Es un examen del aparato locomotor con especial incidencia en pies, piernas y pelvis. La exploración no debe consistir únicamente en una prueba (ej. Presiones del pie), sino que debe englobar una historia clínica completa,  un examen físico exhaustivo con el paciente tumbado, un análisis con el paciente de pie para determinar el reparto de las cargas y un examen de la marcha y/o la carrera.

¿Quién debe realizar la exploración biomecánica, qué nos diferencia?

Somos investigadores en el área de análisis de la marcha humana con amplia experiencia en biomecánica clínica.

En muchas ocasiones se realizan diagnósticos de la pisada por profesionales no sanitarios y basados únicamente en la información de una prueba (pronadores o supinadores). Por desgracia estos análisis no son tan sencillos, ya que existen infinitas combinaciones biomecánicas en función de la estructura de cada una de las articulaciones del paciente.

Tenemos pacientes en los que cada pie se comporta de modo distinto (uno pronador y otro supinador). Otros pacientes tienen un comportamiento distinto dependiendo de la fase de la pisada que analizamos. Otros pacientes se comportan en carrera de modo diferente (y en ocasiones contrario) al comportamiento en estática.

1)Historia clínica

En la misma obtenemos datos importantes sobre el desarrollo de la actividad, el proceso de la lesión, el pronóstico …

2)Exploración en descarga
  • Obtenemos los rangos articulares libres de cadera, rodilla, tobillo, subastragalina, mediotarsiana, radios, metatarsofalangicas …
  • Buscamos puntos de dolor relacionados con el problema y con problemas de mecánica.
  • Realizamos pruebas de mecánica generales (estabilidad, función, ejes mecánicos).
  • Realizamos mediciones clínicas de los miembros inferiores.

 

 

   
   
   
3)Exploración en carga estática

En carga estática comprobamos como estas estructuras se comportan ante el peso del individuo, influyen factores ligamentosos y musculares fundamentalmente. Realizamos pruebas como:

Alineacion general en estática. Como se comporta la pelvis (si hay una más alta que otra), la espalda (si existe escoliosis), las caderas y rodillas (están en ligera flexión o hiperextensión) y por supuesto los pies en cada una de sus articulaciones (tobillo, ASA, mediotarsiana …).

En la actualidad utilizamos un software de ultima generación para valorar la postura en los tres planos del espacio y dar una mayor solidez a nuestras mediciones. Se valora la postura y como esta se modifica con la introducción de diferentes elementos ortésicos.

Valoracion de la huella en el podoscopio, tipo de huella, como asume carga cada zona de la planta del pie…

Tambien realizamos en carga estática una podobarometría para valorar el apoyo global, los porcentajes de apoyo en cada pierna y cada zona del pie. Valoración del centro de presiones para con los datos anteriores detectar las compensaciones en la cadera y la espalda.

 

 
   
   

 

 

4)Exploración en carga dinámica

La exploración en carga dinámica es una de las más importantes, y para ello se debe realizar de la forma más natural posible. En nuestro centro tenemos una zona reservada en el suelo para este propósito, de modo que el paciente está caminando por el suelo y es grabado por una serie de cámaras en cada uno de los planos de movimiento del espacio.

También se realiza barometría (toma y análisis de presiones en dinámica) cuando camina ya que existe una plataforma oculta en el suelo.

5)Exploración de la carrera

En ocasiones con los datos anteriores no tenemos explicación mecánica de la sintomatología que refiere el paciente, y es cuando la respuesta suele estar en el gesto deportivo, para esto es importante contar con una cinta de correr o espacio suficiente para trotar un poco.

 

   
   
 

 

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