Standardization use of the international classification of functioning, disability and health in the determination of health status in patients with post-acute COVID-19 syndrome.

PURPOSE: To propose a standardized method for the use of the International Classification of Functioning, Disability and Health (ICF) to describe the health status in Post-Acute COVID-19 Syndrome (PACS) and investigate interrater agreement in the linking process in instruments and clinical exams using the ICF categories. MATERIALS AND METHODS: Cross-sectional and interrater agreement study that followed the Guidelines for Reporting Reliability and Agreement Studies. Two raters performed the linking coding process in instruments of quality of life, anxiety and depression, fatigue and pulmonary function, inspiratory muscle strength and cardiopulmonary exercise testing. The codes were qualified by standards defined to each instrument and exams. RESULTS: The instrument with the lowest Cohen's Kappa coefficient was anxiety and depression (k = 0.57). Forty ICF codes were linked to clinical instruments and exams. The fatigue instrument presented a higher degree of disability by the qualification process, from severe to complete, in the linked codes. CONCLUSION: The study presents a standardized method for the assessment of the health status of patients with PACS through ICF. Restriction in work performance, socialization and family relationships as well as disabilities in physical endurance, fatigue and exercise tolerance were found in the sample. The agreement between the raters was moderate to perfect, demonstrating that the method can be reproducible.

The body structures and functions, environmental factors, activities and participation in a person's environment are determinant aspects of his health.Ways to measure these aspects are key to assessing health not only as absence of disease, so the International Classification of Disability and Functional Health demonstrates the ability to fully describe health.This study proposes a standardization in the use of the tool to facilitate usability in clinical practice.

Impairments and related social inequalities among adults: a population-based study in São Paulo city, Brazil.

The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.

Reliability and validity of the Brazilian version of the world health organization disability assessment schedule (WHODAS 2.0) questionnaire for women with urinary incontinence.

PURPOSE: To analyze the reliability and validity of the WHODAS 2.0 instrument for women with urinary incontinence (UI). METHODS: This is a methodological study with Brazilian women with complaints of urge, stress or mixed UI, over 18 years old, without cognitive disorders. The WHODAS 2.0 (36-item version) and the auxiliary instruments were applied through face-to-face and telephone interviews after 7-14 d. The psychometric properties evaluated were: Cronbach's alpha for internal consistency, intraclass correlation coefficient (ICC) for intra-rater test-retest, Spearman's correlation coefficient (rho) for construct validity of WHODAS 2.0 with auxiliary instruments; and ANOVA for discriminative validity with UI severity. RESULTS: 101 women with UI with a mean age of 50.71 ± 10.39 were included. WHODAS 2.0 showed good reliability in all domains and excellent reliability in the total score (>0.80). The intra-evaluator test-retest showed ICC values between 0.59 and 0.87 (p < 0.001). We observed a positive correlation between the WHODAS 2.0 domains and the instruments recommended by International Continence Society (ICS), with greater emphasis on moderate correlation with the Urinary Impact Questionnaire (IUQ-7) subscale (rho = 0.730 p < 0.001). CONCLUSION: The WHODAS 2.0 instrument is a reliable and valid questionnaire for investigating the functioning and disability of women with UI.

The WHODAS 2.0 is a valid and reliable tool for future functioning research with women with urinary incontinence.The WHODAS 2.0 can be used in clinical practice to assess disabilities in women with urinary incontinence.The validation of WHODAS 2.0 reinforces the need for rehabilitation based on the functioning needs of each patient with urinary incontinence.The WHODAS 2.0 assesses functioning based on the biopsychosocial model, supported by the ICF (International Classification of Functioning, Disability and Health).

Could an increased risk of obstructive sleep apnoea be one of the determinants associated with disability in individuals with cardiovascular and cerebrovascular diseases?

