Efeitos de um programa de intervenção, através da telerreabilitação, para pacientes com dor lombar crônica: um protocolo clínico / Effects of an intervention program, through telerehabilitation, for patients with chronic low back pain: a clinical protocol

Introdução: a dor lombar é um dos mais difundidos problemas de saúde pública enfrentados no mundo e, dessa forma, o acesso aos tratamentos baseados em evidências ­ como educação em neurociência da dor e exercícios terapêuticos ­ é frequentemente limitado devido a inúmeras barreiras. Objetivo: desenvolver um protocolo de intervenção que utilize um programa estruturado de educação em dor associado ao exercício terapêutico para o tratamento da dor lombar crônica, por meio de telerreabilitação. Método: este protocolo descreve um delineamento experimental do tipo ensaio clínico controlado, aleatorizado com avaliador e estatístico mascarados. Discussão: a hipótese aqui apresentada é a de que o programa de telerreabilitação beneficiará pacientes com dor lombar crônica, reduzindo a intensidade da dor, melhorando a função e fatores psicológicos.

Introduction: Low back pain is one of the most widespread public health problems faced in the world. The access to evidence-based treatment, such as pain neuroscience education and therapeutic exercises, is often limited due to numerous barriers. Objective: To develop an intervention protocol that uses a pain education program associated with therapeutic exercise for the treatment of chronic low back pain, through telerehabilitation. Method: This protocol describes an experimental design of the type controlled clinical trial, randomized with evaluator and blinded statistician. Discussion: Our hypothesis is that the telerehabilitation program will benefit patients with chronic low back pain, surprising pain intensity, improving function and psychological factors.

Brazilian Portuguese version and content validity of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the 'Patient Exercise Booklet' and the 'Personal Exercise Guide', to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents 'Patient Exercise Booklet' and 'Personal Exercise Guide' of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity.

The impact of Chikungunya chronic arthralgia on women's upper limbs motor function: a cross-sectional study / O impacto da artralgia crônica pós-Chikungunya na função motora dos membros superiores de mulheres: um estudo transversal / El impacto de la artralgia crónica poschikunguña en la función motora del miembro superior de mujeres: un estudio transversal

ABSTRACT Post-Chikungunya chronic arthralgia (PCCA) may lead to musculoskeletal repercussions and functional loss. The objective was to assess the upper limb physical disability and symptoms during daily, work, and leisure activities of women presenting PCCA compared to healthy controls (HC). This was a cross-sectional study conducted with 52 women. The participants were divided into PCCA (37) and HC (15) groups. Handgrip strength, range of motion, level of pain (numerical rating scale), and participants' physical disability and symptoms (Disabilities of the Arm, Shoulder, and Hand Questionnaire - DASH) were evaluated. Differences between groups were evaluated using the Students t-test and Pearson's correlations. The chi-square test was applied for categorical variables. The significance was set at α=0.05. The disease duration was 19.5±13.1 months. We found no differences between groups for peak force (PCAA:23.6±7.4kgf; HC: 24.5±6.2kgf; p=0.676). The results showed a significant difference between groups regarding range of motion (PCCA: 63.5±17.3o; HC: 77.2±9.6o), level of hand pain (PCCA: 5.8±2.2; HC: 0.4±1.5), and upper limbs functional levels (PCCA: 44.5±17.4; HC: 16.2±20.5). Participants related severe difficulty or inability to perform tasks such as opening a jar (78.4%), placing objects above head height (48.7%), doing heavy household chores (56.8%), and gardening (51.4%). Impairment in the upper limb physical function in daily, work, and leisure activities shows the higher prevalence in the long-term.

RESUMO A artralgia crônica pós-Chikungunya (ACPC) pode gerar repercussões musculoesqueléticas e perda funcional. Nesse sentido, o objetivo deste estudo foi avaliar a incapacidade física e os sintomas de membros superiores de mulheres com ACPC durante atividades diárias, laborais e de lazer comparadas aos controles saudáveis (CS). Para tanto, realizou-se um estudo transversal conduzido com 52 mulheres. As participantes foram divididas entre os grupos com ACPC (37) e CS (15). Foram avaliados força de preensão, amplitude de movimento (ADM), nível de dor (escala numérica de dor) e incapacidade física e sintomas por meio do Disabilities of the Arm, Shoulder and Hand Questionnaire (Dash). Diferenças entre os grupos foram avaliadas pelo teste t de Student e correlações de Pearson. O teste qui-quadrado foi utilizado para variáveis categóricas e α=0,05 foi estabelecido como nível de significância. Verificou-se que a duração da ACPC foi de 19,5±13,1 meses. Não houve diferença entre os grupos para a força pico (ACPC: 23,6±7,4kgf; CS: 24,5±6,2kgf; p=0,676). Os resultados demonstraram diferença significativa entre os grupos em termos de ADM (ACPC: 63,5±17,3o; CS: 77,2±9,6o), nível de dor nas mãos (ACPC: 5,8±2,2; CS: 0,4±1,5) e níveis funcionais dos membros superiores (ACPC: 44,5±17,4; CS: 16,2±20,5). As participantes relataram extrema dificuldade ou incapacidade para realizar tarefas como abrir um pote (78,4%), colocar objetos em um local acima da cabeça (48,7%), realizar atividades domésticas pesadas (56,8%) e atividades de jardinagem (51,4%). Conclui-se que a função física dos membros superiores durante as atividades diárias, laborais e de lazer constitui o maior comprometimento apresentado a longo prazo.

RESUMEN La artralgia crónica poschikunguña (ACPC) puede tener como efecto repercusiones musculoesqueléticas y pérdida funcional. En este sentido, el objetivo de este estudio fue evaluar la discapacidad física y los síntomas de miembros superiores de mujeres con ACPC durante las actividades diarias, laborales y de ocio en comparación con controles sanos (CS). Por ello, se realizó un estudio transversal con 52 mujeres. Las participantes se dividieron en los grupos ACPC (37) y CS (15). La fuerza de agarre, el rango de movimiento (ROM), el nivel de dolor (escala numérica de dolor), la discapacidad física y los síntomas se evaluaron mediante el Disabilities of the Arm, Shoulder and Hand Questionnaire (Dash). Las diferencias entre los grupos se evaluaron con la aplicación de la prueba t de Student y las correlaciones de Pearson. Se utilizó la prueba de chi-cuadrado para las variables categóricas y se estableció como nivel de significación α=0,05. Se encontró que la duración de la ACPC fue de 19,5±13,1 meses. No hubo diferencia entre los grupos para la fuerza máxima (ACPC: 23,6±7,4kgf; CS: 24,5±6,2kgf; p=0,676). Los resultados mostraron una diferencia significativa entre los grupos respecto al ROM (ACPC: 63,5±17,3o; CS: 77,2±9,6o), el nivel de dolor en la mano (ACPC: 5,8±2,2; CS: 0,4±1,5) y los niveles funcionales de miembros superiores (ACPC: 44,5±17,4; CS: 16,2±20,5). Las participantes informaron una extrema dificultad o incapacidad para realizar tareas como abrir un frasco (78,4%), poner objetos en un lugar más alto (48,7%), realizar actividades domésticas pesadas (56,8%) y actividades de jardinería (51,4%). Se concluyó que la función física de los miembros superiores durante las actividades diarias, laborales y de ocio constituye el mayor compromiso a largo plazo.

Performance, metabolic, hemodynamic, and perceived exertion in the six-minute step test at different heights in a healthy population of different age groups

Abstract Aim: This study aimed to compare the performance, metabolic, hemodynamic, and perceived exertion during the 6-minute step test (6MST) conducted with different step heights in healthy subjects and also to compare the performance between different age groups for each step height. The association between age, body mass index, level of physical activity, and lower limb measurements with performance were also evaluated. Methods: This is a cross-sectional study. Anthropometric measures, physical performance, and cardiovascular stress were evaluated during a self-paced 6MST with different step heights in healthy subjects in the age group of 18-59. All the participants underwent three-step tests (15 cm, 20 cm, and 30 cm) on the same day, in a randomized order. Results: Forty participants (20 men and 20 women) performed the tests. The performance in the test for the highest step was significantly lower compared to the step with the lowest height (152 ± 24 vs. 173 ± 27 and 184 ± 33; p < 0,05). The estimated peak oxygen consumption (VO2peak) increased by ∼2.5 mL.kg−1·min−1 with the increase in step height. Hemodynamic variables, such as percent of maximum heart rate (%HRmáx), and systolic blood pressure increased as the step height increased. There was a fair correlation between performance and the level of physical activity in the test with a step height of 15 cm and 20 cm. Conclusion: A higher step height caused greater cardiovascular stress, without exceeding the submaximal levels of the test, indicating that the 6MST can be used as an accurate instrument for evaluating aerobic capacity in healthy individuals.

