O pé plano flexível é condição frequente na criança e apresenta forte tendência para correção espontânea ou tornar-se deformidade moderada ou leve no adulto, que não causará problema. Entretanto, em uma pequena proporção de casos, a deformidade é mais grave, não melhora espontaneamente ou com métodos conservadores, há comprometimento mecânico, deformidade e, eventualmente, dor. Assim, o tratamento cirúrgico deve ser considerado e, para isso, várias técnicas são descritas. O objetivo desta revisão sistemática foi avaliar os resultados da literatura do tratamento do pé plano flexível sintomático da criança ou adolescente pela osteotomia de alongamento da coluna lateral do calcâneo e pela artrorrise subtalar. Foi realizada busca sistemática eletrônica nas bases de dados PubMed, Web of Science, SCOPUS, Cochrane, LILACS e SCIELO, além de sites relevantes, por artigos publicados entre 1975 e novembro de 2016. Após aplicação dos critérios de elegibilidade, os artigos selecionados foram avaliados quanto aos resultados clínicos, radiográficos e complicações. Dos 393 artigos encontrados nas bases de dados, apenas 32 estudos foram selecionados, segundo os critérios de inclusão e exclusão, 24 artigos avaliaram artrorrise subtalar (total de 1.395 pacientes, 2.307 pés tratados) e oito avaliaram osteotomia de alongamento da coluna lateral do calcâneo (total de 105 pacientes, 167 pés). O seguimento pós-operatório médio foi de 51,8 meses (mínimo de dois e máximo de 225 meses) para artrorrise subtalar e 34,8 meses (mínimo de seis e máximo de 156 meses) para osteotomia de alongamento da coluna lateral do calcâneo. A idade mínima no momento de realização da cirurgia foi de quatro anos e a idade máxima foi de 18 anos. Somente seis autores realizaram estudo prospectivo, apenas um comparou as duas técnicas, mas sem caso-controle ou aleatorização. Clinicamente, houve 88,3% de pacientes satisfeitos ou muito satisfeitos submetidos à artrorrise subtalar e 91,4% dos submetidos a osteotomia de alongamento da coluna lateral do calcâneo e 8% de insatisfeitos submetidos a artrorrise subtalar e 6,2% de insatisfeitos submetidos a osteotomia de alongamento da coluna lateral do calcâneo. Quanto aos parâmetros radiográficos, houve melhora de todos os sete ângulos avaliados nas duas técnicas. A taxa total de complicações foi de 18,2% para os submetidos a artrorrise subtalar, compostas principalmente por dor residual (11,5%), necessidade de reabordagem (8,9%), quebra de implante (5,2%), necessidade de retirada do implante (5,2%), para osteotomia de alongamento da coluna lateral do calcâneo a taxa total de complicações foi de 20,9%, compostas principalmente por deiscência de ferida operatória (19%), dor residual (17,2%), deslocamento do enxerto ósseo (9%) e pseudoartrose (7,1%). As publicações no período avaliado são compostas em sua maioria por estudos descritivos ou série de casos (nível de evidência III ou IV), com grandes variações metodológicas, mas com alto índice de satisfação dos pacientes e cirurgiões, em relação aos resultados nas duas técnicas. Entretanto, são necessárias novas pesquisas com desenho prospectivo, aleatorizado, grupo controle adequado e critérios de avaliação validados. / Flexible flatfoot is a common pediatric condition and has a strong tendency to spontaneously regress as growth progresses. However, in a small number of cases, the deformity is more severe, does not improve spontaneously or with conservative methods and may cause mechanical impairment and pain. In such cases, operative management should be considered, and several correction techniques are available. The aim of this systematic review was to evaluate the publications on calcaneal lateral column lengthening osteotomy or subtalar arthroereisis for severe flexible flatfoot in children or adolescents. A systematic search was performed of the electronic databases PubMed, Web of Science, SCOPUS, Cochrane, LILACS, CINAHL and SciELO for articles published between 1975 and 2016. After applying the eligibility