ISABEL DE CAMARGO NEVES SACCO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
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article 2 Citação(ões) na Scopus The Association Between Rearfoot Motion While Barefoot and Shod in Different Types of Running Shoes in Recreational Runners(2020) SILVA, Erica Q.; MIANA, Andreia N.; FERREIRA, Jane S. S. P.; KIYOMOTO, Henry D.; DINATO, Mauro C. M. E.; SACCO, Isabel C. N.The rearfoot angle (RFA) is a biomechanical variable widely used to determine the rearfoot motion (RM). Shoe manufacturers began to develop running shoes with RM control that would supposedly alter foot-ground interaction mechanics and neutralize excessive pronation or supination; moreover, some studies have not shown differences in rearfoot motion in shod condition compared to barefoot. This study intended to answer three questions: Do the shoes runners wear correspond to their respective barefoot RM? Does the eversion angle change during shod running, regardless the shoes worn? Can footwear designed for a specific RM (supination, pronation, neutral) correct or neutralize the eversion angle of runners? One hundred and eleven runners (38.6 +/- 9.7years; 74.9 +/- 12.0kg; 1.74 +/- 0.08 m), who ran an average of 32 +/- 17km/week, were included in this cross-sectional study. They had their RFA measured by a motion capture system when running barefoot and wearing their habitual running shoes (shod condition). Chi-squared test was used to assess associations between barefoot and shod condition and RFA was compared between conditions using Wilcoxon tests (p = 0.05). There was no association between the type of running shoe and barefoot RM (p > 0.05). There was an association between RFA when barefoot and when shod (p < 0.05). Among all participants classified as neutral, 61% continued to exhibit a normal/neutral RFA when wearing their habitual shoes. Among the overpronators, 100% showed a change in the RM to either normal or supinator. Among the participants classified as supinators, 62% exhibited normal pronation when shod even without using the appropriate footwear, claimed by the manufacturer. Only 44.1% of the sample chose the correct running shoe for their barefoot RM. The majority of runners did not choose their shoes designed for their natural type of RM. The rearfoot eversion angle changed an average 4 degrees when running shod and the RM barefoot altered quite a lot when using a running shoe. The running shoes did not correct the pronation detected barefoot, as claimed by the manufacturers.conferenceObject CHRONIC EFFECTS OF A FLEXIBLE AND MINIMALIST FOOTWEAR ON CLINICAL, FUNCTIONAL AND GAIT BIOMECHANICAL ASPECTS IN THE KNEE OSTEOARTHRITIS: A SINGLE-BLIND RANDOMIZED CLINICAL TRIAL(2012) TROMBINI-SOUZA, F.; MATIAS, A.; YOKOTA, M.; SCHAINBERG, C.; FULLER, R.; SACCO, I. C.Purpose: Recent studies have shown that the acute use of shoes that mimic barefoot gait decrease substantially knee loads while walking in elderly with knee osteoarthritis (OA). Probably due to methodological difficulties to implement this type of conservative treatment during extended period, the effectiveness of minimalist footwear has not been evaluated yet in elderly patients with knee OA. The purpose is to describe a randomized clinical trial protocol for evaluating the therapeutic effect of a minimalist (flexible, non-heeled) and inexpensive footwear on clinical, functional, and biomechanical gait in elderly women with knee OA. Methods: Fifty six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence) will be randomized in blocks and allocated in the intervention group that will use a flexible non-heeled shoes- Moleca® forat least 6 hours daily or in the control group, which could not use these shoes or be under physical therapy or acupuncture treatment throughout these sis months. The use of Paracetamol 500 mg every six hour was allowed for both groups in case of pain. Moleca® (Calçados Beira Rio S.A., Novo Hamburgo, RS, Brazil) is a women's double canvas flexiblefl at walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. The mean weight is 172±19.6 g, ranging from 142 to 193 g depending