Relevance. Foot deformities are the most common locomotor pathology in children with infantile cerebral paralysis. At the same time many children suffering from this pathology wear standard shoes that do not take into account the individual foot anatomy. Purpose of the study — to justify the expedience of individual approach to orthopaedic support for children with infantile cerebral paralysis. Materials and methods. The authors examined 220 feet in 110 patients aging from 3 to 18 years: 62 patients with spastic form of infantile cerebral paralysis and 48 children who were examined during periodic screening at general education institutions (control group). Clinical examination methods, computerized plantography and podometry by flatbed foot scanning (ventrally, posteriorly, medially) in standing position were used in the present study. Results. Statistically significant variances (p*<0.005) were obtained for 8 indicators of foot deformity in three planes in children with infantile cerebral paralysis as compared to the norm, as well as differences between the groups of patients with varying degree of disorders in gross motor functions. The authors established pathological foot deformities in children with infantile cerebral paralysis; statistically significant variances in types and degrees of these disorders for patient groups with different levels of gross motor functions disorders; distinctiveness of foot deformities within each of the groups. Conclusion. Objectively instrumental method was used to identify the main components of foot deformities in patients with infantile cerebral paralysis with preservation and realization of walking capability: loss of height of longitudinal arches, midfoot pronation and hindfoot valgus, hallux valgus. Increased elevation of longitudinal arches (cavus foot), midfoot supination and hindfoot varus are rarer components of deformities occurring more often in patients with severer forms of the pathology. Strong variation in the spread of foot anatomy parameters observed within different groups of motor dysfunctions indicates the expediency of individual approach to footwear recommendations: standard, less or more complex orthopaedic shoes. Implementation of obtained data into the clinical practice requires additional series of biomechanical trials aimed at elaboration of criteria for recommendations and efficiency evaluation of various footwear types that take into account not only specifics of foot anatomy but also its statodynamic function as well as the level of gross motor functions of a particular patient.
Background Hamstring muscle injuries are one of the most common traumas occurring in athletes and football players. Thus, the recovery time is crucial for their return to full athlete activity. Objective This article examines cases of hamstring injury in futsal players and finds association between the active range of motion (AROM) deficit and the full recovery time. Methods For this study, 200 futsal players with acute, first-time, unilateral posterior hamstring injuries were recruited, all men. All patients underwent clinical examination and ultrasonography. In 74 of 200 patients, sonography revealed no abnormalities in the musculoligamentary structures. Thereby, they were excluded from further investigation. Only 126 futsal players underwent measurement of the active range of motion with a 30-cm clear plastic inclinometer. Injured areas were compared with the normal hamstrings in all athletes and with the control group, and the AROM deficit was evaluated. The association between the full recovery time and the AROM deficit was identified. A control group (100 men) underwent examination in the same series of steps as the study group. Results Biceps femoris was the most commonly injured muscle, making up 80% of injuries. The musculotendinous junction, proximal and distal, was involved in 91% of injury cases. Twelve athletes had an AROM deficit of 25 to 35 degrees and reached full recovery at 2.5 months and later. Seventy or 55.5% of athletes had an AROM deficit less than 15 degrees and felt fully recovered only in a month. Conclusions The classification system of hamstring muscle injuries that is offered here is based on an objective clinical marker (active knee ROM deficit), is easily applicable, and is indicative of recovery duration.
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