Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris

The purpose of the present study was to translate the Roland-Morris (RM) questionnaire into Brazilian-Portuguese and adapt and validate it. First 3 English teachers independently translated the original questionnaire into Brazilian-Portuguese and a consensus version was generated. Later, 3 other translators, blind to the original questionnaire, performed a back translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of 3 rheumatologists and the final Brazilian version was established (Brazil-RM). This version was then pretested on 30 chronic low back pain patients consecutively selected from the spine disorders outpatient clinic. In addition to the traditional clinical outcome measures, the Brazil-RM, a 6-point pain scale (from no pain to unbearable pain), and its numerical pain rating scale (PS) (0 to 5) and a visual analog scale (VAS) (0 to 10) were administered twice by one interviewer (1 week apart) and once by one independent interviewer. Spearman's correlation coefficient (SCC) and intraclass correlation coefficient (ICC) were computed to assess test-retest and interobserver reliability. Cross-sectional construct validity was evaluated using the SCC. In the pretesting session, all questions were well understood by the patients. The mean time of questionnaire administration was 4 min and 53 s. The SCC and ICC were 0.88 (P<0.01) and 0.94, respectively, for the test-retest reliability and 0.86 (P<0.01) and 0.95, respectively, for interobserver reliability. The correlation coefficient was 0.80 (P<0.01) between the PS and Brazil-RM score and 0.79 (P<0.01) between the VAS and Brazil-RM score. We conclude that the Brazil-RM was successfully translated and adapted for application to Brazilian patients, with satisfactory reliability and cross-sectional construct validity.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Disciplina de ReumatologiaUNIFESP, EPM, Disciplina de ReumatologiaSciEL

The Development and Validation of a Low Back Pain Knowledge Questionnaire – LKQ

OBJECTIVE: The objective of this study was to develop and validate a questionnaire on specific knowledge about low back pain entitled "The Low Back Pain Knowledge Questionnaire". INTRODUCTION: There is a need for instruments to assess patient knowledge regarding chronic illness. Such methods can contribute to the education of patients. METHODS: The Low Back Pain Knowledge Questionnaire was developed through five focus groups. The questionnaire was distributed to 50 patients to assess their comprehension of the terms. To assess the reproducibility, 20 patients were surveyed by two different interviewers on the same day and twice by a single interviewer with a one-to-two week interval. For the construct validation, the Low Back Pain Knowledge Questionnaire was given to 20 healthcare professionals with knowledge on low back pain and 20 patients to determine whether the questionnaire would discriminate between the two different populations. To assess the sensitivity of the questionnaire to changes in the knowledge level of the patients, it was given to 60 patients who were randomly assigned to the Intervention Group and the Control Group. The Intervention Group answered the questionnaire both before and after attending a chronic back pain educational program (back school), whereas the Control Group answered the questionnaire twice with an interval of one month and no educational intervention. RESULTS: The focus groups generated a questionnaire with 16 items. The Spearman's correlation coefficient and the intra-class correlation coefficients ranged from 0.61 to 0.95 in the assessments of the intra-observer and inter-observer reproducibility (p< 0.01). In the construct validation, the healthcare professionals and patients showed statistically different scores (p< 0.001). In the phase regarding the sensitivity to change, the Intervention Group exhibited a significant increase in their specific knowledge over the Control Group (p< 0.001). CONCLUSION: The Low Back Pain Knowledge Questionnaire was validated and proved to be reproducible, valid and sensitive to changes in patient knowledge

The value of the image diagnosis methods in the evaluation of reactions/stress fractures

UNIFESP Departamento de Diagnóstico por ImagemUNIFESPUNIFESP, Depto. de Diagnóstico por ImagemUNIFESPSciEL

Intensity level for exercise training in fibromyalgia by using mathematical models

