Desequilíbrio muscular dos flexores e extensores do joelho associado ao surgimento de lesão musculoesquelética relacionada à corrida: um estudo de coorte prospectivo

ResumoO objetivo deste estudo foi verificar se o desequilíbrio dos músculos do joelho pode estar associado com o surgimento de lesões em corredores. Vinte corredores fizeram uma avaliação isocinética nas velocidades de 60, 180 e 300o/s e foram acompanhados por três meses para verificar a ocorrência de lesões. Quatro atletas (21%) apresentaram lesões que envolveram a região do joelho e o desequilíbrio muscular encontrado foi associado ao surgimento de lesões, nas três velocidades testadas (p<0,05).AbstractThe aim of this study was to determine whether a muscle imbalance of the knee is associated with running injuries. Twenty runners were evaluated by an isokinetic dynamometer at 60, 180 and 300 degrees/second. Runners were followed for three months to determine the incidence of injuries. We used the chi‐square test to verify the association between muscular imbalance and the appearance of injury. Four athletes experienced injuries (21%), all registered in the knee. Muscle imbalance was associated with running‐related injuries for the three tested velocities (p<0.05). To conclude, a muscle imbalance may be associated with running injuries

Prevalence of musculoskeletal pain in walkers: a cross-sectional study

Este artículo tuvo el propósito de verificar la prevalencia de dolor musculo esquelético en practicantes de caminatas y los posibles factores asociados a esta práctica. Se trata de estudio transversal, que se realizó mediante un cuestionario aplicado a los practicantes de caminatas en parques y lugares que son comunes a esta actividad. El cuestionario se componía por informaciones personales de los practicantes, la rutina de la práctica, el historial de lesiones y la presencia de dolor musculo esquelético durante la entrevista. Para ello, se ha hecho un análisis descriptivo de las características de los participantes, y se han utilizados la prueba t independiente, la prueba de Mann-Whitney y la prueba de Chi Cuadrado para la comparación de los datos entre los participantes con y sin dolor en la ocasión de la entrevista. Se han entrevistados 136 practicantes de caminatas, y el 8% fue la prevalencia de dolor musculo esquelético encontrada. La zona más afectada por el dolor entre los participantes fue la articulación de rodilla (45%). Entre las variables evaluadas, se ha demostrado que la presencia de lesiones previas de los últimos 12 meses está asociada estadísticamente (pO presente estudo teve como objetivo verificar a prevalência de dor de origem musculoesquelética em praticantes de caminhada e os possíveis fatores associados. Trata-se de um estudo transversal, realizado por meio de um formulário aplicado aos praticantes de caminhada em parques comuns à prática desta atividade. O formulário utilizado foi composto de questões sobre informações pessoais dos participantes, a rotina da prática de caminhada, o histórico de lesões e a presença de dor musculoesquelética no momento da entrevista. Foi realizada uma análise descritiva das características dos participantes e utilizado o teste t independente, teste de Mann-Whitney e teste de qui-quadrado para a comparação dos dados entre os participantes com dor e sem dor no momento da entrevista. Foram entrevistados 136 praticantes de caminhada, sendo que a prevalência de dor musculoesquelética foi de 8%. A articulação do joelho foi a região mais acometida pela dor entre os participantes (45%). Entre as variáveis analisadas, a presença de lesões prévias nos últimos 12 meses demostrou uma associação estatisticamente significativa (pThe aim of this study was to determine the prevalence of musculoskeletal pain in walkers and the associated factors. This is a cross sectional study, conducted through a questionnaire applied to walkers in parks in which this activity is commonly seen. The form used was composed of questions about personal information, walking practice routine, injury history and the presence of musculoskeletal pain during the interview. We performed a descriptive analysis of the characteristics of the participants and used the independent t test, Mann-Whitney's test e chi-square test for the comparison of data between participants with and without pain at the moment of the interview. We interviewed 136 walkers, and the prevalence of musculoskeletal pain was 8%. The knee joint was the most affected region by pain between the participants (45%). Among the variables analyzed, the presence of previous injuries in the last 12 months showed a statistically significant association (

The contemporary management of non-specific low back pain: treatment, mechanisms and outcomes