criteria, the publications were evaluated for clinical and radiographic results and complications. We identified 393 articles, but only selected 32 studies using the inclusion and exclusion criteria. These studies included a total of eight articles (105 patients and 167 feet) for calcaneal lateral column lengthening and 24 articles for subtalar arthroereisis (1,395 patients and 2,307 feet). The mean postoperative follow-up was 34.8 months (minimum: 6 months) for calcaneal osteotomy and 51.8 months (minimum of two months) for subtalar arthroereisis. The minimum and maximum ages at the time of the surgery were four years and 18 years, respectively. Only six authors conducted prospective studies, but their reports did not include case-controls or randomization. According to these studies, clinically, there were 88.3% of satisfied or very satisfied patients submitted to subtalar arthroereisis and 91.4% of those undergoing calcaneal lateral column lengthening osteotomy and 8% of dissatisfied patients undergoing subtalar arthroereisis and 6.2% of dissatisfied for calcaneal lateral column lengthening osteotomy. Regarding the radiographic parameters, there was improvement of all seven angles evaluated in the two techniques. The total rate of complications was 18.2% for those undergoing subtalar arthroereisis, composed mainly of residual pain (11.5%), need for reboarding (8.9%), implant failure (5.2%), need for implant removal (5,2%). The total complication rate was 20.9% for calcaneal lateral column lengthening osteotomy, consisting mainly of operative wound dehiscence (19%), residual pain (17,2%), displacement of the bone graft (9%) and pseudoarthrosis (7.1%). The majority of publications were descriptive studies or case series (evidence level III or IV), with different study designs, but patients and surgeons reported high satisfaction with the results. However, more research is needed with a prospective and randomized design, adequate control groups, and objective evaluation criteria.

O pé plano flexível é condição frequente na criança e apresenta forte tendência para correção espontânea ou tornar-se deformidade moderada ou leve no adulto, que não causará problema. Entretanto, em uma pequena proporção de casos, a deformidade é mais grave, não melhora espontaneamente ou com métodos conservadores, há comprometimento mecânico, deformidade e, eventualmente, dor. Assim, o tratamento cirúrgico deve ser considerado e, para isso, várias técnicas são descritas. O objetivo desta revisão sistemática foi avaliar os resultados da literatura do tratamento do pé plano flexível sintomático da criança ou adolescente pela osteotomia de alongamento da coluna lateral do calcâneo e pela artrorrise subtalar. Foi realizada busca sistemática eletrônica nas bases de dados PubMed, Web of Science, SCOPUS, Cochrane, LILACS e SCIELO, além de sites relevantes, por artigos publicados entre 1975 e novembro de 2016. Após aplicação dos critérios de elegibilidade, os artigos selecionados foram avaliados quanto aos resultados clínicos, radiográficos e complicações. Dos 393 artigos encontrados nas bases de dados, apenas 32 estudos foram selecionados, segundo os critérios de inclusão e exclusão, 24 artigos avaliaram artrorrise subtalar (total de 1.395 pacientes, 2.307 pés tratados) e oito avaliaram osteotomia de alongamento da coluna lateral do calcâneo (total de 105 pacientes, 167 pés). O seguimento pós-operatório médio foi de 51,8 meses (mínimo de dois e máximo de 225 meses) para artrorrise subtalar e 34,8 meses (mínimo de seis e máximo de 156 meses) para osteotomia de alongamento da coluna lateral do calcâneo. A idade mínima no momento de realização da cirurgia foi de quatro anos e a idade máxima foi de 18 anos. Somente seis autores realizaram estudo prospectivo, apenas um comparou as duas técnicas, mas sem caso-controle ou aleatorização. Clinicamente, houve 88,3% de pacientes satisfeitos ou muito satisfeitos submetidos à artrorrise subtalar e 91,4% dos submetidos a osteotomia de alongamento da