Effects of educational sessions on school backpack use among elementary school students

OBJETIVO: Avaliar a modificação na quantidade de carga transportada, o modelo e o modo de transportar mochilas escolares após sessões educativas. MÉTODOS: Estudo de uma série de casos, com 99 crianças de sete a 11 anos do ensino fundamental, em escola particular da cidade São Paulo, São Paulo. Foram avaliadas a massa corporal (kg) e estatura dos alunos (cm), quantidade de carga transportada nas mochilas (kg). Os modelos e os modos de transporte das mochilas foram avaliados por filmagem pré e pós-intervenção. Como medida de intervenção, os sujeitos (crianças, pais e professores) foram submetidos a uma sessão educativa, que consistiu de orientações teóricas sobre coluna vertebral e transporte de carga. Para os escolares foi adicionada orientação prática das posturas corretas no transporte de carga. Os escolares receberam um reforço prático mensal por três meses. Pais e professores receberam reforço em folheto informativo e orientações na homepage da escola. Os dados foram analisados pelos testes estatísticos de igualdade de duas proporções e Wilcoxon. O nível de significância adotado foi 5%. RESULTADOS: O modelo de mochila modificou para duas alças de 46,5% para 60,6% (p=0,046), modo de transporte para ombro bilateral de 41,4% para 55,6% (p=0,047). A carga transportada nas mochilas diminuiu 2,66kg (p<0,001) e a relação massa corporal do sujeito e carga transportada nas mochilas diminuiu 7%. Na modificação por categorias, o número de alunos do grupo inadequado (carga transportada>15% da massa corporal do aluno) diminuiu (p<0,001). CONCLUSÕES: As sessões educativas promoveram mudanças na utilização de mochilas, revelando adesão satisfatória ao modelo de intervenção proposto entre os escolares e o importante papel da Fisioterapia na saúde escolar.OBJECTIVE: To evaluate the changes in loads carried, in the model of backpack used and in the way of carrying school backpacks after the implementation of an educational program. METHODS: This study was performed on 99 children aged seven to 11 years at elementary school level in a private school in São Paulo, São Paulo, Brazil. The subjects' body mass (kg) and height (cm) and the loads carried in their backpacks (kg) were evaluated. The backpack models and the ways of carrying them were evaluated by filming before and after the intervention. The intervention program consisted of educational sessions offered to the children, parents and teachers. The sessions involved lectures about the spine and about the principles of load carrying. The children also received practical guidance relating to correct postures for load carrying. The children received monthly practical reinforcement for three months. The parents and teachers received reinforcement by means of information flyers and guidance on the school's home page. The data were analyzed by means of two-proportion equality and Wilcoxon statistical tests. The significance level was considered as &#945;=0.05. RESULTS: The use of a two-strap backpack model increased from 46.5% to 60.6% (p=0.046) and carrying it on two shoulders increased from 41.4% to 55.6% (p=0.047). The load carried in the backpacks decreased by 2.66kg (p<0.001) and the ratio between the subject's body mass and the load carried in the backpacks decreased by 7%. With regard to change per category, the number of subjects in the inappropriate group (load carried>15% of the subject's body mass) decreased (p<0.001). CONCLUSIONS: The educational sessions promoted changes in backpack use and it was observed a satisfactory adherence to the intervention program proposed. These results demonstrate the importance of Physical Therapy educational programs in schoolchildren's health

Efficacy of diadynamic currents as an adjunct to exercise to manage symptoms of knee osteoarthritis in adults: A randomized controlled clinical trial

Objective To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. Design A randomized-controlled trial. Setting Special Rehabilitation Services in Taboão da Serra. Participants Patients with bilateral knee osteoarthritis. Intervention Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. Main outcome measures The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). Results There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was −3.08 points (95% confidence interval −4.13; −2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was −2.40 points (95% confidence interval −3.34; −1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was −4.08 points (95% confidence interval −5.89; −2.26), p < 0.01 with an effect size of 1.04. Conclusion Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months

Efficacy of prolonged application of low-level laser therapy combined with exercise in knee osteoarthritis: A randomized controlled double-blind study.