on the size. Both groups will be followed during 6 months. They will be assessed at baseline condition, after 3 months (intervention group) and after 6 months of baseline condition(end of intervention, both groups). All the assessments will be performed by a physiotherapist that is blind to which group thepatient was allocated. The main outcome assessmentis the pain WOMAC score and the secondary outcomes are other WOMAC scores pain assessment (visual analogue scale - VAS), Lequesne index, Six-Minute Walk Test, and biomechanical gait analysis by means of 6 infrared cameras and a multi-component force plate to determine the knee adduction moment during gait. At baseline, all patients receive a diary to record the hours of daily use of footwear intervention. Every two weeks, the same physiotherapist carries phone calls to all patients in order to verify adherence to treatment and the correct filling this diary. Theinter group andinter-moments will be performed by repeated measures analysis of variance (α=0.05). This Trial was approved by the local Ethics Committee and was registered in ClinicalTrials.gov Identifier: NCT01342458. Results: Six hundred thirty-four elderly women have been contacted so far and 20 have already been allocated in the intervention group (9) and in the control (11). Five patients from intervention group have already completed all 3 assessments and finished the protocol. The preliminary results have shown that the elderly women of the intervention group have used the Moleca® shoe for an average monthly of 7 hours and 24 minutes (±3:47), corresponding to approximately 50% of the home-work hours of the day. Conclusion: This is the first randomized clinical trial protocol to assess the chronic effect of a minimalist footwear on the clinical, functional and gait biomechanics of elderly women with knee osteoarthritis. We expect that the use of Moleca® shoes for 6 months provides pain relief, reduction of the knee adduction moment while walking and improves joint function in elderly women with knee OA, and therefore can be considered as another inexpensive option for conservative OA treatment. The authors are pleased to acknowledge the financial support of State of São Paulo Research Foundation - FAPESP (processes: 2011/01640-8, 2011/03300-0, 2011/03069-6).- Decreased muscle strength is associated with proinflammatory cytokines but not testosterone levels in men with diabetes(2018) FERREIRA, J.P.; LEAL, A.M.O.; VASILCEAC, F.A.; SARTOR, C.D.; SACCO, I.C.N.; SOARES, A.S.; SALVINI, T.F.The aim of this study was to compare muscle strength in male subjects with type 2 diabetes mellitus (DM2) with and without low plasma testosterone levels and assess the relationship between muscle strength, testosterone levels, and proinflammatory cytokines. Males (75) aged between 18 and 65 years were divided into 3 groups: control group that did not have diabetes and had a normal testosterone plasma level (>250 ng/dL), DnormalTT group that had DM2 with normal testosterone levels, and the DlowTT group that had DM2 and low plasma testosterone levels (<250 ng/dL). The age (means±SD) of the groups was 48.4±10, 52.6±7, and 54.6±7 years, respectively. Isokinetic concentric and isometric torque of knee flexors and extensors were analyzed by an isokinetic dynamometer. Plasma testosterone and proinflammatory cytokine levels were determined by chemiluminescence and ELISA, respectively. Glycemic control was analyzed by glycated hemoglobin (HbA1C). In general, concentric and isometric torques were lower and tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β plasma levels were higher in the groups with diabetes than in controls. There was no correlation between testosterone level and knee torques or proinflammatory cytokines. Concentric and isometric knee flexion and extension torque were negatively correlated with TNF-α, IL-6, and HbA1C. IL-6 and TNF-α were positively correlated with HbA1C. The results of this study demonstrated that muscle strength was not associated with testosterone levels in men with DM2. Low muscle strength was associated with inflammatory markers and poor glycemic control.
