Fisioterapia

This study was undertaken to establish normal reference ranges for abdominal muscle size and symmetry and to examine the effects on these of gender and age. We studied 123 subjects, consisting of 55 men (aged 21-72 years) and 68 women (aged 20-64 years). Real-time ultra-sound imaging of the abdominal muscles was performed. Thickness of internal and external oblique (IO, EO), transversus abdominis (TA), and rectus abdominis (RA), and cross-sectional area (CSA) of RA were measured , and absolute and relative muscle thickness (percent total muscle thickness), order of thickness, and symmetry (percent difference between sides) were determined. Males had significantly larger muscles than females and size was poorly correlated with age. The pattern of relative muscle thickness was RA IO EO TA. Symmetry for total absolute thickness of all three lateral muscles was 8%-9% (mean) but for individual muscles there was asymmetry of absolute size (13%-24%), whereas relative thickness was symmetrical for all muscles. These findings provide robust reference data for the abdominal muscles in normal males and females in order to enable comparison with clinical groups to assess abnormalities and establish sensitivity for evaluating the effectiveness of interventions.

This study was undertaken to establish normal reference ranges for abdominal muscle size and symmetry and to examine the effects on these of gender and age. We studied 123 subjects, consisting of 55 men (aged 21-72 years) and 68 women (aged 20-64 years). Real-time ultra-sound imaging of the abdominal muscles was performed. Thickness of internal and external oblique (IO, EO), transversus abdominis (TA), and rectus abdominis (RA), and cross-sectional area (CSA) of RA were measured , and absolute and relative muscle thickness (percent total muscle thickness), order of thickness, and symmetry (percent difference between sides) were determined. Males had significantly larger muscles than females and size was poorly correlated with age. The pattern of relative muscle thickness was RA IO EO TA. Symmetry for total absolute thickness of all three lateral muscles was 8%-9% (mean) but for individual muscles there was asymmetry of absolute size (13%-24%), whereas relative thickness was symmetrical for all muscles. These findings provide robust reference data for the abdominal muscles in normal males and females in order to enable comparison with clinical groups to assess abnormalities and establish sensitivity for evaluating the effectiveness of interventions.

RESUMEN La articulación mediotarsiana (AMT) o articu-lación de Chopart, es un complejo articular que establece la unión entre el tarso posterior (cal-cáneo y astrágalo) y el tarso medio (escafoides y cuboides). Por tanto se encuentra formada por las articulaciones astragaloescafoidea y la calca-neocuboidea, siendo su función principal la de adaptar la bóveda plantar al terreno. A lo largo de los años numerosos autores han descrito diferentes maniobras exploratorias para analizar su movimiento y comprender, de este modo, su funcionamiento en dinámica. El objetivo principal de este trabajo es el de realizar una revisión bibliográi ca de todas las maniobras descritas para conocer cuál es la más i able y válida, para unii car criterios y establecer así un protocolo de exploración adecuado. Durante años, el modelo exploratorio aplicado de la AMT ha sido la valoración visual descrita por Root en 1977. Se trata de un paradigma teórico que nos ha servido para comprender el funciona-miento de esta articulación. Sin embargo, actualmente se le atribuyen nu-merosos sesgos intraobservador e interobserva-dor, puesto que la valoración visual queda sujeta a la percepción del observador. Por ello considera-mos que se suscita la necesidad de conocer nue-vos métodos exploratorios que aporten datos más objetivos a la exploración de dicha articulación. Hasta el momento el instrumento más útil y vá-lido es el goniómetro de dos ramas, instrumento de fácil manejo que disponemos en consulta, algo que ha permitido que se consolide como el méto-do más i able para cuantii car en grados la posi-ción en que se encuentra el antepié. PALABRAS CLAVE Articulación mediotarsiana, valoración articu-lar, eje de movimiento. ABSTRACT The midtarsal joint or Chopart joint is a joint complex that establishes the connection between the posterior tarsus (calcaneus and talus) and tarsi medium (navicular and cuboid). Thus is formed by the talonavicular joint and calcaneocuboid, and its main function is to adapt the plantar arch to the ground. Over the years many authors have described different exploratory maneuvers to analyze and understand their movement, thus, its dynamic operation. The main objective of this work is to conduct a literature review of all the maneuvers described to know which is the most reliable and valid, to unify criteria and to establish a proper examination protocol. For years, the exploratory model of the MTA applied visual assessment has been described by Root in 1977. This is a theoretical paradigm that has helped us to understand the functioning of this joint. Currently, however, attributed many intraob-server and interobserver bias, since the visual assessment is subject to the observer's perception. We therefore consider that the need arises to meet new exploratory methods that provide more objective data on the exploration of the joint. So far the most useful and valid is the two-arm goniometer, user-friendly instrument we have in view, which has allowed it to consolidate its position as the most reliable method for measuring in degrees the position that is the forefoot. KEY WORDS Midtarsal joint, joint assessment, the axis of movement.