A fisioterapia na autogestão da dor crónica

Comunicação apresentada nas Jornadas da Fisioterapia e Doença Crónica, Beja, 201

Individual patient responder analysis of the effectiveness of a pain neuroscience education programme in chronic low back pain

Trabalho apresentado na IFOMPT Conference, 4 a 8 de julho de 2016, Glasgow, Escóci

Arts, literature and reflective writing as educational stratagies to facilitate empathy and reflexive skills among physiotherapy students

Comunicação apresentada no 3rd European Congress on Physiotherapy Education, Viena, 201

Thrombotic events and COVID-19 vaccines

COVID-19 vaccines are considered promising agents in the control of the pandemic. Although their safety was assessed in randomised clinical trials, severe adverse events (AEs) have been reported after large-scale administration. This study aims to evaluate thromboembolic AEs reported after vaccination in a real-world context and how they led to the interruption of vaccination campaigns. We also review the benefits and risks of the vaccines approved in the European Union and provide recommendations. A review of the literature was performed using Medline/PubMed electronic database as well as institutional and pharmacovigilance official reports. Our findings show that vaccine-induced prothrombotic immune thrombocytopenia has been suggested as a very rare AE associated with viral vector vaccines. Unusual thrombotic events combined with moderate-to-severe thrombocytopenia were reported mainly in women under 60 years of age. As safety signals emerged, Vaxzevria and Janssen´s COVID-19 vaccine campaigns have been paused while investigations proceed. On the other hand, the number of deep vein thrombosis and pulmonary embolism reports have not increased. Post-marketing surveillance indicated that mRNA vaccines are safe and should continue to be used. The thrombotic events report rate is not increased in people over 60 years. As they are at greater risk for COVID-19 complications and death, no vaccine restrictions are recommended in this group. Risk factors for vaccine-induced prothrombotic immune thrombocytopenia should be established so that evidence-based decisions can be made. Systematic monitoring of COVID-19 vaccine safety is essential to ensure that the benefits of vaccination outweigh the risks.All authors had full access to the complete data in the study and accepted the responsibility to submit it for publication. AA holds a PhD Grant (Ref. 2020. 09390.BD), co-funded by the Fundação para a Ciência e a Tecnologia, Lisbon, Portugal, and the Fundo Social Europeu Programme

COVID-19 vaccines effectiveness against symptomatic disease and severe outcomes, 2021-2022: a test-negative case-control study

Objectives: This study evaluated the effectiveness of COVID-19 vaccines in preventing symptomatic and severe disease.Study design: This was an observational test-negative case-control study.Methods: Study participants were adults with at least one symptom included in the World Health Or-ganization COVID-19 definition who sought health care in a public emergency department between 1 November 2021 and 2 March 2022 (corresponding with the fifth pandemic wave in Portugal dominated by the Omicron variant). This study used multivariable logistic regression models to estimate and compare the odds ratio of vaccination between test-positive cases and test-negative controls to calculate the absolute and relative vaccine effectiveness.Results: The study included 1059 individuals (522 cases and 537 controls) with a median age of 56 years and 58% were women. Compared with the effectiveness of the primary vaccination scheme that had been completed >= 180 days earlier, the relative effectiveness against symptomatic infection of a booster administered between 14 and 132 days earlier was 71% (95% confidence interval [CI]: 57%, 81%; P = 180 days.Conclusions: Despite the known immunological evasion characteristics of the Omicron variant, results from this study show that vaccine effectiveness increases after booster administration. COVID-19 vaccine effectiveness decreases to less than 50% between 3 and 6 months after completion of the primary cycle; therefore, this would be an appropriate time to administer a booster to restore immunity.(c) 2023 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Ana Aguiar holds a PhD grant (Reference: 2020.09390.BD) , co-funded by the Fundacao para a Ciencia e a Tecnologia (FCT) and the Fundo Social Europeu (FSE) Program

Clinical course of physiotherapy treatment response in patients with chronic low back pain- a prospective cohort study with survival analysis

