The social dimension of quality of life following spinal cord injury or disease: an international ICF-linking study.

STUDY DESIGN: International Classification of Functioning, Disability and Health (ICF) linking study. OBJECTIVE: Analyze cognitive interview data using the ICF as an analytic framework, to examine aspects of social life relevant to quality of life (QoL) according to people with spinal cord injury or disease (SCI/D). This study builds upon results of an international study about the cross-cultural validity of the International SCI QoL Basic Data Set (QoL-BDS). SETTING: Four specialized outpatient clinics in SCI/D rehabilitation, from the US, Brazil and Australia. METHODS: Analysis of qualitative data from 39 cognitive interviews with SCI/D patients at least one year post onset. Participants were asked to define their concept of QoL, overall life satisfaction, physical health and psychological health, and other relevant matters. Four independent researchers coded text fragments related to the items, and fragments were linked to ICF chapters d6-d9, following established linking rules. RESULTS: The proportion of text referring to social life was 35.8% (definition QoL), 24.9% (QoL life as whole), 6.0% (physical health) and 34.9% (psychological health). The most frequent ICF categories were d760 Family relationships, d770 Intimate relationships and d920 Recreation and leisure. Most frequent responded social topics to the 'other issues' item were d770 Intimate relationships, d760 Formal relationships, and d870 Economic self-sufficiency. CONCLUSION: The importance of social life aspects to the QoL was highlighted based on responses of SCI/D patients, clearly demonstrated through the ICF linking process. Adding a satisfaction with social life item to the QoL-BDS has made this instrument a more comprehensive measure.

A cross-cultural mixed methods validation study of the spinal cord injury quality of life basic dataset (SCI QoL-BDS).

STUDY DESIGN: Mixed methods inquiry using cognitive interviews and thematic content analysis. OBJECTIVES: Cross-validation of the concept of quality of life (QoL) and of the International Spinal Cord Injury Quality of Life Basic DataSet (SCI QoL-BDS) items across five sites in four countries: United States, Australia, Brazil, and the Netherlands. Analysis aimed to uncover patterns, differences, and similarities suggesting conceptual equivalence for overall QoL and the three SCI QoL-BDS items. SETTING: International, community. METHODS: Semi-structured cognitive interviews with 51 participants across five sites and four countries. Participants with spinal cord injury/disease (SCI/D) completed the SCI QoL-BDS items and one additional question. Interviews were audio recorded and transcribed. Transcripts were coded using NVivo software. Coded data were analyzed using thematic content analysis. Seventeen themes were identified. Responses by sites were compared for conceptual equivalence. RESULTS: Across the five sites, equivalence in the conceptual meaning of QoL was found based on the frequent commonalities in terminology employed to describe it. Despite sample differences in terms of demographic and SCI characteristics, participants across all sites replied to the SCI QoL-BDS items in a similar way, suggesting good item equivalence. Qualitatively, the differences noted with respect to the use of themes for each question suggest some variability on how participants with SCI/D describe QoL. In spite of these contextual differences, there is a high degree of commonalty not explained by participants' demographic or injury/disease characteristics. CONCLUSIONS: The SCI QoL-BDS shows good cross-cultural validity among the international sites included in this study.

The dose-response phenomenon associated with strength training is independent of the volume of sets and repetitions per session / O fenômeno de dose-resposta associado ao treinamento de força é independente do volume de séries e repetições por sessão / El fenómeno de dosis-respuesta asociado al entrenamiento de fuerza es independiente del volumen de series y repeticiones por sesión

ABSTRACT Introduction There are few studies on the effectiveness of training models with high volume sets per session in particular muscle groups. Objective The aim of the study was to investigate the effects of different resistance training (RT) repetitions with equalized volumes on muscle adaptations. Methods This study used an experimental design in which forty-seven volunteers underwent 8 weeks of RT after having been distributed randomly into three groups: ten sets of three maximum repetitions (10x3), three sets of ten maximum repetitions (3x10) and five sets of six maximum repetitions (5x6) for each muscular group per training session. Maximum strength (1RM test) and muscle thickness (MT) were evaluated as outcomes. Results A significant main effect (p=0.001) of time on maximum strength was observed for the three groups, but no significance was observed (p>0.05) in time x group interactions. A significant main effect (p=0.001) of time was observed on MT for biceps, triceps and vastus lateralis, without significant differences for time x group interactions. Significant correlations were found between maximum strength and muscle thickness after general statistical analyses for all protocols. Conclusion Improvements in maximum strength and muscle thickness are similar when repetition volumes are equalized through the number of series and repetitions. Level of evidence I; Therapeutic studies, investigation of treatment results.

RESUMO Introdução Existem poucos estudos sobre a eficácia de modelos de treinamento com conjuntos de alto volume por sessão em grupos musculares específicos. Objetivos O objetivo do estudo foi investigar os efeitos de diferentes repetições do treinamento de resistência (TR) com volumes equalizados nas adaptações musculares. Métodos Este estudo tem desenho experimental com 47 voluntários que realizaram oito semanas de TR depois de serem distribuídos randomicamente em três grupos: dez séries de três repetições máximas (10x3), três séries de dez repetições máximas (3x10) e cinco séries de seis repetições máximas (5x6) para cada grupo muscular por sessão de treinamento. A força máxima (teste de 1RM) e a espessura muscular (EM) foram avaliadas como desfecho. Resultados Verificou-se efeito significativo (p = 0,001) sobre o tempo na força máxima nos três grupos, contudo, nenhuma significância (p > 0,05) foi observada nas interações entre tempo e grupo. Constatou-se efeito significativo (p = 0,001) do tempo sobre a EM para bíceps, tríceps e vasto lateral, sem diferenças significativas nas interações entre tempo e grupo. Correlações significativas foram encontradas entre força máxima e espessura muscular depois das análises estatísticas gerais para todos os protocolos. