ABSTRACT
SUMMARY OBJECTIVE: This study aimed to compare pain intensity, stiffness, functionality, central sensitization, and self-efficacy, between individuals with bilateral knee osteoarthritis and unilateral knee osteoarthritis. METHODS: We included sedentary participants with knee osteoarthritis. The diagnosis was defined by a specialist, in which there was a complaint of pain and/or altered function in the lower limbs (duration ≥3 months); morning stiffness; pain intensity ≥3; Kellgren-Lawrence 2-3° associated with X-ray; persistence of symptoms >3 months. We used the following tools: Western Ontario and McMaster Universities Arthritis Index, Numerical Pain Scale, Central Sensitization Inventory, and Pain Self-Efficacy Questionnaire. Intergroup comparisons were performed using the t-test. RESULTS: The sample consisted of 118 adult individuals, divided into two groups: bilateral knee osteoarthritis (n=59) and unilateral knee osteoarthritis (n=59). We observed a significant difference (p<0.05) and a large effect size (d≥0.8), in the comparisons between: stature, body mass index, physical function, central sensitization, and self-efficacy. CONCLUSION: Individuals with bilateral knee osteoarthritis have higher levels of central sensitization, impaired functionality, and a lower level of self-efficacy.
ABSTRACT
BACKGROUND: The original structure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been contested in several languages. OBJECTIVE: To assess the structural validity of the Brazilian version of WOMAC among patients with knee osteoarthritis. DESIGN AND SETTING: Structural validity study conducted at physiotherapy clinics and primary healthcare units. METHODS: The study included males and females aged 40 to 80 years who were all native Brazilian Portuguese speakers, with knee pain in the previous six months and a diagnosis of knee osteoarthritis. We used exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) with implementation of a polychoric matrix and the robust diagonally weighted least squares (RDWLS) extraction method. The adequacy of the model was assessed using the following fit indices: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR) and chi-square/degree of freedom (DF). RESULTS: 203 patients with knee osteoarthritis were included. The model proposed in this study with two factors, i.e. "pain" (items 1, 2, 3 and 4) and "physical function" (items 10, 11, 16, 17, 18, 19, 21 and 22), showed adequate fit indices in CFA: chi-square/DF = 1.30; CFI = 0.976; TLI = 0.970; RMSEA = 0.039; and SRMR = 0.070. The factorial loads ranged from 0.68 to 0.76 for the "pain" domain and 0.44 to 0.62 for the "physical function" domain. CONCLUSION: The Brazilian version of WOMAC with two domains, i.e. "pain" (four items) and "physical function" (eight items), presents the best structure.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surveys and Questionnaires , Osteoarthritis, Knee/diagnosis , Language , Brazil , Reproducibility of ResultsABSTRACT
A proposta deste estudo foi analisar e verificar a existência de alterações neurofisiológicas nos indivíduos com síndrome de Down, como a hiporreflexia, estática e dinâmica, que, se presente, pode ocasionar prejuízo no controle sensório-motor dos músculos, e consequentemente a hipotonia, contribuindo para alterações no desenvolvimento motor. O sinal eletromiográfico (EMG), início e término do sinal eletromiográfico, foi coletado de 24 voluntários com diagnóstico de síndrome de Down e 25 voluntários como grupo controle, durante 2 situações distintas: período de latência dinâmico e teste de reflexo monossináptico (estático) patelar e aquileu. Em relação aos aspectos neurofisiológicos, observou-se que, para todas as variáveis analisadas, houve diferença estatisticamente significante (p<0,05) entre os grupos. A existência de alterações neurofisiológicas (retardo do período de latência) comprovadas neste estudo, oriundas de um prejuízo no controle sensório-motor, as quais podem ser responsáveis pela hipotonia muscular, mostrou-se como um dos vários possíveis fatores determinantes pelas alterações no desenvolvimento motor dessas crianças, tornando-se importante devido às alterações neuromusculares que podem interferir nas atividades funcionais.