coluna lateral do calcâneo e 8% de insatisfeitos submetidos a artrorrise subtalar e 6,2% de insatisfeitos submetidos a osteotomia de alongamento da coluna lateral do calcâneo. Quanto aos parâmetros radiográficos, houve melhora de todos os sete ângulos avaliados nas duas técnicas. A taxa total de complicações foi de 18,2% para os submetidos a artrorrise subtalar, compostas principalmente por dor residual (11,5%), necessidade de reabordagem (8,9%), quebra de implante (5,2%), necessidade de retirada do implante (5,2%), para osteotomia de alongamento da coluna lateral do calcâneo a taxa total de complicações foi de 20,9%, compostas principalmente por deiscência de ferida operatória (19%), dor residual (17,2%), deslocamento do enxerto ósseo (9%) e pseudoartrose (7,1%). As publicações no período avaliado são compostas em sua maioria por estudos descritivos ou série de casos (nível de evidência III ou IV), com grandes variações metodológicas, mas com alto índice de satisfação dos pacientes e cirurgiões, em relação aos resultados nas duas técnicas. Entretanto, são necessárias novas pesquisas com desenho prospectivo, aleatorizado, grupo controle adequado e critérios de avaliação validados. / Flexible flatfoot is a common pediatric condition and has a strong tendency to spontaneously regress as growth progresses. However, in a small number of cases, the deformity is more severe, does not improve spontaneously or with conservative methods and may cause mechanical impairment and pain. In such cases, operative management should be considered, and several correction techniques are available. The aim of this systematic review was to evaluate the publications on calcaneal lateral column lengthening osteotomy or subtalar arthroereisis for severe flexible flatfoot in children or adolescents. A systematic search was performed of the electronic databases PubMed, Web of Science, SCOPUS, Cochrane, LILACS, CINAHL and SciELO for articles published between 1975 and 2016. After applying the eligibility criteria, the publications were evaluated for clinical and radiographic results and complications. We identified 393 articles, but only selected 32 studies using the inclusion and exclusion criteria. These studies included a total of eight articles (105 patients and 167 feet) for calcaneal lateral column lengthening and 24 articles for subtalar arthroereisis (1,395 patients and 2,307 feet). The mean postoperative follow-up was 34.8 months (minimum: 6 months) for calcaneal osteotomy and 51.8 months (minimum of two months) for subtalar arthroereisis. The minimum and maximum ages at the time of the surgery were four years and 18 years, respectively. Only six authors conducted prospective studies, but their reports did not include case-controls or randomization. According to these studies, clinically, there were 88.3% of satisfied or very satisfied patients submitted to subtalar arthroereisis and 91.4% of those undergoing calcaneal lateral column lengthening osteotomy and 8% of dissatisfied patients undergoing subtalar arthroereisis and 6.2% of dissatisfied for calcaneal lateral column lengthening osteotomy. Regarding the radiographic parameters, there was improvement of all seven angles evaluated in the two techniques. The total rate of complications was 18.2% for those undergoing subtalar arthroereisis, composed mainly of residual pain (11.5%), need for reboarding (8.9%), implant failure (5.2%), need for implant removal (5,2%). The total complication rate was 20.9% for calcaneal lateral column lengthening osteotomy, consisting mainly of operative wound dehiscence (19%), residual pain (17,2%), displacement of the bone graft (9%) and pseudoarthrosis (7.1%). The majority of publications were descriptive studies or case series (evidence level III or IV), with different study designs, but patients and surgeons reported high satisfaction with the results. However, more research is needed with a prospective and randomized design, adequate control groups, and objective evaluation criteria.

