Resumo em Inglês:

BACKGROUND: Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus, and pharmacological therapies are ineffective in many patients. Therefore, other treatment modalities should be considered, including electrical stimulation and electromagnetic fields. OBJECTIVES: The research objective was to evaluate the effect of treatment with electrical stimulation and electromagnetic fields on pain and sensitivity in patients with painful diabetic neuropathy compared with placebo or another intervention. METHOD: We searched the following electronic databases (from inception to April 2012): MEDLINE (accessed by PubMed), LILACS, Physiotherapy Evidence Database (PEDro), EMBASE and Cochrane CENTRAL. We included randomized trials that compared electrical stimulation or electromagnetic fields with control groups in which the objective was to assess pain and sensitivity in patients with PDN. Two reviewers independently extracted the data. A random-effects model was used for the main analysis. RESULTS: The search retrieved 1336 articles, of which 12 studies were included. Reductions in the mean pain score were significantly greater in the TENS (transcutaneous electrical nerve stimulation) group than in the placebo group [-0.44 (95% CI: -0.79 to -0.09; I2: 0%)]. There was no improvement in pain relief when electromagnetic fields were compared with the control group [-0.69 (95% CI: -1.86 to 0.48; I2: 63%)]. CONCLUSIONS: We found that TENS improved pain relief in patients with diabetic neuropathy, while no such improvement was observed with the use of electromagnetic field treatment. Due to the methodological differences between the studies, a meta-analysis for the outcome of sensitivity could not be performed.

Resumo em Português:

CONTEXTUALIZAÇÃO: Os recém-nascidos pré-termos possuem maior complacência torácica, oferecendo menor estabilidade às diferentes forças de distorção impostas à parede torácica, o que leva à instabilidade da caixa torácica. A posição corporal adequada pode diminuir essa instabilidade, facilitando o trabalho respiratório. OBJETIVO: Verificar a resposta da saturação de oxigênio em recém-nascido pré-termo com estabilização do gradil costal com faixa elástica em dois posicionamentos corporais. MÉTODO: Estudo com delineamento de ensaio clínico prospectivo, randomizado e tipo crossover. Foram avaliados 16 recém-nascidos com idade gestacional de 31 a 35 semanas (média 32,8 semanas) e sem oxigênio suplementar, em instituição de nível terciário. O grupo foi submetido à sequência de decúbitos posturais ventral e dorsal, alterando-os com e sem estabilização do tórax por meio da faixa elástica. Os indicadores biológicos colhidos foram frequência respiratória, frequência cardíaca e saturação de oxigênio. Os dados foram coletados de 10 em 10 minutos, totalizando 60 minutos com sete coletas. O critério de interrupção da coleta se deu pela saturação menor que 90%. RESULTADOS: O grupo estudado apresentou média de idade gestacional de 32,8±1,5 semanas e peso ao nascimento de 1.789±255g. Encontramos melhores valores das variáveis na supinação com faixa quando comparada com supinação sem faixa. Os valores médios menores da frequência respiratória e da frequência cardíaca foram alcançados no decúbito com faixa, já a saturação de oxigênio respondeu com maior valor CONCLUSÃO: O uso da faixa elástica torácica pode favorecer os melhores valores dos indicadores respiratórios, como a saturação de oxigênio.

Resumo em Inglês:

BACKGROUND: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. OBJECTIVE: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. METHOD: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. RESULTS: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. CONCLUSION: The use of an elastic chest band improves respiratory indicators such as oxygen saturation.

Resumo em Inglês:

BACKGROUND: The isokinetic dynamometer has been considered the gold-standard measurement of muscle performance. However, the reliability for the passive mode in children has not been reported to date. OBJECTIVES: The purpose was to evaluate the reliability of the isokinetic dynamometer in passive mode in children. METHOD: Twenty-one healthy children (ten girls, eleven boys), aged 5 to 12 years (age: 8.5±2.2 years), were evaluated using an isokinetic dynamometer. Each participant was tested twice with a one-week interval and performed five consecutive cycles of knee extension and flexion. The test was performed at 60º/s in the concentric passive mode and the children performed maximal contractions. The measured variables were peak torque, average peak torque, total work, and average power, time to peak torque and angle of peak torque for dominant and non-dominant lower limbs. Reliabilities were determined using intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM and SEM%), and coefficient of variation (CV). RESULTS: We found good reliability in both lower limbs for peak torque, average peak torque, total work and average power of knee flexors and extensors, with ICC3,1 values greater than 0.80; SEM ranging from 6.7 to 79.2; SEM% ranging from 10.4% to 16.8%; CV lower than 15%. Bland-Altman analysis showed that the bias was low than 10% and limits of agreement (LOAs) ranging from 33.9% to 59.2%, and -28.8% and -52.8%, showing that measures tended to disagree. However, time to peak torque (ICC3,1<0.68; SEM > 0.34; SEM%>37.4%; CV>41.7%; bias >24.0%; LOA>101.0%) and angle of peak torque (ICC3,1<0.76; SEM>9.3; SEM%>27.6%; CV>15.3%; bias>11.0%; LOA>61.0%) were not reliable. CONCLUSIONS: The findings indicate that isokinetic evaluation in passive mode for knee extensors and flexors of dominant and non-dominant lower limbs of children without disabilities was reliable for peak torque, average peak torque, work, and power. However, average time to peak torque and angle of peak torque were not reliable.

Resumo em Português:

CONTEXTUALIZAÇÃO: A disfunção temporomandibular (DTM) é considerada multifatorial e se define como um grupo de condições dolorosas que se caracteriza por apresentar alterações funcionais do sistema estomatognático que podem estar relacionadas à perturbação ou a uma contribuição em relação ao controle da postura. OBJETIVO: Verificar o efeito imediato da mobilização mandibular inespecífica (MMI) sobre o controle postural em indivíduos com e sem diagnóstico de DTM. MÉTODO: Realizou-se um ensaio clinico controlado, randomizado, simples cego, com 50 indivíduos de ambos os gêneros, alocados em dois grupos: grupo DTM e grupo controle, diagnosticados segundo o RDC/TMD. Realizou-se uma avaliação estabilométrica com os indivíduos sobre uma plataforma de força, em duas condições visuais: olhos abertos e fechados. As variáveis referentes ao centro de oscilação do corpo (COP) analisadas foram: deslocamento, amplitude, velocidade de deslocamentos ântero-posterior (AP) e médio-lateral (ML) e área de oscilação do centro de pressão (COP). Os valores médios de cada variável foram comparados, considerando o nível de significância aceito de p<0,05. RESULTADOS: Foi possível verificar diferença significativa entre as médias pré e pós-MMI nos indivíduos diagnosticados com DTM na condição visual olhos fechados. Houve diferença estatisticamente significante na área de oscilação do COP (p<0,03) no deslocamento médio-lateral COPML (p<0,006), na amplitude médio-lateral COPML (p<0,01) e na variável velocidade nas direções ântero-posterior, COPAP (p<0,03) e médio-lateral COPML (p<0,03) simultaneamente. CONCLUSÃO: Os resultados deste estudo indicam que a mobilização inespecífica da articulação temporomandibular contribui para a melhora imediata do controle postural em indivíduos com DTM.

Resumo em Inglês:

BACKGROUND: Temporomandibular disorder (TMD) is considered multifactorial and is defined as a group of pain conditions characterized by functional stomatognathic system alterations, which may be affected by or related disrupted postural control. OBJECTIVE: Assess the immediate effect of nonspecific mandibular mobilization (NMM) on the postural control of subjects diagnosed or not with TMD. METHOD: A simple-blind, randomized, controlled clinical trial was performed involving 50 subjects of both genders assigned to two groups: the TMD group and the control group. TMD was diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A stabilometric assessment was performed by testing subjects in a quiet stance on a dual force platform under two visual conditions (eyes open and eyes closed). The Center of Pressure (CoP)-related variables analyzed were displacement, amplitude, speed of anterior-posterior (AP) and medial-lateral (ML) displacements and CoP sway area. The mean values of each variable were compared, considering the accepted significance value of p<0.05. RESULTS: A significant difference between the pre- and post-NMM means could be observed in subjects diagnosed with TMD under the closed-eyes visual condition. There was a statistically significant difference in the CoP sway area (p<0.03) in the ML displacement COPML (p<0.006) and ML amplitude COPML (p<0.01) and in the variable speed in the AP COPAP (p<0.03) and ML COPML (p<0.03) directions, simultaneously. CONCLUSION: These results indicate that nonspecific temporomandibular joint mobilization contributes to the immediate improvement of postural control in patients with TMD.