The purpose of this study was to analyze and verify the existence of neurophysiological changes in individuals with Down syndrome, such as hyporeflexia, static and dynamic, which, if present, may cause impairment in sensory-motor control of muscles, and consequently hypotonia, contributing to changes in motor development. The electromyographic signal (EMG), start and termination electromyographic signal, was collected from 24 volunteers with a diagnosis of Down syndrome and 25 volunteers as controls for 2 different situations: the dynamic latency period and monosynaptic reflex (static) patellar and Achilles. For neurophysiological aspects, it was observed that for all variables analyzed, statistical difference (p<0.05) between groups. The existence of neurophysiological changes (delay of the latency period) demonstrated in this study originated from an impairment in sensory-motor control, which may account for the decreased muscle tone, presents as one of several possible factors for the changes in motor development of children, which shows important due to neuromuscular disorders that can interfere in functional activities.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Down Syndrome , Electromyography , Muscle Hypotonia , Neuromuscular Diseases , Psychomotor Performance , Sensation/physiologyABSTRACT
Uma das alterações mais importantes da marcha de pacientes com seqüela de paralisia cerebral do tipo hemiparesia espástica é o pé eqüino, que, em geral, é causado por fraqueza dos músculos dorsiflexores. Diversas abordagens não invasivas vem sendo utilizadas no tratamento destas crianças, contudo a estimulação elétrica neuromuscular (EENM) não tem sido freqüentemente reportada como um recurso utilizado na terapia destes pacientes, a qual teria por objetivo o recondicionamento muscular, a redução de espasticidade e o auxílio na aprendizagem motora. Este trabalho foi idealizado, portanto, no intuito de verificar as possíveis alterações no comportamento das forças reação do solo durante a marcha de crianças portadoras de paralisia cerebral do tipo hemiparética espástica, imediatamente após o uso de EENM aplicadas sobre o músculo tibial anterior. Neste estudo foram selecionadas 6 crianças, com idade média de 7,83 ± 3,60 anos, em que foram aplicadas a freqüência de 50 Hz no músculo tibial anterior com avaliação do padrão de marcha na plataforma de pressão pré e imediatamente pós EENM. Através dos resultados observou-se que uma única aplicação de EENM não demonstra melhora do comportamento da marcha, quando comparado pré e imediatamente pós EENM, entretanto, faz-se necessário a continuação desse estudo com ênfase em aprendizado motor, intensidade da corrente e freqüência terapêutica.
One of the most important alterations in gait of patients with sequel of spastic hemiparetic cerebral palsy is the equine foot, which, in general, is caused by muscles weakness. Several non-invasive procedures are used to treat these children, however the neuromuscular electrical stimulation (NMES) has not been frequently reported as a resource used in the therapy of these patients, which would have as objective the muscular reconditioned, the reduction of spasticity and aid motor learning. This work aimed at verifying possible alterations in the ground reactions forces during gait of children with spastic hemiparetic cerebral palsy, immediately after the use of NMES on the tibialis anterior muscle. Six children, average age 7.83 ± 3.60 years old, were selected and stimulation frequency at 50 Hz was applied on the tibialis anterior muscle with evaluation of the standard gait in the pressure platform before and after NMES. Through the results it was observed that there is no gait improvement with only one application of NMES, when compared before and after NMES, however, more investigations are necessary to continue this study with emphasis in motor learning, intensity, and therapeutic frequency.
Subject(s)
Cerebral Palsy , Gait , Gait Disorders, Neurologic , Motor Activity , Motor Disorders , Paralysis , ParesisABSTRACT
Visou-se investigar a reprodutibilidade de medições eletromiográficas durante contração isométrica fadigante nos músculos reto femoral, vasto medial e vasto lateral. Dez voluntários saudáveis (cinco homens e cinco mulheres) foram selecionados e avaliados em dois dias (teste e re-teste) com uma semana de intervalo. Os sinais eletromiográficos do reto femoral, vasto medial e vasto lateral foram registrados durante contração sustentada isométrica a 80 por cento.
The purpose of this study was to determine test-retest reability of electromiography (EMG) during sustained fatiguing contractions of the quadriceps. Ten healthy subjects (five male, five female) were tested on two days, one week apart. Surface EMG was recorded from rectus femoris, vastus lateralis and vastus medialis during sustained isometric contractions at 80 per cent...