Chronic lateral instability of the ankle (CLI), defined as frequent sprains and recurrent giving way, difficulty in walking and running on uneven surface, is often connected with pain and swollen ankles. It occurs in 10 to 20 percent after acute ankle injuries. Mechanical instability of the talocrural and subtalar joint, peroneal weakness and impaired proprioception has been suggested as etiological factors. Aim. To investigate the natural course in conservatively treated patients with CLI. To assess the mechanical stability in patients with CLI by measuring the three dimensional motions in the talus, the fibula and the calcaneus in relation to the tibia during different testing procedures pre- and postoperatively. To determine if CLI is associated with proprioceptive deficiency. Patients and Methods. This Thesis includes 127 ankles in 78 patients (30 women, 48 men) with CLI. Thirty-seven patients were followed up 20 years after their first contact with the orthopaedic department because of CLI. Forty-six ankles were evaluated radiographically and the result was compared with a gender- and age - matched control-material. The neuromuscular response to a sudden angular displacement of the ankles was studied in 15 ankles in 13 patients using EMG. Thirty-six patients entered a prospective study using roentgen stereophotogrammetric analysis (RSA) in which the ankles were tested at manual adduction, adduction with predetermined torque, with and without external support and at drawer tests (40 N and 160N). Twenty-seven patients were followed five years postoperatively. Result. After 20 years 22 patients, conservatively treated still suffered from instability of the ankle and ten had recurrent giving way symptoms even on plane surface. Six ankles in the patient group and four in the control group displayed osteoarthritic changes Prolonged ipsilateral reaction time (m. per. long, and m. tib. ant.) was found in patients with CLI indicating proprioceptive insufficiency. Increased talar adduction and a tendency toward increased total translation of the talar center was found in ankles with CLI. Concomitant fibular rotations and translations were found but with no conclusive deviation in the ankles with symptoms. The talo-calcaneal adduction reached the same level in the patient and control groups regardless of symptoms. External support (ankle brace) increased the talar stability. The use of predetermined torque and constrained testing procedure did not add information compared with the manual test Twenty-five patients graded the result as excellent or good five years after lateral ligament reconstruction. Talar stability (decreased adduction and translation) was increased two years postoperatively and was improved or remained the same at five years without comprising the range of motion. Conclusion. In more than half the cases symptoms of CLI did not resolve spontaneously. Minor degenerative changes was found after twenty years, but not to a greater extent than in a control group. CLI was associated with proprioceptive insufficiency and talocrural but not subtalar instability. Increased ankle stability can be obtained by the use of an ankle brace and by an anatomical ligament reconstruction. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1994</p> / digitalisering@umu

Made available in DSpace on 2016-06-02T20:19:17Z (GMT). No. of bitstreams: 1 4135.pdf: 9658653 bytes, checksum: 6618eca6c2ceb9dc687d3ca8dfb2e67a (MD5) Previous issue date: 2012-02-24 / Financiadora de Estudos e Projetos / Alterações na mecânica do pé durante a fase de apoio da marcha podem afetar o alinhamento dinâmico do membro inferior e predispor à ocorrência de lesões no joelho e quadril. Acredita-se que o varismo do antepé (VA) seja uma das causas para a hiperpronação subtalar, e essa alteração de alinhamento vem sendo correlacionada com lesões nos membros inferiores. No entanto, as repercussões do VA nos movimentos de articulações proximais do membro inferior em atividades dinâmicas ainda não são conhecidas. Assim, esse estudo teve como objetivo comparar os padrões de movimento do joelho e quadril de adolescentes de ambos os sexos, com e sem VA, durante uma tarefa dinâmica. Foram recrutados 46 indivíduos sedentários e sadios divididos em 4 grupos: Grupo de homens com VA compensado (GHV, n=11), grupo de homens com antepé alinhado (GHA, n=11), grupo de mulheres com VA compensado (GMV, n=12), grupo de mulheres com antepé alinhado (GMA, n=12). A cinemática tridimensional foi avaliada utilizando-se o equipamento Flock of Birds® enquanto os voluntários realizavam uma tarefa de agachamento unipodal. A comparação inter-grupos foi feita utilizando-se testes de ANOVA two-way (Sexo x Grupo), tendo sido adotado um nível de significância de 5% em todas as análises. Como resultados, observou-se que o GMV apresentou menores valores de abdução (P=0,05) e rotação medial (P=0,03) do joelho quando comparado ao GMA, durante a realização da tarefa. Não foram observadas diferenças entre os grupos GHV e GHA (P>0,05). A partir desses resultados pode-se concluir que o VA apresenta influência sobre os padrões de movimento do membro inferior de mulheres jovens, resultando em menores valores de abdução e rotação medial do joelho durante uma tarefa de agachamento unipodal. É possível que esses padrões de movimento no GMV estejam relacionados a estratégias compensatórias adotadas pelos indivíduos para que o membro inferior não entre em um padrão de movimento potencialmente lesivo, envolvendo combinação de hiperpronação subtalar e abdução do joelho.