OBJECTIVES: To investigate the effect of prolonged low-level laser therapy application combined with exercise on pain and disability in patients with osteoarthritis of the knee. DESIGN: A randomized controlled trial. SETTING: Special rehabilitation services. SUBJECTS: Forty-three participants with knee osteoarthritis. INTERVENTION: Following initial assessment, participants were randomly allocated to the Laser group (n = 22, 44 knees) and received low-level laser therapy while the Placebo group (n = 21, 42 knees) received placebo therapy three times a week for 3 weeks. Both groups then received low-level laser therapy combined with exercise three times a week for the following 8 weeks. MAIN OUTCOME MEASURES: The primary outcome was change in knee pain and disability (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscular strength (dynamometer), activity (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and medication intake and relief. RESULTS: Mean (SD) age of participants was 63.02 (9.9) years. Pain scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 9.1 (1.3), 2.6 (2.3), 0.2 (0.9), and 0.2 (0.8) for the Laser group and 9.5 (8.0), 7.7 (5.3), 5.6 (2.4), and 7.4 (5.0) for the Placebo group, respectively. Disability scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 14.9 (4.7), 7.6 (4.8), 3.9 (4.2), and 3.5 (4.1) for the Laser group and 17.8 (14.7), 15.2 (11.5), 11.6 (6.4), and 15.8 (11.9) for the Placebo Group, respectively. CONCLUSION: In participants with osteoarthritis of the knee, the isolated application of low-level laser therapy in the initial 3 weeks and combined with exercises in the final 8 weeks reduced pain, disability, and intake of medication over a 6-month period

Qualitative postural analysis among boys and girls of seven to ten years of age Análise postural qualitativa entre meninos e meninas de sete a dez anos de idade

BACKGROUND: Postural abnormalities are often found in children. At this stage of life, posture undergoes many adjustments and adaptations due to body changes. Objective: To qualitatively identify the postural abnormalities which occur most frequently among children aged OBJECTIVE: Reven and ten years, comparing boys and girls, and to evaluate these subjects' lumbar flexibility. METHODS: One hundred and ninety-one children were photographed in the sagittal and frontal planes. The variables analyzed were: ankle (valgus and varus), tibiotarsal angle (opened and closed), knee (hyperextension and semiflexion, valgus and varus), pelvis (anteversion and retroversion; lateral pelvic inclination), trunk (antepulsion and retropulsion), lumbar spine (hyperlordosis and rectification), thoracic spine (hyperkyphosis and rectification), cervical spine (hyperlordosis and rectification), scoliosis, shoulder (imbalance and protraction), scapula (winged, abducted and adducted) and head (tilt and protraction). The lumbar flexibility was assessed using Schöber's index. RESULTS: The boys had greater incidence of winged scapula, shoulder imbalance, protraction of shoulders and head and cervical hyperlordosis than the girls did. Conversely, the girls had greater incidence of head tilt and larger Schöber index values. CONCLUSIONS: There were abnormalities in children's postural development that are probably related to muscle, skeletal and flexibility differences between the genders. These differences may influence each child's postural pattern during growth.<br>CONTEXTUALIZAÇÃO: Alterações posturais são freqüentemente encontradas em crianças. Nessa fase, a postura sofre uma série de ajustes e adaptações às mudanças no próprio corpo. OBJETIVO: Identificar, de maneira qualitativa, quais as alterações posturais mais freqüentes em crianças entre sete e dez anos, comparando meninos e meninas, e avaliar a flexibilidade lombar desses sujeitos. MATERIAIS E MÉTODOS: Cento e noventa e uma crianças foram fotografadas nos planos frontal e sagital. As variáveis analisadas foram: tornozelo (valgo e varo), ângulo tíbio-társico (aberto e fechado), joelho (hiperextensão e semiflexão, valgo e varo), pelve (anteversão e retroversão, inclinação pélvica lateral), tronco (antepulsão e retropulsão), lombar (hiperlordose e retificação), torácica (hipercifose e retificação), cervical (hiperlordose e retificação), escoliose, ombro (desnível e protração), escápula (alada, abduzida e aduzida) e cabeça (inclinada e protraída). A flexibilidade da coluna lombar foi avaliada pelo índice de Schöber. RESULTADOS: Os meninos mostraram maior incidência de escápula alada, desnível de ombros, protração de ombros e cabeça e hiperlordose cervical do que as meninas. Por sua vez, as meninas apresentaram maior incidência de inclinação de cabeça e maior valor para o índice de Schöber. CONCLUSÕES: Existem alterações no desenvolvimento postural das crianças que podem estar relacionadas a diferenças, entre os sexos, no sistema muscular, esquelético e na flexibilidade. Estas diferenças podem influenciar o padrão postural do indivíduo durante o crescimento