PURPOSE: To investigate a possible association between the risk of obstructive sleep apnoea (OSA) and disability in individuals with cardiovascular or cerebrovascular diseases. METHODS: Cross-sectional study was conducted with 373 individuals (313 with cardiovascular or cerebrovascular diseases and 60 healthy). Disability was assessed by the 12-item World Health Organization Disability Assessment Schedule (WHODAS), and the risk of OSA was assessed by STOP-BANG. Anxiety and depression symptoms, daytime sleepiness, and cognition were assessed by the Hospital Anxiety and Depression Scale (HADS), Epworth Sleepiness Scale (ESS), and Mini Mental State Examination (MMSE). RESULTS: Greater disability was found in individuals with intermediate or high risk of OSA, considering healthy individuals (p=0.03), or individuals diagnosed with arrhythmia (p<0.01) or coronary artery disease (p=0.04). A high risk of OSA and higher WHODAS scores was significant among women as well as between OSA risk categories (p<0.01). Cognitive deficit and level of education also showed differences between OSA risk categories. Age, depression, and sleepiness were also associated with the subjects' disability (p<0.01). Gamma regression model showed higher WHODAS scores in female, in those with intermediate and high risk of OSA, and in those with depressive symptoms and cognitive deficit. Age also showed a correlation with higher WHODAS scores. The presence of all investigated cardio and cerebrovascular diseases showed an increase in the WHODAS score, implying a greater disability compared to healthy individuals. CONCLUSION: Moderate and high risk of OSA is associated with disability, as well as gender, age, depressive symptoms, cognitive deficit, and cardiovascular diseases.

The Brazilian version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) is reliable and valid for chronic stroke survivors.

BACKGROUND: Stroke is the leading cause of disability worldwide. Assessing stroke's impact on patients' daily activities and social participation can provide important complementary information to their rehabilitation process. However, no previous study had been conducted on the psychometric properties of the Brazilian version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) in the stroke population. OBJECTIVES: This study aimed to examine the internal consistency, test-retest and inter-rater reliability, convergent validity and floor/ceiling effect of the Brazilian version of the WHODAS 2.0 in individuals after chronic stroke. METHODS: Two examiners interviewed 53 chronic stroke individuals who responded to the Brazilian 36-item version of the WHODAS 2.0 three times to analyze test-retest and inter-rater reliabilities. Floor/ceiling effects were calculated as relative frequencies of the lowest or the highest possible WHODAS 2.0 scores. Participants also responded to the Stroke Impact Scale 3.0 (SIS 3.0) and the Functional Independence Measure (FIM) to analyze convergent validity. RESULTS: The internal consistency analyses for domains of WHODAS showed a strong correlation among the items of each domain (0.76-0.91) except for the "getting along" domain, which presented a moderate correlation (ρ = 0,62). Total scores of WHODAS 2.0 showed satisfactory internal consistency (α = 0.93), good inter-rater reliability (ICC = 0.85), excellent test-retest reliability (ICC = 0.92) and no significant floor/ceiling effect. Convergent validity indicated moderate to strong correlations (ρ=-0.51 to ρ=-0.88; p < 0.001), with the highest values associated with the correlation with the SIS scale. CONCLUSIONS: The Brazilian version of the WHODAS 2.0 instrument presented evidence of reliability and validity for chronic post-stroke individuals.

Which Components of The International Classification of Functioning, Disability and Health (ICF) are Covered by Cardiac Rehabilitation Assessment Tools among Individuals with Heart Failure?

BACKGROUND: The therapeutic assessment of functioning in cardiac rehabilitation from the perspective of the International Classification of Functioning, Disability and Health (ICF) can provide a biopsychosocial approach to health care. However, it is unclear which components are reflected in the instruments used for cardiac rehabilitation in individuals with heart failure (HF). OBJECTIVES: To investigate which ICF components (body function, structures, activities, participation, environmental factors, and personal factors) are represented in the assessment instruments used in individuals with HF and to identify the most appropriate instrument to use based on the inclusion of these factors. METHODS: Forty-four clinical trials included in an updated Cochrane systematic review that investigated the effects of exercise-based cardiac rehabilitation in patients with HF were reviewed. The instruments were analyzed to extract significant concepts linked to the ICF codes. RESULTS: A total of 12 outcomes and 40 instruments were identified. The concepts were linked to 2466 codes in the following ICF components: body functions (41.8%), activities (29.7%), participation (8.4%), environmental factors (3.8%), personal factors (1.3%), and body structures (1.0%); other concepts (13.9%) were classified as not covered by ICF. None of the instruments presented concepts linked to all ICF components. The Minnesota Living with Heart Failure Questionnaire (MLHFQ), however, demonstrated comprehensive coverage of the ICF components, with the exception of body structure. CONCLUSIONS: Body function was the most frequently detected ICF component. Individual instruments did not provide a comprehensive perspective on the functioning level of individuals with HF. The MLHFQ provided the greatest coverage of ICF components.