Background: Running has many health benefits and has therefore become a sport with an expanded popularity worldwide. With it comes an increased incidence of overuse injuries, and there is a constant debate whether the shoes a runner uses should be as supportive as possible or minimalistic in order to facilitate a more natural running pattern. Many running retail outlets use video analysis to find out whether the runner has excessive rearfoot eversion (if they overpronate) or not and prescribe running shoes accordingly. Purpose: The purpose of the present study was to investigate the effect of an exercise program on pronation/rearfoot eversion in female recreational runners and compare the results to running with a shoe with support under the midsole, a stability shoe. Method: Eight participants were recruited, and they were all recreational female endurance runners. On test day 1 a maximum voluntary isometric contraction (MVIC) of the ankle invertors was recorded. After that, the rearfoot inversion/ eversion angle was measured whilst running on a treadmill both in neutral and in stability shoes. The participants were divided in two groups using the every other method, and the intervention group (5 participants) went home with an exercise program to carry out over 6-8 weeks, and the control group (3 participants) did not. On test day 2 the same procedure followed. Due to the small sample size the current study is categorised as a pilot study. Results: There was no significant difference (p&gt;0.05) in maximum voluntary isometric contraction between the two test days, in both groups, and also no significant difference (p&gt;0.05) in rearfoot eversion in either of the groups and not when comparing the different types of shoes. Looking at individual results in the study group however there is an indication that rearfoot eversion decreased for more participants than did not, and it would therefore be of interest to look at this topic on a larger group. Conclusion: The results showed no significant difference in rearfoot eversion/ inversion after exercise therapy, however after analysing individual results it would be of interest to see this pilot study on a larger group. / Bakgrund: Löpning har många hälsofördelar och har därför blivit en sport med ökad popularitet över hela världen. Med det kommer en ökad förekomst av skador och det finns en ständig debatt om de skor som en löpare använder ska vara så uppbyggda som möjligt eller mer minimalistiska för att främja ett mer naturligt löpsteg. Många löparbutiker använder videoanalys för att ta reda på om löparen har en överdriven eversion i subtalarleden (om de hyperpronerar) eller inte och rekommenderar löparskor i enlighet med detta. Syfte: Syftet med den aktuella studien var att utreda effekten av ett träningsprogram på pronation/subtalar eversion hos kvinnliga distanslöpare, och att jämföra resultatet med en löparsko med extra stöd under fotvalvet. Metod: Åtta deltagare rekryterades till studien, och de var alla kvinnliga motionslöpare. På testdag 1 registrerades en maximal isometrisk kontraktion av fotledens invertorer. Därefter mättes vinkeln av inversion/eversion under löpning på en löpband både i neutrala och i stabilitetsskor. Deltagarna delades in i två grupper med hjälp av varannan-metoden och interventionsgruppen (5 deltagare) gick hem med ett träningsprogram att utföra över 6-8 veckor, och kontrollgruppen (3 deltagare) gjorde inget. På testdag 2 följde samma procedur. På grund av den lilla gruppstorleken kategoriseras den aktuella studien som en pilotstudie. Resultat: Det var ingen signifikant skillnad (p&gt; 0.05) av på den maximala isometriska kontraktionen mellan de två testdagarna, i någon av grupperna, och ingen signifikant skillnad (p&gt; 0.05) av inversion/eversion i någon av grupperna och inte heller när man jämförde de olika typerna av skor. Om man tittar på individuella resultat i studiegruppen finns det dock en indikation på att nivån av eversion minskade för fler deltagare än inte, och det skulle därför vara intressant att titta på detta ämnet i en större grupp. Konklusion: Resultaten visade inte någon signifikant skillnad i eversion/inversion i subtalarleden efter träningsterapi, men efter analysering av individuella resultat skulle det vara intressant att se denna pilotstudie i större grupp.

