ISOKINETIC EVALUATION OF TARSAL COALITION.
M Imamura, ST Imamura, O Salomao, AE Carvalho Jr, Limamara Rizzo Battistella. Div. PM&R, Foot Clinic, Institute of Orthopedics and Traumatology, Sao Paulo Medical School, Sao Paulo, BRAZIL.
Purpose: To evaluate functional postoperative results of ressection of calcaneonavicular and talocalcaneal coalitions.
Method: Maximum range of motion and isokinetic muscle torque of the invertors and evertors of the foot were tested in 25 patients, 16 female and 9 male. Seventeen of them were talocalcaneal and eight calcaneonavicular coalitions. All talocalcaneal bars were treated with excision of the bar and interposition of an autogenous free fat graft. Calcaneonavicular bars were treated with excision of the bar and interposition of extensor digitorum brevis tendon. Passive range of motion exercises started in the first day postoperatively. Function was assessed clinically by the patient's complaints and ability to perform activities of daily living and sports. Testing was performed on the Cybex 350 dynamometer at least 6 months after surgery, the results were compared to preoperative evaluation. Peak torque at 30 and 120 degrees/second and the ratios of torque development for eversion/inversion were evaluated.
Result: Statistically significant increase in invertors torque production (p<0.05) and range of motion values (p<0.05) after minimum of 6 months postoperatevely was demonstrated.
Conclusion: These operatives techniques followed by physical medicine and rehabilitation procedures are good methods of treating calcaneonavicular and talocalcaneal coalitions, providing good dynamical results.
BACK EXTENSOR STRENGTH AS IT RELATES TO AGE AND GENDER
Benjamin E. Phillips, MMSIII, Yuka Tsutsui, MD, Mehrsheed Sinaki, MD, Mayo Clinic, Rochester, MN. USA
Maintenance of muscle strength will help to reduce the skeletal challenges related to aging. Previous studies have demonstrated that axial loss of muscle strength and bone mass is more significant than appendicular. Therefore, we were mainly interested in trunkal muscle strength. The objective of this study was to document differences in muscle strength between men and women of different ages. Volunteers for this study consisted of 103 healthy men and women aged 20 to 80 years and were grouped by decade and gender. Data gathering involved questions about health and activity, and strength measurement with BID-2000 (table-mounted strain gauge dynamometer). Data analysis showed that back strength peaked in the third decade of life for both men and women, then steadily declined. A weak correlation was found between weight and back extensor strength only in men. When the two genders were compared, muscle strength in women was less than that of men at all ages and women's back extensor strength was found to be about 61% of men's. This discrepancy between the genders was exaggerated after the fifth decade. The finding that muscle strength peaks in both men and women in the third decade of life suggests that maximum muscle strength is not achieved until the third decade. Our study also indicated that physiologic reduction of muscle strength begins early in life. Therefore, one may be able to decrease the risk of age-related musculoskeletal changes through strengthening exercises at a younger age.