Resumo em Português:

CONTEXTUALIZAÇÃO: A avaliação diafragmática é fundamental na prática clínica, e não existem estudos que verificam a reprodutibilidade intra e interobservadores do método radiográfico com objetivo de avaliar a mobilidade diafragmática. OBJETIVO: Analisar a confiabilidade da medida radiográfica como método de avaliação da mobilidade dos hemidiafragmas direito e esquerdo. MÉTODO: Foram avaliados 42 pacientes no pré-operatório de colecistectomia. Os parâmetros utilizados foram: exame físico, prova de função pulmonar e avaliação radiográfica. A medida da mobilidade de cada hemidiafragma foi determinada, aleatoriamente, por dois fisioterapeutas em dois momentos. A reprodutibilidade intra e interobservadores das medidas foi determinada pelo Coeficiente de Correlação Intraclasse (ICC[2,1]) e pelo intervalo de confiança (IC) de 95%. A disposição gráfica de Bland & Altman também foi utilizada. O nível de significância adotado foi de 5%. RESULTADOS: Na análise da reprodutibilidade intraobservador, o ICC[2,1] indicou "correlação muito alta" para o observador A na avaliação radiográfica dos hemidiafragmas direito e esquerdo (ICC[2,1] = 0,99, p<0,001 e ICC[2,1] = 0,97 p<0,001, respectivamente) e também para o observador B (ICC[2,1] = 0,99, p<0,001 e ICC[2,1] = 0,99 p<0,001, respectivamente). Na análise da reprodutibilidade interobservadores, o ICC[2,1] indicou "correlação muito alta" para a 1ª e 2ª avaliações radiográficas dos hemidiafragmas direito (ICC[2,1] = 0,98 e ICC[2,1] = 0,99, respectivamente, p<0,001) e esquerdo (ICC[2,1] = 0,98 e ICC[2,1] = 0,99, respectivamente, p<0,001). CONCLUSÃO: Os exames intra e interobservadores da medida da mobilidade dos hemidiafragmas direito e esquerdo, por meio do método radiográfico, apresentaram alta confiabilidade.

Resumo em Inglês:

BACKGROUND: Diaphragmatic evaluation is crucial in clinical practice, and no studies have reported the intra- and interobserver reproducibilities of the radiographic method to evaluate diaphragmatic mobility. OBJECTIVE: To analyze the reliability of radiographic measurement as a method for assessing the mobility of the left and right hemidiaphragms. METHOD: Forty-two patients, who were waiting for cholecystectomy surgery, were evaluated relative to the following parameters: physical examination, pulmonary function and radiographic evaluation. The measure of mobility of each hemidiaphragm was randomly determined by two physical therapists at two different times. The intra- and interobserver reproducibilities of the measurements were determined by the intraclass correlation coefficient (ICC[2,1]) and the 95% confidence interval (CI). The Bland-Altman plot was also used. The level of significance was 5%. RESULTS: In the analysis of intra-observer reproducibility in radiographic evaluations of the left and right hemidiaphragms, ICC[2,1] indicated a "very high correlation" for both observer A (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.97, p <0.001, respectively) and observer B (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.99 p <0.001, respectively). In the analysis of interobserver reproducibility, the ICC[2,1] indicated a "very high correlation" for the 1st and 2nd radiographic evaluations of the right hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0,99, respectively, p <0.001) and left hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0.99, respectively, p <0.001). CONCLUSION: The intra and interobserver tests of the radiographic measure of mobility of the left and right hemidiaphragms showed high reliability.