Tyrimo objektas: Normalios ir plokščios pėdos raumenų elektrinis aktyvumas. Tyrimo tikslas: Nustatyti ir palyginti pėdos raumenų elektrinį aktyvumą esant normaliai ir plokščiai pėdai. Tyrimo uždaviniai: 1. Nustatyti ir palyginti atitraukiamojo kojos nykščio, priekinio blauzdos ir ilgojo šeivinio raumenų elektrinį aktyvumą stovint ant dviejų ir ant vienos kojos atpalaiduotoje ir neutralioje pašokikaulinio sąnario padėtyje esant normaliai pėdai. 2. Nustatyti ir palyginti atitraukiamojo kojos nykščio, priekinio blauzdos ir ilgojo šeivinio raumenų elektrinį aktyvumą stovint ant dviejų ir ant vienos kojos atpalaiduotoje ir neutralioje pašokikaulinio sąnario padėtyje esant plokščiai pėdai. 3. Palyginti atitraukiamojo kojos nykščio, priekinio blauzdos ir ilgojo šeivinio raumenų elektrinį aktyvumą stovint ant dviejų ir vienos kojos atpalaiduotoje ir neutralioje pašokikaulinio sąnario padėtyje tarp normalios ir plokščios pėdos. Tyrimo problema: Pėdos raumenys yra svarbūs išlaikant vidinį išilginį pėdos skliautą. Tačiau nėra žinoma ar skiriasi pėdos skliautą išlaikančių raumenų aktyvumas esant normaliai ir plokščiai pėdai. Išvados: 1. Esant normaliai pėdai atitraukiamasis kojos nykščio raumuo aktyviausias stovint ant vienos kojos neutralioje pašokikaulinio sąnario padėtyje (p<0,05), ilgasis šeivinis raumuo – stovint ant vienos kojos atpalaidavus (p<0,05). Statistiškai reikšmingo priekinio blauzdos raumens elektrinio aktyvumo pokyčių nenustatyta. 2. Esant plokščiai pėdai... [toliau žr. visą tekstą] / Object of the research: electromyographic activity of the normal and flat foot muscles. The aim of the research: To evaluate and compare electromyographic activity of foot muscles in subjects with normal and flat foot. The tasks of the research: 1. To evaluate and compare electromyographic activity of abductor hallucis, tibialis anterior and peroneus longus musles standing on two or one leg in relaxed and subtalar neutral position in subjects with normal foot. 2. To evaluate and compare electromyographic activity of abductor hallucis, tibialis anterior and peroneus longus muscles standing on two or one leg in relaxed and subtalar neutral position in subjects with flat foot. 3. To compare electromyographic activity of abductor hallucis, tibialis anterior and peroneus longus muscles standing on two or one leg in relaxed and subtalar neutral position between subjects with normal and flat foot. Problem of the research: Intrinsic and extrinsic foot muscles are important supporting medial longitudinal arch. However, there is no research about foot muscle activity in subjects with different foot types. Conclusions: 1. In subjects with normal foot the greatest electromyographic activity of abductor hallucis was standing on one leg in neutral subtalar joint position (p<0,05), the greatest activity of peroneus longus – standing on one leg in relaxed subtalar joint position (p<0,05). There were no significant differences in electromyographic activity of tibialis anetrior. 2. In... [to full text]

L’Instabilité Chronique de la Cheville (ICC) est une possible complication fonctionnelle consécutive à une entorse collatérale latérale et est définie par une sensation de « giving way » décrite subjectivement, qui correspond au dérobement de la cheville pendant sa mise en charge. Afin de mieux caractériser l’ICC, il est important de pouvoir proposer des mesures objectives. Ce travail a pour objectif d’évaluer de manière globale, au cours de diverses tâches, les différents mécanismes impliqués dans l’ICC, et ce, en comparant la motricité de sujets asymptomatiques et de personnes souffrant de cette pathologie.Les résultats de ce travail mettent en évidence plusieurs mécanismes caractéristiques qui témoignent d’une augmentation du risque d’entorses et d’instabilités latérales. Ces mécanismes affectent le