Disminución de la altura del arco longitudinal interno del pie y prevalencia de puntos gatillo miofasciales latentes en la extremidad inferior

Résumé

ABSTRACT Background The medial longitudinal arch (MLA) of the foot is responsible for shock absorptions and forces transmission. Changes in its height are related to several changes and pathologies. In fact, it is considered that a flat foot may facilitate the presence of myofascial trigger points. Aims The main aims of the present study were to find out about the correlation between the navicular drop test (NDT) and the Clarke angle (AC), the Staheli index (SI) and the Chippaux-Smirnak index (CSI) in subjects with normal and lower medial longitudinal arch; to evaluate the prevalence of latent trigger points (LTrPs) in non-injured subjects in different lower limb muscles; and to evaluate the prevalence of latent myofascial trigger points in several muscles of the lower limb in subjects with a lower MLA compared with controls with a normal MLA. Methods Four researches have been undertaken. Study 1 evaluated the correlation between the NDT and the CA, the SI and the CSI, as well as its reliability in a sample of 86 subjects. Study 2 evaluated the correlation between the NDT and the CA, the SI and the CSI and the Foot Posture Index-6 (FPI-6), and its reliability in a sample of 71 flat foot subjects. Study 3 evaluated the LTrPs prevalence in different lower limb muscles, as well as the reliability and prevalence of the diagnostic criteria in a sample of 206 non-injured subjects. Study 4 compared the LTrPs prevalence between lower MLA (n=82) and normal MLA subjects (n=82), as well as the reliability and prevalence of the diagnostic criteria. Results Studies 1 and 2 showed strong correlations between the NDT and the CA, the SI and the CSI. The stronger correlation was found in the Study 2 (r=|0,722-0,788|) versus the Study 1 (r=|0,614-0,643|). The reliability of the test was very high in both studies. A strong correlation was also found between the NDT and the FPI-6 (r=0,800) in Study 2. Study 3 showed a 77,670 % of the studied sample with at least one of the LTrPs (mean=7,484±7,648), being the gastrocnemius LTrPs the most prevalent. The most prevalent and reliable diagnosis criteria were the presence of a taut band and a spot tender. Study 4 showed that MLA group presented significantly (p<0,05) more LTrPs (mean=4,463+-4,077) than the control group (mean=3,317+-3,243). The prevalence of LTrPs (p<0,05) in flexor digitorum longus, tibialis anterior and vastus medialis in the MLA group was also higher versus the control group. Conclusions The NDT showed a strong correlation with the NDT and the CA, the SI and the CSI both in lower and normal MLA subjects, also showing a very good reliability. The LTrPs of the lower limb muscles are more prevalent in non-injured subjects. MLA subjects showed a greater prevalence of LTrPs versus controls in the lower limb. The realiability for the LTrPs diagnostic is very good, being the presence of taut band and the tender spot the most reliable and prevalent criteria.