Impairments, health conditions and health risk behaviors: occurrence and associations, in the National Health Survey, Brazil, 2019.

OBJECTIVE: To analyze association of visual, hearing, mental/intellectual, physical and multiple impairments with health conditions and health risk behaviors in Brazil. METHODS: This was a cross-sectional study, using data from the 2019 National Health Survey; associations between impairments and presence of cardiovascular disease (CVD), hypertension, diabetes mellitus (DM), high cholesterol, alcohol abuse and smoking were estimated using logistic regression, thus obtaining the odds ratios (OR). RESULTS: Impairment was reported by 7.6% of the 90,846 participants. Having a impairment was associated with greater odds of reporting chronic conditions, especially CVD (OR = 2.11; 95%CI 1.76;2.54) and DM (OR = 1.78; 95%CI 1.56;2.02 ); visual impairment was associated with greater odds of smoking (OR = 1.52; 95%CI 1.28;1.81); mental/intellectual impairment was inversely related to smoking (OR = 0.45; 95%CI 0.30;0.67) and alcohol abuse (OR = 0.13; 95%CI 0.06;0.26). CONCLUSION: Having any of the impairments studied may be associated with greater odds of having chronic health conditions. MAIN RESULTS: Positive association was identified between having one or more impairments, and health conditions and health risk behaviors. The higher the prevalence of mental/intellectual, physical and multiple impairments, the lower alcohol abuse and smoking. IMPLICATIONS FOR SERVICES: As this population is vulnerable to chronic health conditions, health services need strategies to reduce barriers to access, as well as health promotion actions, such as health education, adapted for people with impairments. PERSPECTIVES: Topics for future studies, examining the inverse relationship between impairments and alcohol abuse and smoking, in addition to acting on the causal chain, so as to prevent health conditions and health risk behaviors.

Translation and cross-cultural adaptation of the Model Disability Survey (MDS) for Brazil.

OBJECTIVE: This study has as objective the translation and cross-cultural adaptation of the Model Disability Survey (MDS), a World Health Organization instrument that provides comprehensive information on disability/functioning, for Brazil. METHODS: This is a cross-sectional methodological study, carried out through five stages - initial translation, synthesis of translations, reverse translation, review by a specialist committee, and pre-test -, considering properties such as semantic, idiomatic, experimental, and conceptual equivalence. Translators, researchers, a mediating team, health professionals, a methodologist and a language specialist were needed to pass through the stages. Statistical analysis was produced from absolute and relative frequencies, measures of central tendency and dispersion, normality tests and content validity index (CVI) > 0.80. RESULTS: The MDS has 474 items, which generated 1,896 analyzes of equivalence. Of these, 160 items had a CVI < 0.80 in at least one of the four types of equivalence and required adjustments. After adaptations and approval by the judges, the pre-final version went on to the pre-test with 30 participants from four regions of the Brazilian Northeast. Regarding this sample, 83.3% are women, single, with an average age of 33.7 years (SD 18.8), self-declared as black or brown, active workers, with technical education and living with three residents. Interviews lasted 123 minutes on average, where 127 health conditions were mentioned, and the most frequent cited were anxiety and back pain. Answers were analyzed and 63 items were cited as needing some adjustment, two of which were submitted for analysis by the committee because they presented a CVI < 0.80. The instrument, guide and presentation cards were adjusted after a new pre-test. CONCLUSIONS: The MDS was translated and cross-culturally adapted to Brazilian Portuguese and showed adequate content validity.

Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review.

PURPOSE: We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs. METHODS: We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM. RESULTS: We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity. CONCLUSION: Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.