Trabalho apresentado 10th Congress of European Pain Federation (EFIC), 6-9 setembro de 2017, Copenhaga, DinamarcaN/

Combining exercise with education based on transformative learning principles in fibromyalgia patients: a case series

Proceeding de trabalho apresentado no 7th World, 7 a 10 de maio, Congress of the World Institute of Pain, Maastricht, Holand

The Role of Pain and Disability Changes After Physiotherapy Treatment on Global Perception of Improvement in Patients with Chronic Low Back Pain

Background: The effectiveness of physiotherapy in patients with chronic low back pain is usually measured through changes in pain and disability domains. However, recent research has suggested that these two domains are not sufficient to capture all the physiotherapy benefits when patients' perspective is considered. Objective: The aim of this study was to investigate the role of pain and disability changes in explaining the global perception of improvement in patients with chronic low back pain undergoing physiotherapy. Design: Prospective cohort study. Methods: The study was conducted on183 patients who were referred to physiotherapy treatment due to low back pain lasting more than 12 weeks. Sociodemographic and clinical characteristics were measured at baseline, together with pain intensity and disability. Eight (post-intervention) and twelve weeks later, global perception of improvement was measured together with pain and disability. The Pearson correlation coefficient and linear regression models were used for analyses. Results: Of the 183 participants included, 144 completed the 12-weeks follow-up. Significant and moderate correlation was found between pain and disability changes and the global perception of improvement after intervention and at the 12-weeks follow-up. Pain and disability changes explained 20.7%-36.3% of the variance in the global perception of improvement. Conclusions: Pain and disability changes are related and contributed to explaining a partial proportion of variance in the global perception of improvement. The findings suggest that these domains are not sufficient to explain and measure all of the benefits of physiotherapy when patients' global perception of improvement is considered.info:eu-repo/semantics/publishedVersio

Responsiveness and Interpretability of the Portuguese Version of the Quebec Back Pain Disability Scale in Patients With Chronic Low Back Pain

Improving functional capacity is a common goal when providing physiotherapy treatment to patients with chronic low back pain (CLBP). In a clinical setting, clinicians and researchers are often interested in measuring change in a patient’s condition as a result of an intervention or to distinguish individual differences in response to treatment. To address change accurately in health-related outcomes, such as functional disability, clinicians need measurement tools that show responsiveness and are able to detect minimal changes in performance over time.This change must be large enough to be considered a “real” change and precise enough to detect small but important clinical changes over time considered to be important by patients and/or clinicians.The concepts of “minimal detectable change” (MDC) and “minimal clinically important difference” (MCID) have been introduced to help clinicians and researchers in assessing and interpreting patient changes. The MDC has been defi ned as the minimal amount of change that can be considered above the threshold of error expected in the measurement, whereas the MCID has been defined as the smallest change in an outcome measure that is perceived as benefi cial by the patient and that would lead to a change in the patient’s management, assuming an absence of excessive side effects and costs. The Quebec Back Pain Disability Scale (QBPDS) is a well established functional self-report questionnaire to assess changes in function in patients with CLBP participating in rehabilitation programs. Several studies have evaluated its reliability and validity and have had good results. However, studies addressing its responsiveness are scarce, especially in samples of patients with CLBP, and there is little agreement in their fi ndings. In those studies the MDC was in the range 11.04 23 to 24.6 (95% confi dence interval [CI]: 19.9–32.4) 14 and the MCID was in the range from 5 9 to 8.5 points. Moreover, and in what concerns its interpretability, there are only a few studies that have considered the MCID in relation to the MDC. Therefore, the purpose of this study was to examine the responsiveness of the QBPDS Portuguese version (PT) and to determine the MCID, MDC, and the floor/ceiling effects, in patients with CLBP.info:eu-repo/semantics/publishedVersio

How to define the success of physiotherapy in chronic low back pain patients?

Trabalho apresentado no 10th Congress of European Pain Federation (EFIC), 6-9 setembro 2017, Copenhaga, DinamarcaN/