Incidence of injuries and associated factors in treadmill runners: a prospective cohort study

Abstract Aims: To determine the incidence of injuries in exclusive treadmill runners and the main associated factors in 24 weeks. Methods: The incidence of injuries was investigated every two weeks by an electronic form. To analyze the associated factors, muscle force output, range of motion, and flexibility were investigated. To perform a descriptive analysis (baseline) and injury predictive factors (regression), we divided runners into two groups, injured and uninjured. Comparisons between groups were assessed evaluated by Student's t-test, Mann-Whitney, or Chi-square test. The relationship between associated factors and incidence of injuries was estimated by Logistic regression analysis. The model's accuracy was assessed by the receiver-operating characteristic curve (ROC). Thirty-seven runners completed the study. Results: The incidence of injuries was 6.8 per 1,000 hours of exposure. Among the associated factors, we highlight that runners with higher hip flexor force output were 4 times more likely not to injure (OR 4.0; CI 95% 1.03 -16.23) and lower knee extensor force output was related to a greater chance of injury (OR .24; 95% CI .65 - .93). The area under the ROC curve was 0.84. Conclusion: The incidence of injuries in treadmill runners was high. The factors associated with the injuries were the output of the flexor strength of the hip and the extensor force of the knee.

Violência entre parceiros íntimos: uma comparação dos índices em relacionamentos hetero e homossexuais / Intimate partner violence: a comparison of indices in hetero and gay relationships / Violencia en la pareja: una comparación de los índices en las relaciones heterosexuales y homosexuales

A violência entre parceiros íntimos (VPI) pode ser perpetrada por homens e mulheres. Entretanto esse tipo de violência costuma ser mais abordada pela literatura em relacionamentos heterossexuais, apresentando apenas a mulher como vítima e o homem como seu principal agressor. Desta forma, diante das novas configurações sociais e familiares, torna-se importante abordar a violência de modo mais amplo sem restrições de relacionamentos ou de gênero. Neste sentido, este trabalho traz os resultados de duas revisões sistemáticas, uma sobre a VPI em relacionamentos homossexuais e outra sobre a VPI em relacionamentos heterossexuais onde o homem tenha sido vítima de sua respectiva companheira(o). Os resultaram foram obtidos através de análises comparativas e do Teste Qui-quadrado chegando-se a uma amostra total de 196 publicações. Algumas categorias como vítimas, agressores e intervenção apresentaram diferenças significativas com p abaixo de 0,05. Outras foram comparadas através de estatísticas descritivas, como por exemplo, os principais países de publicação com os Estados Unidos (65) e Brasil (3) na revisão sistemática de VPI contra homens e (19) e (18) respectivamente na revisão da VPI em relacionamento homoafetivos. Propõe-se assim com este trabalho uma análise ampliada da VPI, de forma a contribuir para futuras prevenções e intervenções, independente do tipo de relacionamento ou da opção sexual de seus parceiros.

Intimate partner violence (IPV) may be perpetrated by men and women. However, is more often addressed at heterosexual relationships by literature featuring only women as victims and men as their primary aggressor. Because of this, in the face of new social and families structures, it is important to address violence unrestricted relationships or gender. Thus, this paper presents the results of two systematic reviews, one about the VPI in homosexual relationships and another on IPV in heterosexual relationships which the men have been the victims of their respective wives/girlfriends. The results were obtained through comparative analysis and Chi-square test getting up a full sample of 196 publications. Some categories as victims, aggressors and intervention had presented statistically significant differences with p bellow .05. Others were compared through descriptive statistics, for example, principals publications countries as United States (65) and Brazil (3) in the systematic review of IPV against men and (19) and (18) respectively in the review of IPV in homosexuals relationships. Therefore this work proposes an extended analysis of IPV in order to contribute to future preventions and interventions, regardless of the relationships ways or sexual orientation of its partners.

La violencia en la pareja puede ser perpetrada por hombres y mujeres. Sin embargo, es más común en las relaciones heterosexuales en las que la mujer es la principal víctima y el hombre agresor. Así, a través de los nuevos perfiles sociales y familiares, es importante para hacer frente a la violencia de manera más amplia, teniendo en cuenta todas las relaciones y orientaciones sexuales. En este sentido, este trabajo presenta datos de dos revisiones sistemáticas, una en el VP en las relaciones homosexuales y el otro sobre la violencia en las relaciones heterosexuales donde el hombre fue agredido por su pareja. El resultado se obtuvo a través del análisis comparativo y la prueba de Chi-cuadrado llegando a una muestra total de 196 publicaciones. Algunas categorías de víctimas, los acosadores y la intervención mostró diferencias significativas con p por debajo de .05. Otros se compararon mediante estadística descriptiva, por ejemplo, los principales países de la publicación con los Estados Unidos (65) y Brasil (3) en la revisión sistemática de la violencia contra los hombres y (19) y (18) respectivamente, en la revisión de La violencia en relación homosexual. Así, se propone en este trabajo un análisis de la violencia ampliada con el fin de contribuir a la prevención y la intervención futura, independientemente del tipo de relación o la orientación sexual de sus parejas.