Geil MD, Goerger BM, Linens SW. Four-week ankle-rehabilitation programs in adolescent athletes with chronic ankle instability. J Athl Train. 2020;55(8):801-10.
27. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2.nd ed. Abingdon, Inglaterra: Routledge; 1988. p. 567.
28. Tavara-Vidalón P, Monge-Vera M, Lafuente-Sotillos G, Domínguez-Maldonado G, Munuera-Martínez P. Static range of motion of the first metatarsal in the sagittal and frontal planes. J Clin Med. 2018;7(11):456.
29. Landis J, Koch G. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74.
30. Murley GS, Menz HB, Landorf KB. Foot posture influences the electromyographic activity of selected lower limb muscles during gait. J Foot Ankle Res. 2009;2(1):35.
31. Thordarson D, Schmotzer H, Chon J, Peters J. Dynamic support of the human longitudinal arch. A biomechanical evaluation. Clin Orthop Relat Res. 1995;316:165-72.
32. McLoda TA, Hansen AJ. Effect of a task failure exercise on the peroneus longus and brevis during perturbed gait. Electromyogr Clin Neurophysiol. 2005;45:53-8.
33. Bavdek R, Zdolšek A, Strojnik V, Dolenec A. Peroneal muscle activity during different types of walking. J Foot Ankle Res. 2018;11(1):50.
34. Ha S, Fong D, Chan K. Review of ankle inversion sprain simulators in the biomechanics laboratory. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(4):114-21.
35. Peng HT, Song CY, Chen ZR, Lai CT, Gu CY, Wang LI. Effects of attaching elastic bands to the waist and heels on drop jumps. Eur J Sport Sci. 2022;22(6):808-16.
36. Veneri D. Combining the treatment modalities of body weight support treadmill training and thera-band: A case study of an individual with hemiparetic gait. Top Stroke Rehabil. 2011;18(4):402-16.
37. Yu W, An C, Kang H. Effects of resistance exercise using thera-band on balance of elderly adults: a randomized controlled trial. J. Phys Ther Scl. 2013;25:1471-3.
38. Patil P, Rao SA. Effects of Thera band elastic resistance-assisted gait training in stroke patients. Eur J Phys Rehabil Med. 2011;47(3):427-33.
39. Choi SA, Cynn HS, Yi CH, Kwon OY, Yoon TL, Choi WJ, et al. Isometric hip abduction using a Thera-Band alters gluteus maximus muscle activity and the anterior pelvic tilt angle during bridging exercise. J Od Electromyogr Kinesiol. 2015;25:310-5.
40. Ludwig O, Kelm J, Fröhlich M. The influence of insoles with a peroneal pressure point on the electromyographic activity of tibialis anterior and peroneus longus during gait. J Foot Ankle Res. 2016;9(1):33.