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.- 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.
- 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.
- 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.
- Effect of a rocker non-heeled shoe on EMG and ground reaction forces during gait without previous training(2012) SACCO, Isabel C. N.; SARTOR, Cristina D.; CACCIARI, Licia P.; ONODERA, Andrea N.; DINATO, Roberto C.; PANTALEAO JR., Elcio; MATIAS, Alessandra B.; CEZARIO, Fernanda G.; TONICELLI, Lucas M. G.; MARTINS, Maria Cecilia S.; YOKOTA, Mariane; MARQUES, Paulo Eduardo C.; COSTA, Paulo Henrique C.Unstable shoes have been designed to promote ""natural instability"" and during walking they should simulate barefoot gait, enhancing muscle activity and, thus, attributing an advantage over regular tennis shoes. Recent studies showed that, after special training on the appropriate walking pattern, the use of the Masai Barefoot Technology (MBT) shoe increases muscle activation during walking. Our study presents a comparison of muscle activity as well as horizontal and vertical forces during gait with the MBT, a standard tennis shoe and barefoot walking of healthy individuals without previous training. These variables were compared in 25 female subjects and gait conditions were compared using ANOVA repeated measures (effect size:0.25). Walking with the MBT shoe in this non-instructed condition produced higher vertical forces (first vertical peak and weight acceptance rate) than walking with a standard shoe or walking barefoot, which suggests an increase in the loads received by the musculoskeletal system, especially at heel strike. Walking with the MBT shoe did not increase muscle activity when compared to walking with the standard shoe. The barefoot condition was more effective than the MBT shoe at enhancing muscle activation. Therefore, in healthy individuals, no advantage was found in using the MBT over a standard tennis shoe without a special training period. Further studies using the MBT without any instruction over a longer period are needed to evaluate if the higher loads observed in the present study would return to their baseline values after a period of adaptation, and if the muscle activity would increase over time.
- Vibration perception among children and adolescents with Charcot-Marie-tooth disease and implications for foot posture(2023) CARDOSO, Juliana; BAPTISTA, Cyntia Rogean de Jesus Alves de; BUZZETTI, Beatriz Parra; SARTOR, Cristina Dallemole; JR, Wilson Marques; SACCO, Isabel de Camargo Neves; MATTIELLO-SVERZUT, A. C.Background: Alterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated. Methods: Participants aged 9-18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs. Findings: Children with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (beta = 31.02, p = 0.04). Interpretation: These new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.
- Not All Forefoot Striking Is Equal(2019) MATIAS, Alessandra; OUTERLEYS, Jereme; SACCO, Isabel; DAVIS, Irene
- Attenuation of foot pressure during running on four different surfaces: asphalt, concrete, rubber, and natural grass(2012) TESSUTTI, Vitor; RIBEIRO, Ana Paula; TROMBINI-SOUZA, Francis; SACCO, Isabel C. N.The practice of running has consistently increased worldwide, and with it, related lower limb injuries. The type of running surface has been associated with running injury etiology, in addition other factors, such as the relationship between the amount and intensity of training. There is still controversy in the literature regarding the biomechanical effects of different types of running surfaces on foot-floor interaction. The aim of this study was to investigate the influence of running on asphalt, concrete, natural grass, and rubber on in-shoe pressure patterns in adult recreational runners. Forty-seven adult recreational runners ran twice for 40 m on all four different surfaces at 12 +/- 5% km . h(-1). Peak pressure, pressure-time integral, and contact time were recorded by Pedar X insoles. Asphalt and concrete were similar for all plantar variables and pressure zones. Running on grass produced peak pressures 9.3% to 16.6% lower (P < 0.001) than the other surfaces in the rearfoot and 4.7% to 12.3% (P < 0.05) lower in the forefoot. The contact time on rubber was greater than on concrete for the rearfoot and midfoot. The behaviour of rubber was similar to that obtained for the rigid surfaces - concrete and asphalt - possibly because of its time of usage (five years). Running on natural grass attenuates in-shoe plantar pressures in recreational runners. If a runner controls the amount and intensity of practice, running on grass may reduce the total stress on the musculoskeletal system compared with the total musculoskeletal stress when running on more rigid surfaces, such as asphalt and concrete.
