Prevalence, characteristics, and impact of spinal and lower limb recurrent pain at age 13.

OBJECTIVES: To compare spinal and lower limb pain in adolescents regarding prevalence, characteristics, causes, and impact. METHODS: A descriptive cross-sectional study was conducted in 13-year-old adolescents (female n=2210; male n=2353) from the Portuguese Generation XXI birth cohort. Data were collected between 2018 and 2020 through personal interviews by applying the Luebeck Pain Questionnaire. The pain features examined in each anatomical location (back and lower limb) were recurrence, duration, frequency, intensity, perceived causes, and impact on school and leisure activities. Frequencies and the Chi-square test were used. RESULTS: Questionnaires from 4563 adolescents were analysed, 57.9% had pain in the last three months (main pain in the spine: 11.6%; main pain in the lower limb: 29.0%). Of those, 69.4% and 62.4% reported recurrent pain in the spine and lower limb, respectively. Recurrent pain was more frequent in girls than in boys (spine: 80.0%; 57.0%; lower limb: 70.4%; 58.1% respectively). Pain lasted more than three months in most adolescents (spine: about 60%; lower limb: above 50%); frequency was similarly high in both regions and both sexes (girls: 47.0%; boys: 45.7% in the spine; girls: 45.7%; boys: 40.3% in the lower limb); intensity was rated as high by girls (spine: 45.5%; lower limb: 47.3%) and moderate by boys (spine: 42.0%; lower limb: 41.0%). The leading causes of pain were daily living activities, both for the spine (girls: 65.9%; boys: 76.5%) and the lower limb (girls: 62.2%; boys: 72.1%). Psychosocial causes were the second most common cause of spinal pain (girls: 25.0%; boys: 21.0%). Other causes of lower limb pain were traumatic (girls: 25.5%; boys: 16.6%) and physical factors (girls: 20.7%; boys: 23.8%). Absences from school (girls: 11.7%; boys: 4.8%) and restrictions of leisure activities (girls: 20.7%; boys: 25.2%) were more related to pain in the lower limb. CONCLUSION: More than half of the adolescents reported spinal or lower limb recurrent pain, which presents a higher frequency, higher intensity, and longer duration in the spine. However, lower limb pain led to more concurrent limitations.

The Impact of Clinical Pilates Exercises on Tension-Type Headaches: A Case Series.

Tension-type-headaches appear as the third most common disease in the general population and have a big impact on quality of life. The aim is to verify the impact of clinical Pilates exercises on pain intensity, impact headaches, neck disability, state of anxiety, depression, stress and quality of sleep in higher-education students. After a sample selection questionnaire was completed, a series of cases was carried out with 9 undergraduate students with tension-type headaches. Five instruments were applied before and after an intervention program: (i) Numerical Rating Scale-NRS, (ii) Headache Impact Test-HIT-6™, (iii) Neck Disability Index, (iv) Depression, Anxiety, Stress Scales and (v) Pittsburgh Sleep Quality Index. Four sessions of 30 min classes of Pilates exercises were held for 2 weeks. The pain intensity decreased in only 2 participants. The impact of tension-type headaches on normal daily life and ability to function was improved in all patients, and only one patient's functional disability caused by pain in the cervical region did not improve. In regard to negative emotional states, 6 individuals reported improvements, and only one individual reported a lower quality of sleep after the program. The exercise program can induce positive effects on disorders associated with tension-type-headaches.

Reeducation of pelvic floor muscles in volleyball athletes / Reeducação dos músculos do pavimento pélvico em atletas de voleibol

Objective: to verify the effectiveness of the pelvic floor muscles rehabilitation program (PFMRP) in female volleyball athletes, analyzing the amount and frequency of urinary leakage. Methods: experimental study. The sample consisted of 32 female athletes from Famalicão Athletic Volleyball Club (Portugal). The athletes were selected by convenience and distributed randomly into two groups: experimental group (EG = 16 athletes) and the control group (CG = 16 athletes). The EG underwent PFMRP for three months. The PFMRP was the awareness and identification of the pelvic floor muscles (PFM), pre-timed PFM contraction prior to occasions of increased intra-abdominal pressure, and 30 daily contractions of MPP at home. The CG had only access to the pamphlet. The assessment instruments included the questionnaires, the Pad Test (amount of urinary leakage) and frequency record of urinary leakage (7-day diary) before and after PFMRP. Results: the amount of urine leakage decreased in 45.5% of athletes under PFMRP intervention, and in 4.9% of athletes in CG, with statistical differences between the groups (p < 0.001). The reduction in the frequency of urinary leakage was 14.3% in EG, and 0.05% in CG, a statistically significant difference between the groups (p < 0.001). Conclusion: PFMRP in this study was effective to reduce stress urinary incontinence in female volleyball athletes. The program allowed significant improvement of symptoms of quantity and frequency of urinary leakage. .

Objetivo: verificar a eficácia do programa de reeducação dos músculos do pavimento pélvico (PRMPP) em atletas femininas de voleibol, analisando a quantidade e a frequência das perdas urinárias. Métodos: estudo experimental. A amostra foi constituída por 32 atletas do sexo feminino do Atlético Voleibol Clube de Famalicão (Portugal). As atletas foram selecionadas por conveniência e distribuídas aleatoriamente em dois grupos: o grupo experimental (GE = 16 atletas) e o grupo-controle (GC = 16 atletas). O GE foi submetido ao PRMPP durante 3 meses; o programa consistiu na conscientização e identificação dos músculos do pavimento pélvico (MPP), na pré-contração dos MPP ao aumento da pressão intra-abdominal, e em 30 contrações diárias dos MPP no domicílio. O GC teve acesso unicamente ao panfleto. Os instrumentos de avaliação englobaram os questionários, o pad-test (quantidade de perda urinária) e o PRMPP. Resultados: a quantidade de perda urinária diminuiu 45,5% no GE, com intervenção do PRMPP, e 4,9% nas atletas do GC, verificando-se diferenças estatisticamente significativas entre os grupos (p<0,001). Na frequência das perdas urinárias, a redução foi de 14,3% no GE e de 0,05% no GC, verificando-se diferenças estatisticamente significativas entre os grupos (p<0,001). Conclusão: o PRMPP, nessa amostra, foi eficaz na incontinência urinária de esforço em atletas do sexo feminino de voleibol, pois permitiu melhorar significativamente os sintomas de quantidade e frequência das perdas urinárias. .

Impact of low cost strength training of dorsi- and plantar flexors on balance and functional mobility in institutionalized elderly people.

AIM: To evaluate the effects of a low cost strength training program of the dorsi- and ankle plantar flexors on muscle strength, balance and functional mobility, in elderly institutionalized subjects; and to determine the association between strength gain and balance and/or functional mobility gain. METHODS: Forty-eight volunteers were recruited and equally divided into two groups: intervention (aged 78.44 +/- 3.84 years) and control (aged 79.78 +/- 3.90 years). Both groups were tested at baseline and outcome for ankle dorsi- and plantar flexors muscle strength, balance and functional mobility. The intervention group participated in a 6-week program, three-sessions-per-week, of resisted ankle dorsi- and plantar flexion exercises using elastic bands. RESULTS: In the intervention group, maximal isometric dorsi- (from 8.4 +/- 0.45 to 12.6 +/- 0.95 kg; P