The broad aim of this thesis was to contribute to a better understanding of the contemporary management of non-specific low back pain (LBP) by investigating treatment options, mechanisms and outcomes. Chapter Two investigated the effectiveness of paracetamol for LBP in a Cochrane systematic review revealing high-quality evidence that there is no difference between paracetamol and placebo for acute LBP. Chapter Three and Chapter Four are two Cochrane reviews investigating the effectiveness of motor control exercise (MCE) for acute and chronic LBP. For acute, there is low to moderate quality evidence indicating no clinically important differences between MCE and manual therapy or other exercises. For chronic, there is low to high quality evidence that MCE is effective for pain and function compared with minimal intervention, but not clinically different from other exercises or manual therapy. Chapter Five evaluated the clinimetric properties of the Lumbar Spine Instability Questionnaire (LSIQ) in 107 people with LBP. The LSIQ seemed a unidimensional measure and had adequate reliability. However, it had poor internal consistency and did not function as an interval-level measure. Chapter Six investigated the credibility of subgroup claims in LBP trials using a 10-item checklist addressing design, analysis, and context. The credibility of subgroup claims was typically low and overstated by authors. Chapter Seven is a viewpoint exploring the advantages and disadvantages of subgroup analyses, considering the progress made to date, and the relevant literature in adjacent fields. Chapter Eight, a secondary analysis of Cochrane reviews, showed that LBP treatments usually provide larger effects for pain than for disability. The studies in this thesis have provided an important contribution to the contemporary management of LBP. The main implications are: i) paracetamol should not be endorsed in guidelines; ii) MCE is effective for chronic LBP, although it is not superior to other exercises; iii) subgroups in LBP have low credibility and lack validation, but a simple checklist can help improve research in this area; iv) the LSIQ needs more studies to understand its use and construct measured; and v) pain intensity should still be the primary measure of treatment success in chronic pain

Prevalência de dor musculoesquelética em corredores de rua no momento em que precede o início da corrida

A participação em corridas de rua vem aumentando significativamente nos últimos anos, motivada pelos benefícios a saúde, fácil execução e baixo custo. Os objetivos desse estudo foram: analisar a prevalência de dor musculoesquelética em corredores de rua no momento em que precede o início da prova, além de discutir alguns fatores etiológicos relacionados à prática da corrida. Os participantes foram divididos em dois grupos, um grupo foi composto por corredores com queixa de dor musculoesquelética e outro sem queixa. Foi constatada uma diferença estatisticamente significante quando comparados o número de treinos por semana (p=0,03) e a quilometragem semanal percorrida (p=0,01). Concluímos que a prevalência de dor foi de aproximadamente 25% e estava diretamente associada ao volume de treino semanal

Understanding and interpreting confidence and credible intervals around effect estimates

Introduction: Reporting confidence intervals in scientific articles is important and relevant for evidence-based practice. Clinicians should understand confidence intervals in order to determine if they can realistically expect results similar to those presented in research studies when they implement the scientific evidence in clinical practice. The aims of this masterclass are: (1) to discuss confidence intervals around effect estimates; (2) to understand confidence intervals estimation (frequentist and Bayesian approaches); and (3) to interpret such uncertainty measures. Content: Confidence intervals are measures of uncertainty around effect estimates. Interpretation of the frequentist 95% confidence interval: we can be 95% confident that the true (unknown) estimate would lie within the lower and upper limits of the interval, based on hypothesized repeats of the experiment. Many researchers and health professionals oversimplify the interpretation of the frequentist 95% confidence interval by dichotomizing it in statistically significant or non-statistically significant, hampering a proper discussion on the values, the width (precision) and the practical implications of such interval. Interpretation of the Bayesian 95% confidence interval (which is known as credible interval): there is a 95% probability that the true (unknown) estimate would lie within the interval, given the evidence provided by the observed data. Conclusions: The use and reporting of confidence intervals should be encouraged in all scientific articles. Clinicians should consider using the interpretation, relevance and applicability of confidence intervals in real-world decision-making. Training and education may enhance knowledge and skills related to estimating, understanding and interpreting uncertainty measures, reducing the barriers for their use under either frequentist or Bayesian approaches

Effect of a telerehabilitation exercise program versus a digital booklet with self-care for patients with chronic non-specific neck pain: a protocol of a randomized controlled trial assessor-blinded, 3 months follow-up

