Plantar maneuver increases the podal contact area, balance and reduces the risk of fall in elderly

Authors

  • Ana Elisa Zuliani Stroppa-Marques Fisioterapeuta. Doutorado em Desenvolvimento Humano e Tecnologias. Universidade Estadual Paulista (UNESP), Departamento de Fisioterapia e Terapia Ocupacional, Marília, SP, Brasil.
  • Daiany Sousa Silva Fisioterapeuta. Centro Universitário de Rio Preto (UNIRP), São José do Rio Preto, SP, Brasil.
  • Fernanda Barbosa de Oliveira Fisioterapeuta. Centro Universitário de Rio Preto (UNIRP), São José do Rio Preto, SP, Brasil.
  • Jessica Cristina Bonfim Graciozo Fisioterapeuta. Centro Universitário de Rio Preto (UNIRP), São José do Rio Preto, SP, Brasil.
  • João Simão de Melo-Neto Fisioterapeuta. Doutorado em Ciências da Saúde. Universidade Federal do Pará (UFPA), Belém, PA, Brasil.
  • Laís Passos Marcondes Fisioterapeuta. Especialista em Fisiologia e Biomecânica do Exercício Físico e MBA Executivo em Recursos Humanos. UNIRP, São José do Rio Preto, SP, Brasil.

DOI:

https://doi.org/10.15448/1983-652X.2019.1.31383

Keywords:

postural balance, posture, foot, aged.

Abstract

Objective: To analyze the acute effect of the foot manipulation on the plantar support, balance, gait and risk of falls in elderly. Materials and Methods: Pre and post quasi-experimental study. Fourteen healthy elderly (12 women) with a mean age of 66±5 years were evaluated before and after plantar maneuvers. The evaluation protocol consisted of the plantar area contact (cm²), performed by plantigraphy; the index of the plantar arch, by the Staheli index (mm); balance, gait and risk of falls, performed using the Tinetti scale. The elderly patients were submitted to manipulations of the fascia and intrinsic musculature of the foot. The data were analyzed statistically.

Results: The index of the plantar arch showed no significant differences. There was an increase in the contact area on the right foot (before 113.24±13.07 cm², after 115.07±14.02 cm²; p=0.025, paired t-test) and left (before 112.98±15.58 cm², after

116.48±15.25 cm²; p=0.006, paired t test). The Tinetti scale showed a significant increase in balance (before 14.21±0.22, after

15.21±0.57, p=0.016, Wilcoxon test) and low risk of falls (before 25.7±0.29, after 27.1±0.1, p=0.008, Wilcoxon test) after the maneuvers. The gait showed no significant differences. In addition, during the analysis of the Pearson’s correlation coefficient (r), there was a moderate relationship between the plantar contact area with the balance (r=0.405; p=0.033) and the risk of fall (r=0.379; p=0.008).

Conclusion: The plantar maneuver increases the plantar contact area, improves balance and reduces the risk of falling.

References

Campos ACV, Gonçalves LHT. Aging demographic profile in municipalities in the state of Pará, Brazil. Rev Bras Enferm. 2018; 71(Suppl. 1):591-8.

Chen PY, Wei SH, Hsieh WL, Cheen JR, Chen LK, Kao CL. Lower limb power rehabilitation (LLPR) using interactive video game for improvement of balance function in older people. Arch Gerontol Geriatr. 2012;55(3):677-82.

Gagey PM, Weber B. Posturologia: regulación y alteraciones de la bipedestación. Barcelona: Masson; 2001.

Wiszomirska I, Kaczmarczyk K, Błaz k̇ iewicz M, Wit A. The impact of a vestibular-stimulating exercise regime on postural stability in people with visual impairment. Biomed Res Int. 2015;2015:136969.

Carvalho CE, Silva RA, Gil AW, Oliveira MR, Nascimento JA, PiresOliveira DAA. Relationship between foot posture measurements and force platform parameters during two balance tasks in older and younger subjects. J Phys Ther Sci. 2015;27(3):705-10.