Resumo em Português:

CONTEXTUALIZAÇÃO: Estudos demonstraram que a pré-ativação de músculos antagonistas pode aumentar o desempenho neuromuscular agonista. Além disso, estudos sugerem que programas de exercício resistido (ER) de curta duração podem ser úteis para aumentar a força muscular e o desempenho. OBJETIVOS: Avaliar os efeitos de três sessões de ER por meio do método de ações recíprocas no desempenho muscular de homens sadios e comparar com um grupo de ER tradicional. MÉTODO: Trinta e três homens (21,1 ± 2,3 anos) foram randomicamente alocados em três grupos: Recíproco (REC: uma repetição de flexão do joelho imediatamente seguida por uma de extensão do joelho); Tradicional (TRA: exercício concêntrico de extensão do joelho) e Controle (CON: não realizaram exercício). O REC e o TRA realizaram quatro séries de dez repetições a 60º.s-1 com um minuto entre séries. As avaliações pré e pós-ER foram caracterizadas por duas séries de quatro repetições máximas a 60º.s-1 e 180º.s-1. Utilizou-se ANOVA 3x2, com post-hoc de Tukey para verificar diferenças no pico de torque (PT), taxa de desenvolvimento de aceleração (TDA) e tempo para atingir o PT (TEMPtorque). RESULTADOS: Houve um aumento do PT para o REC e o TRA (p<0.05) a 60º.s-1 e apenas para o REC a 180º.s-1 (p<0,05). Houve diminuição da TDA para o REC e o TRA (p<0,05) e, apenas no REC, o TEMPtorque apresentou quedas significantes. A análise intergrupos mostrou que o REC foi mais efetivo que o TRA para os ganhos de PT em ambas as velocidades (p<0,05). CONCLUSÃO: Sugere-se que a modalidade recíproca seja vantajosa para a prática de profissionais envolvidos no processo de reabilitação neuromuscular.

Resumo em Inglês:

BACKGROUND: Previous studies have shown that preloading an antagonist muscle may increase the acute agonist neuromuscular performance. In addition, studies have suggested that very short-term resistance exercise (RE) programs may also be useful to increase strength and muscular performance. OBJECTIVES: To evaluate the effects of three days of RE using a reciprocal action method on the muscular performance of healthy men and to compare these effects with those of a traditional RE group. METHOD: Thirty-three men (21.1 ± 2.3 years) were randomly assigned to one of three groups: 1) reciprocal (REC; knee flexion immediately followed by a knee extension exercise); 2) traditional (TRA; non-preload; a concentric knee extension exercise); and 3) control (CON; no exercise). The REC and TRA subjects performed four sets of 10 repetitions at 60º/s with one minute of rest. The pre- and post-RE tests included two sets of four maximal concentric repetitions at 60º/s and 180º/s. A 3x2 ANOVA with Tukey post-hoc was used to analyze the differences in peak torque (PT), rating of acceleration development (RAD) and time to peak torque (TIMEtorque). RESULTS: A significant PT increase was found for REC and TRA (p<0.05) at 60º/s and for REC at 180º/s (p<0.05). There was a decrease in the RAD for REC and TRA (p<0.05), and TIMEtorque showed a significant decrease for REC. The inter-group analysis revealed that REC is more effective than TRA for PT gains at both velocities (p<0.05). CONCLUSION: It is recommended that REC offers benefits for the clinical practice of professionals involved in neuromuscular rehabilitation.

Resumo em Português:

