Complex systems approach for sports injuries: moving from risk factor identification to injury pattern recognition-narrative review and new concept.

Injury prediction is one of the most challenging issues in sports and a key component for injury prevention. Sports injuries aetiology investigations have assumed a reductionist view in which a phenomenon has been simplified into units and analysed as the sum of its basic parts and causality has been seen in a linear and unidirectional way. This reductionist approach relies on correlation and regression analyses and, despite the vast effort to predict sports injuries, it has been limited in its ability to successfully identify predictive factors. The majority of human health conditions are complex. In this sense, the multifactorial complex nature of sports injuries arises not from the linear interaction between isolated and predictive factors, but from the complex interaction among a web of determinants. Thus, the aim of this conceptual paper was to propose a complex system model for sports injuries and to demonstrate how the implementation of complex system thinking may allow us to better address the complex nature of the sports injuries aetiology. According to this model, we should identify features that are hallmarks of complex systems, such as the pattern of relationships (interactions) among determinants, the regularities (profiles) that simultaneously characterise and constrain the phenomenon and the emerging pattern that arises from the complex web of determinants. In sports practice, this emerging pattern may be related to injury occurrence or adaptation. This novel view of preventive intervention relies on the identification of regularities or risk profile, moving from risk factors to risk pattern recognition.

Aplicação da classificação internacional de funcionalidade, incapacidade e saúde (CIF) na prática clínica do fisioterapeuta / Application of the international classification of functioning, disability and health (ICF) in physiotherapists clinical practice

A Organizacao Mundial de Saude publicou a Classificacao Internacional de Funcionalidade, Incapacidade e Saude (CIF), em 2001, que reflete a mudanca de uma abordagem baseada na doenca para enfatizar a funcionalidade como um componente da saude. Objetivo: Analisar a aplicabilidade clinica desse modelo e a importancia da CIf para o fisioterapeuta brasileiro. Metodo: Avaliacao fisioterapeutica de tres pacientes com lombalgia cronica, no contexto da CIF. Resultados: o paciente A relatou dor em grau tres, prejudicando a qualidade do sono e algumas atividades de vida diaria, nao apresentou restricao na participacao social e encontrava-se levemente satisfeito com a vida. O individuo B relatou dor graduada como quatro, chegando a nove no trabalho, limitacao na participacao social, principalmente restricoes ao lazer, e mostrou-se levemente insatisfeito com a vida. O individuo C apresentou dos constante e de grau cinco a lombalgia impactava negativamente seu trabalho e lazer. Este individuo mostrou-se extremamente insatisfeito com sua vida. Conclusao: o estudo mostrou que uma mesma patologia diagnosticada em diferentes individuos nao causaea necessariamente as mesmas repercussoes funcionais, dai a necessidade de os profissionais envolvidos na reabilitacao centrarem suas avaliacaoes e intervencoes no paciente, baseando-se no modelo da CIF como ferramenta para a descricao e a classificacao de todo o processo saude-doenca