Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending

Study DesignCross-sectional study.PurposeTo verify the association of hamstring tightness and range of motion in anterior pelvic tilt (PT), lumbar motion (LM), and trunk flexion (TF) during forward bending.Overview of LiteratureIncreased hamstring stiffness could be a possible contributing factor to low back injuries. Clinical observations have suggested that hamstring tightness influences lumbar pelvic rhythm. Movement restrictions or postural asymmetry likely lead to compensatory movement patterns of the lumbar spine, and subsequently to increased stress on the spinal soft tissues and an increased risk of low back pain (LBP).MethodsHamstring muscle tightness was measured using the self-monitored active knee extension (AKE) test. A bubble inclinometer was used to determine the range of motion of PT, LM, and TF during forward bending. Statistical analysis included descriptive statistics, comparisons between groups and a correlation between hamstring tightness (AKE) and anterior PT, TF, and regional LM with p≤0.05.ResultsThe LBP group was composed of 36 participants, and the asymptomatic group consisted of 32 participants. The mean for PT in the control group was 66.7°, 64.5° for LM and 104.6° for TF. Respective values in the symptomatic group were 57.0°, 79.8°, and 82.2°.ConclusionsParticipants with LBP showed restriction in the pelvis and TF range of motion, but had higher amplitudes in the lumbar spine during forward bending

Development of the Avoidance Daily Activities Photo Scale for Patients With Shoulder Pain

OBJECTIVES: The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP shoulder scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. METHODS: Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health (ICF). The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question, "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) of ≥0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI of ≥0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. RESULTS: Of the 107 preselected activities, 21 attained a CVI of ≥0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP shoulder scale consists of 3 domains: "free movement," "high effort," and "self-care." The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. CONCLUSION: The ADAP shoulder scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. IMPACT: The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors

Evaluation of the limitations in daily-life activities and quality of life in leprosy ­patients submitted to surgical neurolysis to treat neuritis

La neurólisis es indicada para reducir el sufrimiento neural e impedir la instalación de secuelas e incapacidades en pacientes con lepra. El objetivo de este estudio fue verificar el grado de limitación de las actividades de la vida diaria y la calidad de vida de pacientes con lepra sometidos a neurólisis para el tratamiento de las neuritas. Participaron del estudio los pacientes sometidos a neurólisis en el período de 1998 a 2011. Fueron recolectadas informaciones sociodemográficas y clínicas, limitaciones de las actividades (SALSA) y la calidad de vida (WHOQOL-bref). Los análisis estadísticos incluirán la frecuencia, las medidas de tendencia central y dispersión, los tests de Mann-Whitney, Kruskall-Wallis y los coeficientes de correlación de Spearman adoptando pNeurolysis is indicated to reduce neural suffering and to prevent sequelae and disabilities in leprosy patients. The aim of this study was to determine the ­degree of limitation of daily activities and quality of life in leprosy patients submitted to neurolysis for neuritis treatment. The study included patients who underwent neurolysis from 1998 to 2011. We collected demographic and clinical information, data about activity limitations (Screening of Activity Limitation and Safety Awareness [SALSA]) and quality of life (WHO Quality of Life - Short Form-26 [WHOQOL-BREF]). Statistical analyses included frequency, central tendency and dispersion measures, Mann-Whitney and Kruskal-Wallis' tests, and Spearman's correlation coefficient adopting pA neurólise é indicada para reduzir o ­sofrimento neural e impedir a instalação de sequelas e incapacidades em pacientes com hanseníase. O objetivo deste estudo foi verificar o grau de limitação das atividades e a qualidade de vida de pacientes com hanseníase submetidos a neurólise para tratamento das neurites. Participaram do estudo os pacientes submetidos à neurólise no período de 1998 a 2011. Foram coletadas informações sociodemográficas e clínicas, limitações das atividades (SALSA) e a qualidade de vida (WHOQOL-bref). As análises estatísticas incluíram a frequência, as medidas de tendência central e dispersão, os testes de Mann-Whitney e Kruskall-Wallis e o coeficiente de correlação de Spearman adotando-se

Iniciativa Choosing Wisely Brasil para a Fisioterapia na Saúde da Mulher/Assoalho Pélvico: protocolo de estudo

