Publication: Efecto de la cuña supinadora de retropié sobre la primera articulación metatarsofalángica
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2016-11-22
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Universidad Complutense de Madrid
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Abstract
La mayoría de los trabajos que intentan determinar cómo influyen las intervenciones ortopédicas sobre el movimiento de FD de la 1ª AMTF se han realizado utilizando plantillas. Las características de las plantillas empleadas han sido variadas y los resultados que muestran estos estudios también son muy variados. Kilmartin encontró que la utilización de una ortesis elaborada con la metodología que describe Root disminuía el movimiento de FD de la 1ª AMTF. Estas variaciones fueron bajas y no mostraron significancia estadística. Munuera y col. utilizando plantillas termoconformadas en polipropileno no observaron cambios en el movimiento de FD de la 1ª AMTF inicialmente pero si en las valoraciones realizadas a los cinco meses de uso. Nawoczensky y col. encontraron cambios en torno a lo 3º que no mostraban significancia pero el análisis de regresión lineal mostro que los cambios observados en el movimiento de FP del primer metatarsiano explicaban el 60% de las variaciones del pico de máxima FD de la 1ª AMTF cuando se utilizaba una plantilla con estabilizaciones externas de antepie y retropié. Finalmente Rao y col mostraron que el uso de ortesis termoconformadas en sujetos con artritis reumatoide incrementaba el pico máximo de FD de la 1ª AMTF, aumentaba el movimiento de FP del primer metatarsiano y disminuían la eversión del retropié. Son muy pocos los trabajos donde se ha evaluado el efecto que tienen las cuñas de retropié sobre el movimiento de FD de la 1ª AMTF. Únicamente hemos encontrado tres trabajos. Uno realizado en estática por Harradine y col. que muestra como la colocación de cuñas pronadoras de retropié disminuye el movimiento de FD de la 1ª AMTF. Los otros están realizados en dinámica y muestran que la utilización de CSR no varía el movimiento de FD de la 1ª AMTF (Halstead y col.) o incluso que lo disminuyen durante la fase propulsiva de la marcha (Smith y col). No se han encontrado trabajos donde se valore específicamente como influyen las CSR sobre el grado de rigidez de la 1ª AMTF al movimiento de FD...
Most of the works trying to determine how to influence orthopedic interventions on the movement of FD of the 1st MTPJ have been using orthotics. The characteristics of the used orthotics have been varied and the results showing these studies are also very varied. Kilmartin found that the use of an elaborate orthotic with the methodology that describes Root decreased movement of FD of the 1st MTPJ. These variations were low and showed no statistical significance. Munuera and col using orthotic moulded in polypropylene no observed changes in the movement of FD of the 1st MTPJ initially but if in the evaluations made at five months of use. Nawoczensky et al found changes around the 3º that did not show significance but the linear regression analysis showed that the observed changes in the movement of FP of the first metatarsal explained 60% of the variations of the maximum peak of FD of the 1st MTPJ when used an orthotic with forefoot and rearfoot external stabilizations. Finally, Rao and col showed that the use of orthoses moulded in subjects with rheumatoid arthritis increased the maximum peak of FD or the 1st MTPJ, increased movement of FP of the first metatarsal and diminishing the rearfoot eversion. There are very few works where it has evaluated the effect that have wedges of hindfoot on the movement of FD of the 1st MTPJ. We have only found three works. One carried out in static by Harradine and col showing how the colocaciond and rearfoot prone wedges decreases movement of FD of the 1st MTPJ. Others are made in dynamics and show that the use of CSR does not vary the movement of FD of the 1st MTPJ (Halstead et al.) or even to lower it during the propulsive phase of gait (Smith and col). Not found works where it is specifically valued as influence the CSR on the degree of stiffness of FD of the 1st MTPJ movement...
Most of the works trying to determine how to influence orthopedic interventions on the movement of FD of the 1st MTPJ have been using orthotics. The characteristics of the used orthotics have been varied and the results showing these studies are also very varied. Kilmartin found that the use of an elaborate orthotic with the methodology that describes Root decreased movement of FD of the 1st MTPJ. These variations were low and showed no statistical significance. Munuera and col using orthotic moulded in polypropylene no observed changes in the movement of FD of the 1st MTPJ initially but if in the evaluations made at five months of use. Nawoczensky et al found changes around the 3º that did not show significance but the linear regression analysis showed that the observed changes in the movement of FP of the first metatarsal explained 60% of the variations of the maximum peak of FD of the 1st MTPJ when used an orthotic with forefoot and rearfoot external stabilizations. Finally, Rao and col showed that the use of orthoses moulded in subjects with rheumatoid arthritis increased the maximum peak of FD or the 1st MTPJ, increased movement of FP of the first metatarsal and diminishing the rearfoot eversion. There are very few works where it has evaluated the effect that have wedges of hindfoot on the movement of FD of the 1st MTPJ. We have only found three works. One carried out in static by Harradine and col showing how the colocaciond and rearfoot prone wedges decreases movement of FD of the 1st MTPJ. Others are made in dynamics and show that the use of CSR does not vary the movement of FD of the 1st MTPJ (Halstead et al.) or even to lower it during the propulsive phase of gait (Smith and col). Not found works where it is specifically valued as influence the CSR on the degree of stiffness of FD of the 1st MTPJ movement...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Enfermería, Fisioterapia y Podología, leída el 13-01-2016