This review adds evidence to the area of musculoskeletal disorders in children and adolescents, which is still underexplored.Valid adult Patient-Reported Outcome Measures (PROMs) have been used to assess disability in children and adolescents with low back pain. However, it is recommended to use PROMs that are tested and valid for evaluation of the population of interest.The activities domain was the International Classification of Functioning, Disability and Health domain that presented the highest number of linked concepts, whereas concepts from personal factors were absent.The modified Hannover Functional Ability Questionnaire and the Micheli Functional Scale could potentially be used to assess disability in children and adolescents with low back pain, but high-quality studies are needed for the measurement properties, in particular content validity and responsiveness.

Is it time to rethink disability assessment in low back pain? Reliability, internal consistency, and construct validity of the Brazilian WHODAS 2.0 for chronic low back pain.

BACKGROUND AND PURPOSE: The World Health Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed to assess health and disability based on the biopsychosocial model. The WHODAS 2.0 has not been validated for Brazilians with chronic non-specific low back pain (LBP). We aimed to evaluate the reliability, internal consistency, and construct validity of the Brazilian version of the WHODAS 2.0 in patients with chronic LBP. METHODS: Methodological study. The Brazilian version of the WHODAS 2.0 was applied to 100 volunteers with chronic nonspecific LBP. Test-retest reliability, internal consistency, and construct validity were assessed using the Spearman correlation test, Cronbach's alpha (α) coefficient, and Spearman's correlation test between WHODAS 2.0, the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Fear Avoidance Beliefs Questionnaire (FABQ), respectively. RESULTS: WHODAS 2.0 showed satisfactory test-retest reliability with a moderate correlation for total WHODAS 2.0 (r = 0.75, p < 0.05). Internal consistency was adequate for all domains and total score (α = 0.82-0.96). Regarding construct validity, WHODAS 2.0, ODI (r = 0.70, p < 0.05), and WHODAS 2.0 and RMDQ (r = 0.71, p < 0.05) had significant correlations. Total WHODAS 2.0 and FABQ-Phys subscale scores correlated moderately (r = 0.66, p < 0.05). DISCUSSION: The Brazilian WHODAS 2.0 was proved to be a valid and reliable tool for patients with chronic LBP. The item referring to sexual intercourse had 27% and 30% of the missing values during the test and retest stage, respectively and had a high percentage of missing data for work-related questions (41% missing data) in the life activities domain; therefore, the data must be interpreted with caution. IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE: WHODAS 2.0 can be used as a disability assessment strategy from a biopsychosocial perspective in this population.

Promoting diversity and overcoming publication barriers in Latin American neuroscience and Alzheimer's disease research: A call to action.

Alzheimer's disease (AD) is a global health issue. Because AD is a condition demanding effective management, its socioeconomic burden is immense and threatens the health systems of both low- and middle-income (LMIC) and high-income (HIC) countries. However, while most of the HICs are increasing their budget for AD research, the situation is different in LMICs, and resources are scarce. In addition, LMIC researchers face significant barriers to publishing in international peer reviewed journals, including funding constraints; language barriers; and in many cases, high article processing charges. In this perspective, we discuss these disparities and propose some actions that could help promote diversity, and ultimately translate into improved AD research capacity in LMICs, especially in Latin American and Caribbean countries. HIGHLIGHTS: Researchers in low- and middle-income countries (LMIC) face increasing difficulties such as financial constraints, language barriers, and article processing charges.Publication fees, in particular, can be a significant barrier in the process of publication and equal access to scientific information.Publication fee equalization initiatives by publishing companies could reduce the scientific inequality that disadvantages researchers in LMICs.

Biopsychosocial Model Domains in Clinical Practice Guidelines for Return to Sport After ACL Injury: Systematic Review Using the AGREE II Checklist.