- The effect of peripheral neuropathy on lower limb muscle strength in diabetic individuals(2017) FERREIRA, Jean P.; SARTOR, Cristina D.; LEAL, Angela M. O.; SACCO, Isabel C. N.; SATO, Tatiana O.; RIBEIRO, Ivana L.; SOARES, Alice S.; CUNHA, Jonathan E.; SALVINI, Tania F.Background: Skeletal muscle strength is poorly described and understood in diabetic participants with diabetic peripheral neuropathy. This study aimed to investigate the extensor and flexor torque of the knee and ankle during concentric, eccentric, and isometric contractions in men with diabetes mellitus type 2 with and without diabetic peripheral neuropathy. Methods: Three groups of adult men (n = 92), similar in age, body mass index, and testosterone levels, were analyzed: 33 non-diabetic controls, 31 with type 2 diabetes mellitus, and 28 with diabetic peripheral neuropathy. The peak torques in the concentric, eccentric, and isometric contractions were evaluated using an isoldnetic dynamometer during knee and ankle flexion and extension. Findings: Individuals with diabetes and diabetic peripheral neuropathy presented similar low concentric and isometric knee and ankle torques that were also lower than the controls. However, the eccentric torque was similar among the groups, the contractions, and the joints. Interpretation: Regardless of the presence of peripheral neuropathy, differences in skeletal muscle function were found. The muscle involvement does not follow the same pattern of sensorial losses, since there are no distal-to proximal impairments. Both knee and ankle were affected, but the effect sizes of the concentric and isometric torques were found to be greater in the participants' knees than in their ankles. The eccentric function did not reveal differences between the healthy control group and the two diabetic groups, raising questions about the involvement of the passive muscle components.
- Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial(2022) SUDA, Eneida Yuri; WATARI, Ricky; MATIAS, Alessandra B.; TADDEI, Ulisses T.; SACCO, Isabel C. N.Background: Running carries the risk of several types of running-related injuries (RRIs), especially in the lower limbs. The variety of risk factors and the lack of strong evidence for several of these injury risks hinder the ability to draw assertive conclusions about them, hampering the implementation of effective preventive strategies. Because the etiology of RRIs seems to be multifactorial, the presence of RRI risk factors might influence the outcome of therapeutic strategies in different ways. Thus, further investigations on how risk and protective factors influence the incidence and prevention of RRIs should be conducted. Purpose: To investigate the predictive effect of well-known risk factors and 1 protective factor-foot-core training-on the incidence of lower limb RRIs in recreational runners. Study Design: Cohort study; Level of evidence, 2. Methods: Middle- and long-distance recreational runners (N = 118) were assessed at baseline and randomly allocated to either an intervention group (n = 57) or a control group (n = 61). The intervention group underwent an 8-week (3 times/wk) foot-core training program. Participants were followed for a year after baseline assessment for the occurrence of RRIs. Logistic regression with backward elimination of variables was used to develop a model for prediction of RRI in recreational runners. Candidate predictor variables included age, sex, body mass index, years of running practice, number of races, training volume, training frequency, previous RRI, and the foot-core exercise training. Results: The final logistic regression model included 3 variables. As previously shown, the foot-core exercise program is a protective factor for RRIs (odds ratio, 0.40; 95% CI, 0.15-0.98). In addition, older age (odds ratio, 1.07; 95% CI, 1.00-1.14) and higher training volume (odds ratio, 1.02; 95% CI, 1.00-1.03) were risk factors for RRIs. Conclusion: The foot-core training was identified as a protective effect against lower limb RRI, which can be negatively influenced by older age and higher weekly training volume. The predictive model showed that RRIs should be considered a multivariate entity owing to the interaction among several factors. Registration: NCT02306148 (ClinicalTrials.gov identifier).