Background: It has not been assessed before whether mathematical models described in the literature for prescriptions of exercise can be used for fibromyalgia syndrome patients. the objective of this paper was to determine how age-predicted heart rate formulas can be used with fibromyalgia syndrome populations as well as to find out which mathematical models are more accurate to control exercise intensity.Methods: A total of 60 women aged 18-65 years with fibromyalgia syndrome were included; 32 were randomized to walking training at anaerobic threshold. Age-predicted formulas to maximum heart rate (220 minus age and 208 minus 0.7 x age) were correlated with achieved maximum heart rate (HRMax) obtained by spiroergometry. Subsequently, six mathematical models using heart rate reserve (HRR) and age-predicted HRMax formulas were studied to estimate the intensity level of exercise training corresponding to heart rate at anaerobic threshold (HRAT) obtained by spiroergometry. Linear and nonlinear regression models were used for correlations and residues analysis for the adequacy of the models.Results: Age-predicted HRMax and HRAT formulas had a good correlation with achieved heart rate obtained in spiroergometry (r = 0.642; p < 0.05). for exercise prescription in the anaerobic threshold intensity, the percentages were 52.2-60.6% HRR and 75.5-80.9% HRMax. Formulas using HRR and the achieved HRMax showed better correlation. Furthermore, the percentages of HRMax and HRR were significantly higher for the trained individuals (p < 0.05).Conclusion: Age-predicted formulas can be used for estimating HRMax and for exercise prescriptions in women with fibromyalgia syndrome. Karnoven's formula using heart rate achieved in ergometric test showed a better correlation. for the prescription of exercises in the threshold intensity, 52% to 60% HRR or 75% to 80% HRMax must be used in sedentary women with fibromyalgia syndrome and these values are higher and must be corrected for trained patients.Universidade Federal de São Paulo, São Paulo, BrazilUniv Fed Espirito Santo, Vitoria, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

The value of the image diagnosis methods in the evaluation of reactions/stress fractures

UNIFESP Departamento de Diagnóstico por ImagemUNIFESPUNIFESP, Depto. de Diagnóstico por ImagemUNIFESPSciEL

Value of the magnetic resonance image of the lumbar spine with load in the evaluation of stenosis of the lumbar spinal canal

UNIFESPUNIFESPSciEL

Contribution of computorized tomography and magnetic resonance in the differentiation between bening and malignant acute fractures of the spine

Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnóstico por ImagemUNIFESP-EPMUNIFESP, EPM, Depto. de Diagnóstico por ImagemUNIFESP, EPMSciEL

ASSESSMENT of the EFFECTIVENESS of A FUNCTIONAL SPLINT for OSTEOARTHRITIS of the TRAPEZIOMETACARPAL JOINT of the DOMINANT HAND: A RANDOMIZED CONTROLLED STUDY

Objective: To assess the effectiveness of a functional splint for trapeziometacarpal osteoarthritis.Methods: Forty patients with a diagnosis of painful trapeziometacarpal osteoarthritis of the dominant hand were randomized into 2 groups. the study group received the splint at baseline and used it during activities of daily living for 180 days and the control group used the splint only during the evaluations for the first 90 days and during activities of daily living for the following 90 days. Pain, strength, hand function and dexterity (with and without splint) were measured by a blinded assessor at baseline, 45, 90 and 180 days.Results: the groups were homogenous at baseline for all outcomes evaluated. Pain without the splint was significantly different between groups over time; the study group experienced a decrease in pain beginning with the first evaluation (45 days), whereas the control group achieved a lower pain score only at the end of the study, after having used the splint for 90 days. No significant differences between groups were found for the other parameters.Conclusion: Splint use during activities of daily living for patients with trapeziometacarpal osteoarthritis reduces pain, but does not alter function, grip strength, pinch strength or dexterity.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Div Rheumatol, Rheumatol Rehabil Sect, Disciplina Reumatol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Rheumatol, Rheumatol Rehabil Sect, Disciplina Reumatol, BR-04023900 São Paulo, BrazilWeb of Scienc

EFFECTIVENESS of A NIGHT-TIME HAND POSITIONING SPLINT in RHEUMATOID ARTHRITIS: A RANDOMIZED CONTROLLED TRIAL

Objective: To evaluate the effectiveness of a night-time hand positioning splint in patients with rheumatoid arthritis.Design: Randomized controlled trial.Methods: Fifty patients with rheumatoid arthritis were divided randomly into 2 groups. the study group used a night-time splint starting at baseline, while the control group used the splint only, during evaluations. All patients attended evaluations wearing their splints, so that the assessor remained blinded to patient allocation. the splints used in the control group were stored in a cabinet between assessments. Participants were evaluated at baseline, 45 and 90 days, using the visual analogue scale for pain; the Jamar dynamometer for grip strength; a pinch gauge for pinch strength; a Health Assessment Questionnaire for function; the Disability of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb disability and symptoms; and a Likert scale for patient satisfaction with treatment.Results: the groups were homogenous for all parameters at baseline. Pain, Health Assessment Questionnaire score, DASH score, grip strength and pinch strength were significantly different between groups over time and satisfaction with the splint was reported as better and much better by most participants.Conclusion: the use of a night-time hand positioning splint reduces pain, improves grip and pinch strength, upper limb function and functional status in patients with rheumatoid arthritis.Universidade Federal de São Paulo, Div Rheumatol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Rheumatol, BR-04023900 São Paulo, BrazilWeb of Scienc