contrôle postural des personnes se plaignant d’une ICC et résultent d’une altération du système proprioceptif, utile dans la régulation des mouvements et des positions des différents segments, ainsi que du système musculaire, générateur de force et stabilisateur de la cheville. Des adaptations centrales illustrant une stratégie visant à protéger la cheville des contraintes éventuellement traumatiques sont également suggérées par les résultats.Les tests mis en place dans ce travail peuvent fournir aux thérapeutes des informations objectives sur l’ICC. L’efficacité de ces tests pour caractériser cette pathologie a été démontrée, mais ceux-ci pourraient également être utilisés comme diagnostic initial et final lors d’une prise en charge rééducative. Ces nouvelles informations pourront effectivement compléter celles concernant l’historique du patient et permettraient ainsi d’apporter une dimension objective à la caractérisation d’une pathologie initialement décrite subjectivement. / Chronic Ankle Instability (CAI) is a possible functional complication consecutive to a lateral ankle sprain and is defined by a feeling of ankle “giving way”, subjectively described, which corresponds to a flinch of this joint during its loading. In order to improve CAI characterization, it is important to submit objectives measures.The objective of this work is to globally assess the different mechanisms involved in CAI, during several functional tasks. A comparison between asymptomatic subjects and subjects with CAI is made about functional abilities.Results highlight several characteristic mechanisms that attest of an increase of ankle sprain and lateral instabilities risks. These mechanisms affect postural control of people complaining CAI, and result in an alteration of proprioceptive system, useful in movement and positioning regulation of body segments, and an alteration of muscular system, which generates force and stabilizes the ankle joint. Central adaptations illustrating a protective strategy against prospective traumatic movements are also suggested by the results.Tests used in this work can provide objective information about CAI to the therapists. Efficiency of these tests to characterize CAI is demonstrated, but they could also be used as an initial or final diagnostic during a rehabilitation program. Indeed, these new information can complete the patient historic and could adduce an objective regard to the characterization of a pathology initially described subjectively by the patient.

Title Atypical Pronation of the Sub-Talar Joint: Its Implications on the Lower Limb Background Atypical pronation of the sub-talar joint, or overpronation of the foot, as it is more commonly known, is a current subtopic in foot and lower limb-related biomechanical issues. Typical pronation is a tri-planar movement that involves eversion of the hindfoot, combined with abduction and dorsiflexion of the forefoot. Atypical pronation is recognized when this motion is excessive, and may be determined by the extent and duration to which this occurs according to the rhythmic timing during the gait pattern. It is a mechanical problem of the foot that primarily results from a subluxation or shift of the sub-talar joint and bones of the mid- and hind-foot. As a common finding in the general population, especially in those with flexible flat feet, atypical pronation may result chronically in a displacement of the bones and joints of the lower limb. Research has stated that excessive pronation of the ankle-foot complex may cause change in position of certain bones in the lower limb. This is believed to occur through an interaction between foot and pelvis through a kinetic chain mechanism. Furthermore, it has been stated that atypical pronation may affect weight transfer of the lower limb during gait that may...