Kubicki A, Mourey F, Bonnetblanc F. Balance control in aging: improvements in anticipatory postural adjustments and updating of internal models. BMC Geriatr. 2015;15:162.

Mckeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015;49(5):290.

Azzi NM, Coelho DB, Teixeira LA. Automatic postural responses are generated according to feet orientation and perturbation magnitude. Gait Posture. 2017;57:172-6.

Cantalino JLR, Mattos HM. Análise das impressões plantares emitidas por dois equipamentos distintos. ConScientiae Saúde. 2008;7(3):367-72.

Angin S, Mickleb KJ, Nester CJ. Contributions of foot muscles and plantar fascia morphology to foot posture. Gait Posture. 2018;61:238-42.

Gillette JC, Stevermer CA, Quick NE, Abbas JJ. Alternative foot placements for individuals with spinal cord injuries standing with the assistance of functional neuromuscular stimulation. Gait Posture. 2008;27(2):280-5.

Stroppa Marques AEZ, Lima NT, Valaretto LS, Melo Neto JS, Jacinto ME, Corrêa PR, Lorenzetti MI. Manipulação da musculatura intrínseca do pé em portadores de lesão encefálica adquirida. Revista Inspirar. 2012;4(20):1-5.

Staheli LT, Chew DE, Corbett M. The longitudinal arch: a survey of eight hundred and eighty-two feet in normal children and adults. J Bone Joint Surg Am. 1987;69(3):426-8.

Tinetti ME, Willians TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986;80(3):429-34.

Kelly LA, Kuitunen S, Racinais S, Cresswell AG. Recruitment of the plantar intrinsic foot muscle with increasing postural demand. Clin Biomech. 2012;27(1):46-51.

Hirata RP, Jørgensen TS, Rosager S, Arendt-Nielsen L, Bliddal H, Henriksen M, et al. Altered visual and feet proprioceptive feedbacks during quiet standing increase postural sway in patients with severe knee osteoarthritis. PLoS One. 2013;8(8):e71253.

Vaillant J, Vuillerme N, Janvey A, Louis F, Braujou R, Juvin R, et al.

Effect of manipulation of the feet and ankles on postural control in elderly adults. Brain Res Bull. 2008;75(1):18-22.

Alfieri FM, Teodori RM, Guirro RRJ. Estudo baropodométrico em idosos submetidos à intervenção fisioterapêutica. Fisioterapia em Movimento. 2006;19(2):67-74.

Perry SD, Mcllroy WE, Maki BE. The role of plantar cutaneous mechanoreceptors in the control of compensatory stepping reactions evoked by unpredictable, multi-directional perturbation. Brain Res. 2000;877(2):401-6.

Wassinger CA, Rockett A, Pitman L, Murphy MM, Peters C. Acute effects of rearfoot manipulation on dynamic standing balance in healthy individuals. Man Ther. 2014;19(3):242-5.

Ruescas-Nicolau MA, Sánchez-Sánchez ML, Marques-Sule E, Espí-López GV. The immediate effect of plantar stimulation on dynamic and static balance: a randomized controlled trial. J Back Musculoskelet Rehabil. 2018 Nov 23. Epub ahead of print.

Stroppa Marques AEZ, Brambati RH, Silva AF, Corrêa PR, Melo Neto JS. Efeito da estimulação abdominal sobre o contato plantar na lesão encefálica adquirida. ConScientiae Saúde. 2014;13(3): 357-63.

Kavounoudias A, Roll R, Roll JP. Foot sole and ankle muscle inputs contribute jointly to human erect posture regulation. J Physiol. 2001;532(Pt 3):869-78.

Vaillant J, Rouland A, Martigné P, Braujou R, Nissen MJ, CaillatMiousse JL, et al. Massage and mobilization of the feet and ankles in elderly adults: effect on clinical balance performance. Man Ther. 2009;14(6):661-4.

Published

2019-03-01

Issue

Section

Original Articles