CONTEXT: The current status of return-to-sport (RTS) criteria can be understood from the International Classification of Functioning, Disability, and Health (ICF), which emphasizes an individual-centered approach and inclusion of all domains of human functioning, and ensures the multifactorial and biopsychosocial nature of decision-making. OBJECTIVE: To analyze the inclusion of biopsychosocial model domains in clinical practice guidelines (CPGs) for RTS after anterior cruciate ligament (ACL) injury, as well as the quality of these CPGs. STUDY DESIGN: Systematic review of CPGs. LEVEL OF EVIDENCE: Level 1. SEARCH STRATEGY: Two independent reviewers developed the search strategy, and a third reviewer corrected and compiled the developed strategies used. DATA SOURCES: Ovid/Medline, Embase, and PEDro without restriction dates. STUDY SELECTION: CPGs for RTS after ACL injury at any age or sport level, and published in English. DATA EXTRACTION: Two independent reviewers codified the RTS criteria recommended in the CPGs according to the ICF domains, and the Appraisal of Guidelines for Research and Evaluation II (AGREE II Checklist) was used for critical appraisal. RESULTS: A total of 715 records were identified, and 7 CPGs were included. Frequency distribution of the biopsychosocial model domains was as follows: body functions (37.77%), activity and participation (20.00%), body structure (13.33%), environmental factors (11.11%), and personal factors (8.88%). In the AGREE II Checklist, the lowest mean domain scores were for rigor of development (37.86 ± 36.35) and applicability (49.29 ± 22.30), and 71.42% were of low or moderate quality. CONCLUSION: The CPGs cannot address the biopsychosocial model domains satisfactorily and some do not address all the ICF conceptual model components, emphasizing body functions and activity and participation domains. Therefore, the functioning model advocated by the World Health Organization has not yet been adequately incorporated into the recommendations for RTS after ACL injury. Moreover, most CPGs are of limited quality.

Impairments, health conditions and health risk behaviors: occurrence and associations, in the National Health Survey, Brazil, 2019 / Discapacidades, condiciones de salud y conductas de riesgo para la salud: ocurrencia y asociaciones, en la Encuesta Nacional de Salud, Brasil, 2019 / Deficiências, condições de saúde e comportamentos de risco à saúde: ocorrência e associações, na Pesquisa Nacional de Saúde, Brasil, 2019

ABSTRACT Objective To analyze association of visual, hearing, mental/intellectual, physical and multiple impairments with health conditions and health risk behaviors in Brazil. Methods This was a cross-sectional study, using data from the 2019 National Health Survey; associations between impairments and presence of cardiovascular disease (CVD), hypertension, diabetes mellitus (DM), high cholesterol, alcohol abuse and smoking were estimated using logistic regression, thus obtaining the odds ratios (OR). Results Impairment was reported by 7.6% of the 90,846 participants. Having a impairment was associated with greater odds of reporting chronic conditions, especially CVD (OR = 2.11; 95%CI 1.76;2.54) and DM (OR = 1.78; 95%CI 1.56;2.02 ); visual impairment was associated with greater odds of smoking (OR = 1.52; 95%CI 1.28;1.81); mental/intellectual impairment was inversely related to smoking (OR = 0.45; 95%CI 0.30;0.67) and alcohol abuse (OR = 0.13; 95%CI 0.06;0.26). Conclusion Having any of the impairments studied may be associated with greater odds of having chronic health conditions.

RESUMEN Objetivo Analizar la asociación entre discapacidad visual, auditiva, mental/intelectual, física y discapacidad múltiple con condiciones y conductas de riesgo para la salud en Brasil. Métodos Estudio transversal utilizando datos de la Encuesta Nacional de Salud de 2019; se estimaron, mediante regresión logística, las asociaciones entre discapacidad con la presencia de enfermedades cardiovasculares (ECV), hipertensión, diabetes, colesterol alto, consumo de alcohol y tabaquismo, obtención del odds ratio (OR). Resultados De los 90.846 participantes, el 7,6% refirió discapacidad. Tener una discapacidad se asoció con una mayor probabilidad de reportar enfermedades crónicas, especialmente ECV (OR = 2,11; IC95% 1,76;2,54) y diabetes (OR = 1,78; IC95% 1,56;2,02); la discapacidad visual se asoció con una mayor probabilidad de fumar (OR = 1,52; IC95% 1,28;1,81); la discapacidad mental/intelectual mostró una relación inversa con el tabaquismo (OR = 0,45; IC95% 0,30;0,67) y el consumo de alcohol (OR = 0,13; IC95% 0,06;0,26). Conclusión Se observó que tener alguna de las discapacidades estudiadas puede estar asociado con mayores posibilidades de tener condiciones crónicas de salud.