Abstract Background Neck pain is the fourth worldwide leading cause of disability and represents 22% of musculoskeletal disorders. Conservative intervention has been strongly recommended to treat chronic neck pain and Telerehabilitation is the alternative for the treatment of musculoskeletal conditions. There is a lack of high-quality research on the effects of telerehabilitation in patients with neck pain and functional disability. Therefore, this study aims to evaluate the effect of a telerehabilitation exercise program versus a digital booklet only with self-care information in individuals with non-specific chronic neck pain. Methods This is a prospectively registered, assessor-blinded, two-arm randomized controlled trial comparing a telerehabilitation exercise program versus a digital booklet with self-care information. Seventy patients will be recruited with non-specific chronic neck pain. Follow-ups will be conducted post-treatment, 6 weeks, and 3 months after randomization. The primary outcome will be disability at post-treatment (6 weeks) measured using neck pain disability. Secondary outcomes will be pain intensity levels, global perceived effect, self-efficacy, quality of life, kinesiophobia, and adherence to treatment. In our hypothesis, patients allocated to the intervention group experience outcomes that are similar to those of those assigned to the self-care digital booklet. Our hypothesis can then be approved or disapproved based on the results of the study. Discussion This randomized clinical trial will provide reliable information on the use of telerehabilitation to treat patients with chronic non-specific neck pain. Trial registration The study was prospectively registered at the Brazilian Registry of Clinical Trials (number: RBR-10h7khvk). Registered on 16 September 2022

What Do Recreational Runners Think About Risk Factors for Running Injuries? A Descriptive Study of Their Beliefs and Opinions

R unning is one of the most popular types of physical activity worldwide. The benefits attributed to recreational running include improvements in physical and mental health, weight control, stress reduction, and social participation. T T OBJECTIVES: To describe the beliefs and opinions of runners about risk factors associated with running injuries. T T BACKGROUND: Despite the health benefits of running, a high prevalence of injury has been reported in runners. Preventive strategies for running injuries may be more successful with a better knowledge of runners&apos; beliefs. T T METHODS: A semi-structured interview of recreational runners was based on the question, &quot;What do you think can cause injuries in runners?&quot; Analysis of the interviews was performed in 3 steps: (1) organizing the data into thematic units, (2) reading and reorganizing the data according to frequency of citation, and (3) interpreting and summarizing the data. The runner interviews were continued until no new beliefs and opinions of runners regarding injuries were being added to the data, indicating saturation of the topic. T T RESULTS: A total of 95 recreational runners (65 men, 30 women) between the ages of 19 and 71 years were interviewed. Of those interviewed, the average running experience was 5.5 years and approximately 45% had experienced a runningrelated injury in the past. The factors suggested by the runners were divided into extrinsic and intrinsic factors. The most cited extrinsic factors were &quot;not stretching,&quot; &quot;excess of training,&quot; &quot;not warming up,&quot; &quot;lack of strength,&quot; and &quot;wearing the wrong shoes.&quot; For the intrinsic factors, the main terms cited were &quot;not respecting the body&apos;s limitations&quot; and &quot;foottype changes.&quot; T T CONCLUSION: Recreational runners mainly attributed injury to factors related to training, running shoes, and exceeding the body&apos;s limits. Knowing the factors identified in this study may contribute to the development of better educational strategies to prevent running injuries, as some of the runners&apos; beliefs are not supported by the research literature

Tratamento fisioterapêutico para epicondilite lateral: uma revisão sistemática

Introdução: Embora o tratamento conservador ainda seja a melhor conduta inicial para a epicondilite lateral do cotovelo, há pouca evidência científica de que o tratamento fisioterapêutico altere o curso natural da doença e seja efetiva no tratamento dessa patologia. Objetivo: Avaliar a efetividade e a segurança das diversas intervenções fisioterapêuticas utilizadas no tratamento conservador da epicondilite lateral. Materiais e mé¬todos: Foram incluídos apenas ensaios clínicos aleatorizados e quase aleatorizados que utilizaram pelo menos uma modalidade fisioterapêutica como uma das intervenções. Foi realizada uma busca nas bases de dados eletrônicos MEDLINE; Embase; LILACS e SciELO até dezembro de 2010. Não houve restrição do período de publicação dos artigos. Com o objetivo de aumentar a sensibilidade e a precisão, a estratégia de busca utilizada foi adaptada para cada base de dados. Foi utilizada a pontuação da escala PEDro para avaliação da qualidade metodológica dos ensaios clínicos aleatorizados. Resultados: 26 artigos foram incluídos na revisão sistemá¬tica e a avaliação da maioria desses artigos apresentou qualidade metodológica satisfatória (6,4 pontos). Em relação aos aspectos mensurados, todos os artigos avaliaram a dor, 18 (69%) examinaram a força de preensão e 11 (42%) a função dos pacientes. Quanto à duração do acompanhamento dos pacientes apenas nove (35%) artigos realizaram acompanhamento a longo prazo. Conclusão: A melhor opção para o tratamento da epicon¬dilite lateral parece ser a combinação de modalidades terapêuticas, o que condiz com a realidade clínica do fisioterapeuta. Porém, mais ensaios clínicos com boa qualidade metodológica são necessários para determinar a efetividade da maioria das modalidades terapêuticas encontradas