INTRODUÇÃO: A iniciativa Choosing Wisely visa promover a discussão entre os profissionais da saúde e pacientes, a fim de reduzir os cuidados de baixo valor que não oferecem nenhum benefício ou podem causar prejuízos para a saúde. OBJETIVO: Descrever o processo de desenvolvimento da lista brasileira Choosing Wisely de Fisioterapia na Saúde da Mulher/Assoalho Pélvico. MÉTODO: A pesquisa será realizada em três etapas. Na primeira etapa, fisioterapeutas com experiência em Saúde da Mulher/Assoalho Pélvico serão convidados para compor um painel de especialistas e responderão a um formulário. O método Delphi será utilizado para se obter uma lista de declarações baseadas em evidência. Na segunda etapa, os membros da equipe de pesquisa analisarão todas as declarações fornecidas pelo painel de especialistas. Na terceira etapa, uma amostra de fisioterapeutas votará nas declarações selecionadas anteriormente. As declarações com mais votos na pesquisa nacional serão submetidas à Choosing Wisely Brasil, e uma lista final de recomendações será publicada

Criação do E-Infradrecri / Creation of E-Infradrecri

A criação de um aplicativo para o Inventário de Fatores de Risco no Ambiente Domiciliar para o Sistema Respiratório da Criança facilita sua utilização e a informação em saúde. Os objetivos do presente estudo foram analisar editores de plataformas de criação de aplicativos sem programação, definir a plataforma e criar o E–INFRADRECRI. A pesquisa foi realizada em três etapas: 1. Busca, análise e definição de plataforma; 2. Criação da estrutura e diagramação do aplicativo; 3. Criação do E-INFRADRECRI. Foram identificadas e analisadas 13 plataformas, a estrutura do aplicativo foi planejada na ferramenta Lucidchart e executada na plataforma Fabapp, utilizando o JotForm como estrutura base para coleta de dados e soma das questões pontuadas a partir das respostas dos questionários. Para disponibilização do aplicativo aos usuários houve necessidade de adesão ao plano pago das plataformas Fabapp e Jotform, demonstrando a necessidade de parceiros financeiros para o produto

Criação do E-infradrecri / Creation of the E-infradrecri

A criação de um aplicativo para o Inventário de Fatores de Risco no Ambiente Domiciliar para o Sistema Respiratório da Criança facilita sua utilização e a informação em saúde. Os objetivos do presente estudo foram analisar editores de plataformas de criação de aplicativos sem programação, definir a plataforma e criar o E–INFRADRECRI. A pesquisa foi realizada em três etapas: 1. Busca, análise e definição de plataforma; 2. Criação da estrutura e diagramação do aplicativo; 3. Criação do E-INFRADRECRI. Foram identificadas e analisadas 13 plataformas, a estrutura do aplicativo foi planejada na ferramenta Lucidchart e executada na plataforma Fabapp, utilizando o JotForm como estrutura base para coleta de dados e soma das questões pontuadas a partir das respostas dos questionários. Para disponibilização do aplicativo aos usuários houve necessidade de adesão ao plano pago das plataformas Fabapp e Jotform, demonstrando a necessidade de parceiros financeiros para o produto

Reliability of isometric and isokinetic trunk flexor strength using a functional electromechanical dynamometer

This paper will be part of Angela Rodriguez-Perea Doctoral Thesis performed in the Biomedicine Doctorate Program of the University of Granada, Spain. We would like to thank the Pleokinetic Network and the students of Catholic University of Most Holy Conception for making this study possible.Aim To determine the absolute and relative reliability of functional trunk tests, using a functional electromechanical dynamometer to evaluate the isokinetic strength of trunk flexors and to determine the most reliable assessment condition, in order to compare the absolute and relative reliability of mean force and peak force of trunk flexors and to determine which isokinetic condition of evaluation is best related to the maximum isometric. Methods Test-retest of thirty-seven physically active male student volunteers who performed the different protocols, isometric contraction and the combination of three velocities (V1 = 015 m s−1 , V2 = 0.30 m s−1, V3 = 0.45 m s−1) and two range of movement (R1 = 25% cm ; R2 = 50% cm) protocols. Results All protocols to evaluate trunk flexors showed an absolute reliability provided a stable repeatability for isometric and dynamic protocols with a coefficient of variation (CV) being below 10% and a high or very high relative reliability (0.69 0.86). The more reliable strength manifestation (CV = 6.82%) to evaluate the concentric contraction of trunk flexors was mean force, with 0.15 m s−1 and short range of movement (V1R1) condition. The most reliable strength manifestation to evaluate the eccentric contraction of trunk flexors was peak force, with 0.15 m s−1 and a large range of movement (V1R2; CV = 5.07%), and the most reliable way to evaluate isometric trunk flexors was by peak force (CV = 7.72%). The mean force of eccentric trunk flexor strength with 0.45 m s−1 and short range of movement (V3R1) condition (r = 0.73) was best related to the maximum isometric contraction. Conclusion Functional electromechanical dynamometry is a reliable evaluation system for assessment of trunk flexor strength