RESUMO Objetivo Analisar a associação de deficiências visual, auditiva, mental/intelectual, física e deficiência múltipla com as condições e comportamentos de risco à saúde no Brasil. Métodos Estudo transversal, utilizando-se dados da Pesquisa Nacional de Saúde de 2019; associações entre deficiências e presença de doença cardiovascular (DCV), hipertensão arterial, diabetes mellitus (DM), colesterol alto, consumo abusivo de álcool e tabagismo foram estimados por regressão logística, obtendo-se a razão de chances (RC). Resultados Dos 90.846 participantes, 7,6% reportaram deficiência. Ter deficiência associou-se a maiores chances de relatar condições crônicas, especialmente DCV (RC = 2,11; IC95% 1,76;2,54) e DM (RC = 1,78; IC95% 1,56;2,02); deficiência visual associou-se a maior chance de tabagismo (RC = 1,52; IC95% 1,28;1,81); deficiência mental/intelectual apresentou relação inversa com tabagismo (RC = 0,45; IC95% 0,30;0,67) e consumo abusivo de álcool (RC = 0,13; IC95% 0,06;0,26). Conclusão Apresentar alguma das deficiências estudadas pode-se associar a maiores chances de ter condições crônicas de saúde.

Translation and cross-cultural adaptation of the Model Disability Survey (MDS) for Brazil / Tradução e adaptação transcultural do Model Disability Survey (MDS) para o Brasil

ABSTRACT OBJECTIVE This study has as objective the translation and cross-cultural adaptation of the Model Disability Survey (MDS), a World Health Organization instrument that provides comprehensive information on disability/functioning, for Brazil. METHODS This is a cross-sectional methodological study, carried out through five stages - initial translation, synthesis of translations, reverse translation, review by a specialist committee, and pre-test -, considering properties such as semantic, idiomatic, experimental, and conceptual equivalence. Translators, researchers, a mediating team, health professionals, a methodologist and a language specialist were needed to pass through the stages. Statistical analysis was produced from absolute and relative frequencies, measures of central tendency and dispersion, normality tests and content validity index (CVI) > 0.80. RESULTS The MDS has 474 items, which generated 1,896 analyzes of equivalence. Of these, 160 items had a CVI < 0.80 in at least one of the four types of equivalence and required adjustments. After adaptations and approval by the judges, the pre-final version went on to the pre-test with 30 participants from four regions of the Brazilian Northeast. Regarding this sample, 83.3% are women, single, with an average age of 33.7 years (SD 18.8), self-declared as black or brown, active workers, with technical education and living with three residents. Interviews lasted 123 minutes on average, where 127 health conditions were mentioned, and the most frequent cited were anxiety and back pain. Answers were analyzed and 63 items were cited as needing some adjustment, two of which were submitted for analysis by the committee because they presented a CVI < 0.80. The instrument, guide and presentation cards were adjusted after a new pre-test. CONCLUSIONS The MDS was translated and cross-culturally adapted to Brazilian Portuguese and showed adequate content validity.