CONTEXTUALIZAÇÃO: O rearranjo no modo de viver, acompanhado de fatores inerentes ao ambiente familiar e social do cuidador, além de aspectos físicos e mentais, irão se associar e serão fundamentais para a boa qualidade de vida (QV) da pessoa que cuida. OBJETIVO: Avaliar a QV e os fatores associados em cuidadores de idosos com comprometimento da capacidade funcional. MÉTODO: Trata-se de um estudo seccional que analisou dados de uma pesquisa de intervenção de base domiciliar. O local de estudo foram as residências dos idosos cadastrados em Unidades de Saúde da Família, no município de Jequié, BA, Brasil. A amostra foi constituída por 40 cuidadores de idosos com comprometimento da capacidade funcional. O instrumento foi constituído de informações sociodemográficas, condições de saúde, Inventário de Percepção do Suporte Familiar, Escala de Satisfação do Suporte Social e o WHOQOL-BREF. Os dados foram analisados no Programa Estatístico SPSS, versão 15.0, sendo realizada análise descritiva e aplicação do qui-quadrado de Pearson, com um nível de significância de 5%. RESULTADOS: Verificou-se associação entre o Domínio Físico do WHOQOL-BREF e as variáveis do estudo: presença de sequelas (p-valor=0,006), afetividade-consistência (p-valor=0,009) e ser cuidador principal (p-valor=0,002). O Domínio Psicológico apresentou associação com a presença de sequelas (p-valor=0,006) e o Domínio Meio Ambiente, com presença de doenças (p-valor<0,001) e ser o cuidador principal (p-valor=0,033) e o Domínio Relações Sociais com presença de doença (p-valor<0,001). CONCLUSÃO: Observou-se que presença de sequelas, doenças, fator afetividade-consistência e ser cuidador principal estiveram relacionados à diminuição de aspectos da QV.

Resumo em Inglês:

BACKGROUND: Lifestyle changes, factors inherent to the caregiver's family and social environment, and physical and mental aspects determine a caregiver's quality of life (QOL). OBJECTIVE: To evaluate the QOL and associated factors for caregivers of functionally impaired elderly people. METHOD: This was a cross-sectional study that analyzed data from a home-based care survey. The study sites were the homes of elderly people enrolled in Family Health Centers (Unidades de Saúde da Família) in Jequié, Bahia, Brazil. The sample consisted of 40 caregivers of functionally impaired elderly people. The instrument consisted of demographic data, health status, the Perceived Family Support Inventory, the Social Support Satisfaction Scale, and the World Health Organization Quality of Life Assessment (WHOQOL-BREF). The data were analyzed using a descriptive analysis and the chi-squared test at a 5% significance level, performed in SPSS version 15.0. RESULTS: An association was found between the WHOQOL-BREF physical domain and the presence of sequelae (p=0.006), affective-cognitive inconsistency (p=0.009), and being the primary caregiver (p=0.002). The psychological domain showed an association with the presence of sequelae (p=0.006), the environment domain with the presence of diseases (p<0.001) and being the primary caregiver (p=0.033), and the social relations domain with the presence of diseases (p<0.001). CONCLUSION: The presence of sequelae or diseases, affective-cognitive inconsistency, and being the primary caregiver were related to decreases in their QOL.

Resumo em Português:

OBJETIVOS: Verificar se há correlação entre a cinética-on do consumo de oxigênio (VO2) e da frequência cardíaca (FC) no teste de carga constante em cicloergômetro (TCC) com o índice BODE e suas variáveis isoladas em pacientes com doença pulmonar obstrutiva crônica (DPOC). MÉTODO: Foram avaliados 14 homens com DPOC de obstrução moderada a muito grave, entre 55 e 78 anos, submetidos em dias alternados à espirometria, teste de caminhada de seis minutos (TC6), teste incremental em cicloergômetro (TI) e TCC. Foram coletados os gases expirados, e a cinética-on do VO2 e da FC foi analisada. O índice BODE foi calculado. RESULTADOS: Observou-se que a tau (τ) e o tempo de resposta média (TRM) do VO2 foram significativamente maiores que a τ e o TRM da FC. Observou-se correlações moderadas e fortes entre a τ e o TRM do VO2 e da FC com o índice BODE (r=0,75 e r=0,78; r=0,62 e r=0,63, respectivamente) e correlações entre a τ e o TRM do VO2 com o volume expiratório forçado no primeiro segundo (VEF1) (r=-0,60; r=-0,53), a distância percorrida no TC6 (DP-TC6) (r=-0,61; r=-0,44) e a DP-TC6 %prevista (r=-0,62; r=-0,46). A τ e o TRM da FC correlacionaram-se com a DP-TC6 (r=-0,59; r=-0,58) e a DP-TC6 %prevista (r=-0,62; r=-0,62). CONCLUSÃO: A lentificação da cinética-on do VO2 e principalmente da FC em cicloergômetro pode ser um marcador importante de gravidade da doença. Adicionalmente, a limitação ao fluxo aéreo e a reduzida capacidade ao exercício estão associadas à lentificação da cinética-on do VO2 e da FC nesses pacientes.