Spreading the word : pediatric pain education from treatment to prevention

Pain affects everyone hence one can argue that it is in each individual’s interest to understand pain in order to hold correct and adaptive beliefs and attitudes about pain. In addition, chronic pain is reaching pandemic proportions and it is now well known that people living with chronic pain have a reduced life expectancy. To address and to prevent the growth of this public health disaster, we must start looking beyond adulthood. How children view pain has an impact on their behavioral coping responses which in turn predict persistent pain early in the lifespan. In addition, children who suffer from chronic pain and who are not (properly) treated for it before adolescence have an increased risk of having chronic pain during their adult life. Explaining pain to children and youth may have a tremendous impact not only on the individual child suffering from chronic pain but also on society, since the key to stop the pain pandemic may well lie in the first two decades of life. In order to facilitate the acquisition of adaptive behavioral coping responses, pain education aims to shift people’s view on pain from being an apparent threat towards being a compelling perceptual experience generated by the brain that will only arise whenever the conceivable proof of danger to the body is greater than the conceivable proof of safety to the body. Nowadays a lot of pain education material is available for adults, but it is not adapted to children’s developmental stage and therefore little or not suitable for them. An overview of the state-of-the-art pain education material for children and youth is provided here, along with its current and future areas of application as well as challenges to its development and delivery. Research on pediatric pain education is still in its infancy and many questions remain to be answered within this emerging field of investigation

AVALIAÇÃO DOS DISTÚRBIOS DO CONTROLE SENSÓRIO-MOTOR EM PESSOAS COM DOR CERVICAL MECÂNICA: UMA REVISÃO

Introdução: A dor cervical mecânica é problema comum na população em geral e engloba a dorcervical aguda, as lesões em chicote, as disfunções cervicais e a dor cervical-ombro. A limitação daamplitude de movimento, a sensação de aumento da tensão muscular, a cefaleia, a braquialgia, a vertigeme outros sinais e sintomas são manifestações comuns e podem ser agravados por movimentos ou pelamanutenção de posturas da coluna cervical. Estudos recentes mostram comprometimento no controlesensório-motor em pessoas com dor cervical manifestando-se por alterações da cinestesia cervicalcom difi culdade no reconhecimento da posição da cabeça, do movimento dos olhos e do equilíbrio.Objetivos: Descrever, com base na revisão da literatura, as manifestações e os métodos de avaliaçãodos distúrbios sensório-motores relacionados à dor cervical mecânica. Métodos: Para a revisão foramutilizadas as bases de dados de literatura científi ca indexada no período de 1965 a 2009. Considerou-separa a inclusão os artigos que abordassem a dor cervical mecânica e os distúrbios da propriocepçãocervical, da coordenação dos movimentos dos olhos e do equilíbrio. Não houve restrição quanto à língua de publicação. O processo de seleção foi realizado por dois examinadores independentes, considerandoa evidência científi ca em ordem decrescente, havendo preferência para as meta-análises eos estudos randomizados controlados. Resultados: Dos 119 artigos encontrados, 69 preenchiam oscritérios de inclusão. Discussão: A presença de alterações dos músculos e das articulações cervicais,o processo de envelhecimento e a presença de dor cervical são descritos como fatores que alteram osistema somatossensorial cervical e devem ser considerados também como perpetuantes. Conclusão:As alterações dos sistemas visual, do equilíbrio e proprioceptivo não podem ser desprezadas e devemser consideradas durante a avaliação fi sioterapêutica dos distúrbios cervicais, visto que existe umaintegração entre os sistemas