RESUMO OBJETIVO Traduzir e adaptar transculturalmente o Model Disability Survey (MDS), instrumento da Organização Mundial da Saúde que fornece informações abrangentes a respeito de deficiência/funcionalidade, para o Brasil. MÉTODOS Trata-se de um estudo metodológico de corte transversal, realizado por meio de cinco etapas - tradução inicial, síntese das traduções, retrotradução, revisão por comitê de especialistas e pré-teste -, considerando propriedades como equivalência semântica, idiomática, experimental e conceitual. Para realização das etapas foram necessários tradutores, pesquisadores, equipe mediadora, profissionais da saúde, metodologista e especialista em idiomas. A análise estatística foi produzida a partir de frequências absolutas e relativas, medidas de tendência central e dispersão, testes de normalidade e índice de validade de conteúdo (IVC) > 0,80. RESULTADOS O instrumento MDS apresenta 474 itens, o que gerou 1.896 análises de equivalências. Destes, 160 itens apresentaram IVC < 0,80 em pelo menos uma das quatro equivalências e necessitaram de ajustes. Após adequações e aprovação dos juízes, a versão pré-final seguiu para o pré-teste com 30 participantes, de quatro regiões do Nordeste brasileiro. Desta amostra, 83,3% são mulheres, solteiras, com idade média de 33,7 (DP 18,8) anos, autodeclaradas pretas ou pardas, trabalhadoras ativas, com escolaridade a partir do ensino técnico e que residiam com três moradores. O tempo médio das entrevistas foi de 123 minutos de duração. Foram mencionadas 127 condições de saúde, sendo as mais frequentes ansiedade e dores nas costas. As respostas foram analisadas e 63 itens foram citados como necessitando de algum ajuste, sendo dois destes encaminhados para análise pelo comitê por possuírem IVC < 0,80. O instrumento, manual e cartões de apresentação foram ajustados após um novo pré-teste. CONCLUSÕES O MDS foi traduzido e adaptado transculturalmente para o português brasileiro e apresentou adequada validade de conteúdo.

Symptomatic perception of patients affected by chronic chikungunya: a qualitative perspective / Percepção dos sintomas de pacientes acometidos por chikungunya crônica: um olhar qualitativo

Objective: To understand the demands caused by chikungunya in the chronic phase and their impacts on patients' mental health and quality of life. Materials and methods: This is a qualitative study, performed from November 2019 to January 2020. Focus groups and deep interviews were carried out. Then, the Discourse Analysis was performed. Results: Chronic pain was the main clinical manifestation reported by the participants, being responsible for affecting aspects related to quality of life and mental health. As for psycological view, this study showed that chronic pain was also reported as one of the main symptoms related to anxiety and depression among research subjects. Conclusion: this study demonstrated how the chronic illness caused by Chikungunya impacted the subjects' perception in the domains related to quality of life and mental health. Furthermore, we seek to focus on the management of disease in a holistic way, putting the patients' own awareness of the impacts of the disease on their lives in a relevant level of their treatment.

Objetivo: Compreender as demandas causadas pela chikungunya em sua fase crônica e seus impactos na saúde mental e na qualidade de vida dos pacientes. Métodos: Trata-se de um estudo com abordagem qualitativa, realizado entre novembro de 2019 a janeiro de 2020. Inicialmetne, foram realizados grupos focais e entrevistas em profundidade; seguidas da Análise do Discurso. Resultados: A dor crônica foi a principal manifestação clínica relatada pelos participantes, sendo responsável por afetar aspectos relacionados à qualidade de vida e saúde mental. Quanto ao aspecto psicológico, este estudo mostrou que a dor crônica também foi relatada como um dos principais sintomas relacionados à ansiedade e depressão entre os sujeitos da pesquisa. Conclusão: este estudo demonstrou como a doença crônica causada pela chikungunya impactou na percepção dos sujeitos em seus domínios relacionados à qualidade de vida e saúde mental. Além disso, procuramos centrar-nos na gestão da doença de forma holística, colocando a consciência dos próprios doentes sobre os impactos da doença nas suas vidas num nível relevante do seu tratamento.

Brazilian practice guidelines for stroke rehabilitation: Part II.

The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderência ao uso de medicamentos, cuidados paliativos, o futuro da reabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World.

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

Brazilian practice guidelines for stroke rehabilitation: part II / Diretrizes brasileiras para reabilitação no acidente vascular cerebral: parte II

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

Association of social factors and health conditions with capacity and performance.

OBJECTIVE: Determine and measure the association of social factors and health conditions with worse capacity and performance levels. METHODS: Dependent variables consisted of performance and capacity; independent variables comprised age, gender, level of education, personal income, and health conditions. Means (95%CI) of performance and capacity were presented according to the independent variables. Generalized linear models, using a mutual adjustment for all variables considered statistically significant (p < 0.05), measured the associations between each exposure and outcomes. Study population included 12,265 individuals. RESULTS: Older women with lower education and income levels and with some health condition showed the worst performance and capacity. CONCLUSION: Results showed that the capacity and performance levels of the Chilean population changed according to social demographic characteristics and health conditions.