Resumo em Inglês:

OBJECTIVES: To assess whether there is a correlation between oxygen uptake (VO2) and heart rate (HR) on-kinetics in the constant-load cycle-ergometer test (CLT) and the BODE index and its isolated variables in patients with chronic obstructive pulmonary disease (COPD). METHOD: Fourteen male patients between 55 and 78 years of age with moderate to severe COPD were evaluated. Each patient underwent spirometry, the six-minute walk test (6MWT), the cycle-ergometer incremental test (IT) and CLT on alternate days. The exhaled gases were collected, and the VO2 and HR on-kinetics were analyzed. The BODE index was calculated. RESULTS: It was noted that the VO2 tau (τ) and mean response time (MRT) were significantly higher than HR τ and MRT. Moderate and strong correlations between τ and MRT of the VO2 and HR and the BODE index was noted (r=0.75 and r=0.78; r=0.62 and r=0.63, respectively), and there were correlations between the VO2 τ and MRT and the forced expiratory volume in one second (FEV1) (r=-0.60; r=-0.53) and the distance traveled at 6MWT (DT-6MWT) (r=-0.61; r=-0.44) and DT-6MWT % predicted (r=-0.62; r=-0.46). The HR τ and MRT were correlated with DT-6MWT (r=-0.59; r=-0.58) and DT-6MWT % predicted (r=-0.62; r=-0.62). CONCLUSION: The slowing of cycle-ergometer VO2, and especially of HR on-kinetics, may be key markers of disease severity. Furthermore, airflow obstruction and reduced exercise capacity are associated with the slowing of patients' VO2 and HR on-kinetics.

Resumo em Português:

CONTEXTUALIZAÇÃO: A aquisição da marcha é suportada por mudanças no sistema neuromusculoesquelético da criança. a literatura aponta que modificações nas dimensões das estruturas corporais resultantes do crescimento da criança explicam, em parte, o aprimoramento da marcha no primeiro ano de vida. OBJETIVOS: Avaliar se mudanças na massa corporal e comprimento da perna modulam o efeito da prática da marcha independente nos seguintes parâmetros da marcha: velocidade e comprimento da passada. MÉTODO: Trinta e dois lactentes com desenvolvimento normal foram acompanhados mensalmente a partir da aquisição da marcha independente até seis meses pós-aquisição. Avaliações longitudinais incluíram mensurações da massa corporal e do comprimento da perna de cada criança. As variáveis temporoespaciais da marcha (velocidade e comprimento da passada) foram documentadas utilizando-se o sistema Qualisys Pro-Reflex(r) . Os dados foram analisados por modelos de regressão multinível, com nível de significância α=0,05. RESULTADOS: Encontrou-se um efeito do tempo de prática nas medidas de velocidade (p<0,0001) e comprimento da passada (p<0,0001). a mudança no comprimento da perna teve um efeito marginal na taxa de mudança da velocidade de marcha: crianças cujo crescimento da perna foi mais acelerado apresentaram uma taxa de mudança de velocidade maior (p=0,07). Nenhum outro efeito dos parâmetros antropométricos foi observado. CONCLUSÕES: Os resultados sugerem que o tempo de prática promove o aprimoramento do padrão de marcha de lactentes no primeiro ano de vida. Por sua vez, os efeitos do comprimento da perna e da massa corporal de lactentes no tempo permanecem indefinidos.

