ABSTRACT
Spinal Cord Injuries (SCI) may cause non-motor symptoms, such as chronic pain, which impair quality of life (QoL)Objective: To investigate the relationship between adapted competitive sports, pain, and QoL in people with SCI in a limited resources setting population.Methods: This prospective cross-sectional observational study involved 16 athletes and 24 non-athletes with SCI and collected data on demographic and clinical variables including scores for pain and pain interference in daily life (Brief Pain Inventory, BPI), neuropathic pain severity (Neuropathic Pain Symptoms Inventory, NPSI) and Quality of life (Word Health Organization Quality of Life Assessment, WHOQOL-BREF). Non-parametric testing was used to compare the groups, and due to athletes being younger, multiple linear regression analyses were used to adjust for the effect of sports practice on the outcome variables when adjusting for age.Results: Athletes were younger (median age 36y) than non-athletes (median age 41.5y; Mann-Whitney U test P = 0.011), and QoL was superior in athletes for the Physical, Psychological, Social Relationships, Self-Evaluation domains, and Total Score when adjusted for age (P < 0.01). Despite having no significant differences in pain intensity scores (NPSI, P = 0.742 and BPI, P = 0.261) athletes had less pain interference on "Relationship with Others", "Enjoyment of Life", and Total score (P < 0.05). Participation in competitive adapted sports (P = 0.004) and Total Pain Interference (P = 0.043) were significantly associated with QoL scores in the multiple linear regression analyses.Conclusion: Athletes with SCI have better QoL and less pain interference in some aspects of life when compared to non-athletes.
Subject(s)
Neuralgia , Spinal Cord Injuries , Humans , Adult , Quality of Life/psychology , Spinal Cord Injuries/complications , Spinal Cord Injuries/psychology , Cross-Sectional Studies , Prospective Studies , Neuralgia/etiology , AthletesABSTRACT
BACKGROUND: Gait disorders are very common in children with spastic diplegia cerebral palsy (CP). In order to improve the CP children's gait and to quantify the outcomes of this intervention it becomes essential to perform an instrumented analysis before and after the intervention. OBJECTIVES: To analyze the correlation among the Edinburgh Visual Gait Scale (EVGS), the Visual Gait Assessment Scale (VGAS) and the Observational Gait Scale (OGS). METHODS: Cross sectional study aiming to analyze the gait of 8 children with spastic diplegia CP with level I or II in the Gross Motor Function Classification System (GMFCS) through the EVGS, VGAS and OGS scales performed by 3 examiners. This study was approved by the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). Weighted Kappa scores were used to analyze the data considering a significance level of 5%. RESULTS: The intra-rater analyses showed a moderate to excellent agreement (k=0.41, 1.00) among the methods of the children's classification, being the comparison between VGAS and the EVGS scales presented the highest level of agreement, while the OGS scale presented a considerable disagreement in comparison with other scales. The inter-rater agreement showed to be predominantly high. CONCLUSIONS: The results provide evidence that the VGAS and the EVGS scales are more suitable for children's spastic diplegia CP gait assessment when compared to OGS.
Subject(s)
Cerebral Palsy/physiopathology , Gait , Child , Cross-Sectional Studies , Female , Humans , Male , Observer Variation , Physical Examination/methods , Physical Examination/statistics & numerical dataABSTRACT
CONTEXTUALIZAÇÃO: Desordens da marcha são comuns em crianças com paralisia cerebral (PC) diparética espástica. Com o intuito de aprimorar a marcha dessas crianças e quantificar os desfechos de tal intervenção, torna-se necessário que se faça uma análise instrumentada pré e pós-intervenção. OBJETIVOS: Correlacionar a Edinburgh Visual Gait Scale (EVGS), a Visual Gait Assessment Scale (VGAS) e a Escala Observacional de Marcha (EOM). MÉTODOS: Estudo transversal de análise da marcha por meio das escalas EVGS, VGAS e EOM, envolvendo oito crianças com PC diparética espástica, nível I ou II do Gross Motor Function Classification System (GMFCS), avaliadas por três examinadores. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Campinas - UNICAMP. Os dados foram analisados pelo índice Kappa ponderado, considerando um nível de significância de 5%. RESULTADOS: O estudo intra-avaliadores mostrou que a concordância entre os métodos na classificação dos sujeitos foi de moderada a excelente (k=0,41, 1,00), sendo a comparação entre a VGAS e a EVGS a de maior índice de concordância, enquanto a EOM obteve grande discordância em comparação com as outras escalas. A concordância interavaliadores se mostrou predominantemente alta. CONCLUSÃO: Os resultados fornecem evidências de que a VGAS e a EVGS são mais adequados para avaliação da marcha de crianças com PC diparética quando comparadas à EOM.
BACKGROUND: Gait disorders are very common in children with spastic diplegia cerebral palsy (CP). In order to improve the CP children's gait and to quantify the outcomes of this intervention it becomes essential to perform an instrumented analysis before and after the intervention. OBJECTIVES: To analyze the correlation among the Edinburgh Visual Gait Scale (EVGS), the Visual Gait Assessment Scale (VGAS) and the Observational Gait Scale (OGS). METHODS: Cross sectional study aiming to analyze the gait of 8 children with spastic diplegia CP with level I or II in the Gross Motor Function Classification System (GMFCS) through the EVGS, VGAS and OGS scales performed by 3 examiners. This study was approved by the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). Weighted Kappa scores were used to analyze the data considering a significance level of 5%. RESULTS: The intra-rater analyses showed a moderate to excellent agreement (k=0.41, 1.00) among the methods of the children's classification, being the comparison between VGAS and the EVGS scales presented the highest level of agreement, while the OGS scale presented a considerable disagreement in comparison with other scales. The inter-rater agreement showed to be predominantly high. CONCLUSIONS: The results provide evidence that the VGAS and the EVGS scales are more suitable for children's spastic diplegia CP gait assessment when compared to OGS.
Subject(s)
Child , Female , Humans , Male , Cerebral Palsy/physiopathology , Gait , Cross-Sectional Studies , Observer Variation , Physical Examination/methods , Physical Examination/statistics & numerical dataABSTRACT
We have analyzed the perceived stress index, the basal salivary cortisol levels, and the awakening cortisol response (ACR) in 86 volunteers of low (LSES) and high socioeconomic status (HSES). The LSES presented higher perceived stress index and basal salivary cortisol levels, nonaltered ACR, or cortisol diurnal rhythm. We have concluded that the LSES is associated with high perceived stress index and salivary cortisol levels, which could impact negatively in health, and that it is related to the daily life stress experienced by individuals in the LSES group. Because the LSES corresponds to about 30% of the total Brazilian population, this conclusion might have a great impact on public health policies and costs.