conferenceObject Wavelet approach for studying motor strategy patterns of diabetic neuropathic individuals in gait cycle(2014) PACHI, C. G. F.; WEIDERPASS, H. A.; YAMAMOTO, J. F.; SACCO, I. C. N.; HAMAMOTO, A.; ONODERA, A. N.The aim of this study was to investigate lower limb muscle's energy patterns and spectral properties of diabetic neuropathic individuals during gait cycle using wavelet approach. The signal's energy and frequency were compared between groups in the whole gait cycle and in specific frequency band (7-542 Hz) using t tests. Principal component analysis was used to assess differences between diabetic and non-diabetic EMG patterns. The diabetic individuals displayed lesser energies in lower frequency bands for all muscles and higher energies in higher-frequency bands in the extensors' muscles. Future studies are important if we consider that by identifying these biomechanical changes in early stages of establishment of neuropathy, it could be possible to develop therapeutic and prophylactic prevention of ulcers and subsequent amputations.- High spatial resolution pressure distribution of the vaginal canal in Pompoir practitioners: A biomechanical approach for assessing the pelvic floor(2017) CACCIARI, Licia P.; PASSARO, Anice C.; AMORIM, Amanda C.; SACCO, Isabel C. N.Background: Pompoir is a technique poorly studied in the literature that claims to improve pelvic floor strength and coordination. This study aims to investigate the pelvic floor muscles' coordination throughout the vaginal canal among Pompoir practitioners and non-practitioners by describing a high resolution map of pressure distribution. Methods: This cross-sectional, study included 40 healthy women in two groups: control and Pompoir. While these women performed both sustained and ""waveform"" pelvic floor muscle contractions, the spatiotemporal pressure distribution in their vaginal canals was evaluated by a non-deformable probe fully instrumented with a 10 x 10 matrix of capacitive transducers. Findings: Pompoir group was able to sustain the pressure levels achieved for a longer period (40% longer, moderate effect, P = 0.04). During the ""waveform"" contraction task, Pompoir group achieved lower, earlier peak pressures (moderate effect, P = 0.05) and decreased rates of contraction (small effect, P = 0:04) and relaxation (large effect, P = 0.01). During both tasks, Pompoir group had smaller relative contributions by the mid-region and the anteroposterior planes and greater contributions by the caudal and cranial regions and the latero-lateral planes. Interpretation: Results suggest that specific coordination training of the pelvic floor muscles alters the pressure distribution profile, promoting a more-symmetric distribution of pressure throughout the vaginal canal. Therefore, this study suggests that pelvic floor muscles can be trained to a degree beyond strengthening by focusing on coordination, which results in changes in symmetry of the spatiotemporal pressure distribution in the vaginal canal.
- Assessing experience in the deliberate practice of running using a fuzzy decision-support system(2017) ROVERI, Maria Isabel; MANOEL, Edison de Jesus; ONODERA, Andrea Naomi; ORTEGA, Neli R. S.; TESSUTTI, Vitor Daniel; VILELA, Emerson; EVENCIO, Nelson; SACCO, Isabel C. N.The judgement of skill experience and its levels is ambiguous though it is crucial for decision- making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time. The model results were highly consistent with the judgment of three expert running coaches (r>0.88, p<0.001) and also with five other expert running coaches (r>0.86, p<0.001). From the expert's knowledge and the fuzzy model, running experience is beyond the so-called ""10-year rule"" and depends not only on practice time, but on the quality of practice (training volume and frequency) and participation in competitions. The fuzzy rule-based model was very reliable, valid, deals with the marked ambiguities inherent in the judgment of experience and has potential applications in research, sports training, and clinical settings.
- Concern About Falling, Confidence in Balance, Quality of Life, and Depression Symptoms in Community-Dwelling Older Adults After a 24-week Dual-Task Training With Variable and Fixed Priority: A Randomized Controlled Trial(2022) TROMBINI-SOUZA, Francis; NOGUEIRA, Renata Taysa de Souza Azevedo; SERAFIM, Ana Cicera Batista; LIMA, Thamires Medeiros Mendes de; XAVIER, Michelle Katherine Andrade; PERRACINI, Monica Rodrigues; ARAUJO, Rodrigo Cappato de; SACCO, Isabel C. N.; NASCIMENTO, Marcelo de MaioObjective To evaluate the effect of a 24-week dual-task training with progression from variable to fixed priority on the concern about falling, confidence in balance, quality of life, and depression symptoms in community-dwelling older adults. Methods A total of 60 participants (60-80 y.o.) were randomly allocated into a dual-task training group with progression from variable to fixed priority (experimental group) or into a dual-task training group with variable priority (control group). Results No between-group difference was observed after the intervention. A significant time effect showed a reduction in concern about falling [mean difference (MD) = -2.91)] and depression symptoms (MD = -1.66), an increase in the physical function (MD = 7.86), overall mental health (MD = 5.82), perception of vitality, energy, and less fatigue (MD = 10.45), general perception of overall health (MD = 6.81), and their health compared to the last year (MD = 11.89). Conclusion The experimental protocol was not superior to the control one. However, both protocols improved these outcomes.