Intervenção nas situações de trabalho em um serviço de nutrição hospitalar e repercussões nos sintomas osteomusculares Intervention in a hospital foodservice and its effects on musculoskeletal symptoms

OBJETIVO: Analisar as situações de trabalho em serviço de nutrição hospitalar, antes e depois da implantação de ações de intervenções ergonômicas, e seu impacto na prevalência de sintomas osteomusculares relacionados ao trabalho. MÉTODOS: Trata-se de estudo de caso desenvolvido em hospital público especializado em cardiologia, localizado em São Paulo, com a participação de 115 trabalhadores. A abordagem metodológica foi a da Análise Ergonômica do Trabalho e da ergonomia participativa. A coleta de dados foi realizada por meio da aplicação de questionários e da análise ergonômica do trabalho, antes e depois da intervenção. A análise dos dados incluiu testes estatísticos para verificar se houve mudança da prevalência de sintomas antes e depois das intervenções, com nível de significância de 5%, por meio dos Programas Statistical Package for Social Sciences 13.0 e Excel 2003. RESULTADOS: A população constitui-se, em sua maioria, de mulheres, na faixa etária de 25 a 34 anos, com grau médio de escolaridade, casadas, com filhos, e que ocupavam o cargo de atendente de nutrição. Os principais problemas observados foram espaço físico reduzido, equipamentos e materiais de trabalho inadequados, deficit de pessoal, volume excessivo de trabalho com elevado esforço mental e alta prevalência de sintomas osteomusculares, principalmente nos membros inferiores e ombros. Após as intervenções realizadas, houve melhora na situação de trabalho, com redução dos sintomas osteomusculares, bem como os profissionais perceberam mudanças em termos de ambiente físico, equipamentos e organização do trabalho. CONCLUSÃO: As intervenções repercutiram em melhorias, principalmente quanto ao ambiente e equipamentos, e na redução dos sintomas osteomusculares nos membros inferiores, ombros, pescoço/região cervical, antebraço e região lombar, apesar de a redução não ter sido estatisticamente significativa.<br>OBJECTIVE: This study analyzed the working conditions of a hospital food service before and after ergonomic interventions and their impact on the prevalence of work-related musculoskeletal symptoms. METHODS: This case study was performed in a public heart hospital in São Paulo , Brazil with 115 workers. The data were collected by questionnaires and ergonomic analysis of the work before and after the intervention. The data were statistically analyzed by the software SPSS 13.0 and Excel 2003 to verify symptom prevalence before and after the interventions. RESULTS: The workers were female nutrition attendants aged 25-34 years, with secondary education, married, with children. Most of the problems regarded limited space, inappropriate equipment and work materials, inadequate number of workers, intense mental effort and high prevalence of musculoskeletal symptoms, mainly in the lower limbs and shoulders. Once the working conditions improved, musculoskeletal symptoms decreased and all workers noted the changes made to the physical environment, equipment and work organization. CONCLUSION: The interventions promoted improvements in the work environment and equipment and reduced the musculoskeletal symptoms experienced in the lower limbs, shoulders, neck, forearm and lower back, although this reduction was not statistically significant