Resumo em Inglês:

BACKGROUND: Gait acquisition is supported by changes in the neuromusculoskeletal system of the child. Changes in the dimensions of the body structures resulting from the growth of the child partly explain gait improvement in the first year of life. OBJECTIVES: To evaluate whether changes in body mass and leg length modulate the effect of independent gait practice (experience) on gait speed and stride length. METHOD: Thirty-two infants with normal development were monitored monthly from the acquisition of independent gait until six months post-acquisition. Longitudinal evaluations included measurements of the body mass and leg length of each child. Temporospatial variables of gait (speed and stride length) were documented using the Qualisys Pro-reflex(r) system. The data were analyzed using multilevel regression models, with a significance level of α=0.05. RESULTS: An effect of the practice time on speed (p<0.0001) and stride length (p<0.0001) was observed. The change in leg length had a marginal effect on the rate of gait speed change: children whose leg growth was faster showed a higher rate of speed change (p=0.07). No other effects of anthropometric parameters were observed. CONCLUSIONS: The results suggest that the practice time promotes the improvement of the gait pattern of infants in the first year of life. However, the effects of the leg length and body weight of infants on the benefit of practice time remain undefined.

Resumo em Inglês:

BACKGROUND: The Activities-specific Balance Confidence (ABC) scale was developed to quantify the self-perceived level of confidence in performing specific activities without losing balance or becoming unsteady. The ABC scale has been adopted in clinical practice and in research, although cross-cultural differences may impose difficulties in its use. OBJECTIVE: To translate, cross-culturally adapt and verify the intra- and inter-rater reliability of the Brazilian-Portuguese version of the ABC scale and describe the self-perceived balance confidence of elderly Brazilian people. METHOD: The ABC scale was translated and culturally adapted. To verify the intra- and inter-rater reliability, 40 elderly individuals with ages ranging from 60 to 88 years were interviewed. The scale was administered by two raters on the same day and readministered after seven days by rater 1. To test the reliability, we used the intraclass correlation coefficient (ICC). RESULTS: Six items from the ABC scale were considered culturally, semantically or regionally inappropriate and were modified. The intra-rater reproducibility was excellent (ICC=0.94), and the inter-rater reproducibility was very good (ICC=0.80). The self-perception of balance in specific activities of the elderly was considered very good, with an average of 81.7 and scores ranging from 61.2 to 96.7. CONCLUSION: The ABC scale was translated and culturally adapted for the Brazilian population and presents good intra- and inter-rater reliability. The self-perceived balance confidence in elderly Brazilian people evaluated with the ABC scale is moderate.

Resumo em Inglês:

BACKGROUND: Patients with idiopathic scoliosis are exposed to approximately 25 radiographic examinations of their spine throughout the clinical follow-up using the Cobb angle. Several non-invasive and radiation-free methods have been proposed to measure scoliotic deformities, including the scoliometer. OBJECTIVES: To measure the intra- and interrater reliability of the scoliometer measurements, to assess the correlation of the values obtained by the scoliometer measurements with the Cobb angles obtained by radiography, and to assess the sensitivity and specificity of the scoliometer measurements for the different diagnostic criteria for the referral of idiopathic scoliosis. METHOD: Sixty-four patients were selected for the study: half with idiopathic scoliosis and half without. The 17 levels of the spine of each volunteer were measured with a scoliometer in the forward bending position. The measurements were performed three times on 42 volunteers by two different raters to obtain data for calculating the reliability values. Anteroposterior radiographs were taken to determine the Cobb angles, which were then compared with the highest trunk rotation value. Sensitivity and specificity were evaluated using radiograph criteria for referral: a Cobb angle of 10º and axial trunk rotation values between 5º and 10º. RESULTS: Excellent intrarater reliability values and very good interrater reliability values were obtained. The correlation between the scoliometer measurements and radiograph analyses was considered good (r=0.7, p<0.05). The highest sensitivity value was for a trunk rotation of 5º at 87%. CONCLUSIONS: The scoliometer measurements showed a good correlation with the radiographic measurements.

Resumo em Inglês:

BACKGROUND: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. OBJECTIVES: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. METHOD: Forty-nine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22) and Painful Group (n=27). The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation), isometric shoulder strength (internal and external rotation) and posterior shoulder tightness by blind evaluators. RESULTS: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05). The intragroup analysis (dominant versus non-dominant) in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05). CONCLUSIONS: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM), external rotation gain (ROM) and deficits in external rotation strength than the tennis players without pain.