- The effects of plantar fasciitis and pain on plantar pressure distribution of recreational runners(2011) RIBEIRO, Ana Paula; TROMBINI-SOUZA, Francis; TESSUTTI, Vitor D.; LIMA, Fernanda R.; JOAO, Silvia M. A.; SACCO, Isabel C. N.Background: Plantar fasciitis is the third most frequent injury in runners. Despite its high prevalence, its pathogenesis remains inconclusive. The literature reports overload as the basic mechanism for its development. However, the way that these plantar loads are distributed on the foot surface of runners with plantar fasciitis and the effects of pain on this mechanical factor has not yet been investigated. Therefore, the aim of this study was to evaluate and compare the plantar pressure distributions during running in runners with symptom or history of plantar fasciitis and runners without the disease. Methods: Forty-five recreational runners with plantar fasciitis (30 symptomatic and 15 with previous history of the disease) and 60 runners without plantar fasciitis (control group) were evaluated. Pain was assessed by a visual analogue scale. All runners were evaluated by means of the Pedar system insoles during running forty meters at a speed of 12(5%) km/h, using standard sport footwear. Two-way ANOVAS were employed to investigate the main and interaction effects between groups and plantar areas. Findings: No interaction effects were found for any of the investigated variables: peak pressure (P=0.61), contact area (P=0.38), contact time (P=0.91), and the pressure-time integral (P=0.50). Interpretation: These findings indicated that the patterns of plantar pressure distribution were not affected in recreational runners with plantar fasciitis when compared to control runners. Pain also did not interfere with the dynamic patterns of the plantar pressure distributions.
conferenceObject EFFECTIVENESS OF LONG-TERM USE OF MINIMALIST FOOTWEAR ON PAIN AND FUNCTION IN KNEE OSTEOARTHRITIS(2013) GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, Ricardo; MATIAS, Alessandra; YOKOTA, Mariane; BUTUGAN, Marco; TROMBINI-SOUZA, Francis; SACCO, Isabel- DIABETES AND PERIPHERAL NEUROPATHY ARE RELATED TO HIGHER PASSIVE TORQUE AND STIFFNESS OF THE KNEE AND ANKLE JOINTS(2022) FERREIRA, Jean P.; ARAUJO, Vanessa L.; LEAL, Angela M. O.; SERRAO, Paula R. M. S.; PEREA, Julya P. M.; SANTUNE, Afonso H. A.; PON-JUNIOR, Henrique; FERNANDES, Ricardo A. S.; ARANHA, Gabriel D. A.; SACCO, Isabel C. N.; SALVINI, Tania F.The aim of this study was to investigate the ankle and knee stiffness and passive torque in individuals with diabetes mellitus type 2 (DM2), with and without diabetic peripheral neuropathy (DPN) at different speed of motion. Forty-nine male individuals of a similar age were studied (17 with DM2 without DPN, 15 with DM2 and DPN, and 17 controls). Knee and ankle flexion and extension passive torques were assessed on an isokinetic dynamometer at 5??/s, 30??/s, and 60??/s. Our results showed that the individuals with DM2 exhibited greater knee stiffness compared to the controls and the individuals with DPN presented greater ankle stiffness and passive torque compared to the controls and those with DM2 without DPN. The mechanical impairments at the ankle passive structures were most evident at low speeds while the knee alterations were at 30??/s and 60??/s. Although the presence of DPN was a key factor for the increased passive ankle stiffness and torque, it was not related to the increase in the knee passive stiffness. Preventive measures for avoiding stiffness and motion impairments at the ankle and knee could be adopted in the early stages of DM2.