ANA PAULA RIBEIRO
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- Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study(2015) RIBEIRO, Ana Paula; JOAO, Silvia Maria Amado; DINATO, Roberto Casanova; TESSUTTI, Vitor Daniel; SACCO, Isabel Camargo NevesAim/Hypothesis The etiology of plantar fasciitis (PF) has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage. Objective Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the chronic stage of the injury in relation to healthy runners. Methods Forty-five runners with unilateral PF (30 acute and 15 chronic) and 30 healthy control runners were evaluated while running at 12 km/h for 40 meters wearing standardized running shoes and Pedar-X insoles. The contact area and time, maximum force, and force-time integral over the rearfoot, midfoot, and forefoot were recorded and the loading rate (20-80% of the first vertical peak) was calculated. Groups were compared by ANOVAs (p<0.05). Results Maximum force and force-time integral over the rearfoot and the loading rate was higher in runners with PF (acute and chronic) compared with controls (p<0.01). Runners with PF in the acute stage showed lower loading rate and maximum force over the rearfoot compared to runners in the chronic stage (p<0.01). Conclusion Runners with PF showed different dynamic patterns of plantar loads during running over the rearfoot area depending on the injury stage (acute or chronic). In the acute stage of PF, runners presented lower loading rate and forces over the rearfoot, possibly due to dynamic mechanisms related to pain protection of the calcaneal area.
- Posture and Gait Biomechanical Aspects during Pregnancy and the Importance of Therapeutic Exercise: Literature Review(2015) RIBEIRO, Ana PaulaThe purpose of this study was to analyze studies that have investigated posture and gait during pregnancy and the importance of exercise. For this purpose, a systematic literature search was conducted on the following electronic databases: Scielo, Scopus, Embase, Pubmed, and Medline. Gait biomechanics, posture, lower limb alignment, postural balance, and physical exercise studies from 1943 to 2014 were accepted as potentially relevant for inclusion in this review. In general, posture studies showed that pregnant women demonstrated pain and discomfort in the pelvis and lumbar spine during pregnancy and after childbirth. Static posture changes, such as increased lumbar and thoracic curvatures during pregnancy and up to two months after childbirth, pelvic anteversion, and stretching of the abdominal musculature resulted in reduced functional stability of the hip. The lower limb alignment studies showed hyperextension or valgus knee and decreased longitudinal arch with increased support bases and distances between the feet. Postural balance studies showed that postural stability decreased during pregnancy and after childbirth, leading to an increased risk of falls. Gait studies showed a pattern of feet rollover with greater stance phase duration, a decrease of plantar flexion and propulsion force associated with increased hip flexion, as well as extensor and abductor moments. Other changes were characterized by greater anterior-posterior and medial-lateral sway with increased plantar load over the forefoot and rearfoot areas. Gait training and resistance exercises at moderate intensity showed to be low-cost aerobic exercises with positive therapeutic effects to reduce the risk of pre-eclampsia and gestational diabetes mellitus. However, no studies were found regarding the therapeutic effects of exercise to improve the biomechanical aspects of posture, specially lumbar curvature, knee angle and plantar arch, and of gait, such as propulsion, hip angle and overload feet in pregnant women.
- Biomechanical variables and perception of comfort in running shoes with different cushioning technologies(2015) DINATO, Roberto C.; RIBEIRO, Ana P.; BUTUGAN, Marco K.; PEREIRA, Ivye L. R.; ONODERA, Andrea N.; SACCO, Isabel C. N.Objectives: To investigate the relationships between the perception of comfort and biomechanical parameters (plantar pressure and ground reaction force) during running with four different types of cushioning technology in running shoes. Design: Randomized repeated measures. Methods: Twenty-two men, recreational runners (18-45 years) ran 12 km/h with running shoes with four different cushioning systems. Outcome measures included nine items related to perception of comfort and 12 biomechanical measures related to the ground reaction forces and plantar pressures. Repeated measure ANOVAs, Pearson correlation coefficients, and step-wise multiple regression analyses were employed (p <= 0.05). Results: No significant correlations were found between the perception of comfort and the biomechanical parameters for the four types of investigated shoes. Regression analysis revealed that 56% of the perceived general comfort can be explained by the variables push-off rate and pressure integral over the forefoot (p = 0.015) and that 33% of the perception of comfort over the forefoot can be explained by second peak force and push-off rate (p = 0.016). Conclusions: The results did not demonstrate significant relationships between the perception of comfort and the biomechanical parameters for the three types of shoes investigated (Gel, Air, and ethylene-vinyl acetate). Only the shoe with Adiprene+ technology had its general comfort and cushioning perception predicted by the loads over the forefoot. Thus, in general, one cannot predict the perception of comfort of a running shoe through impact and plantar pressure received.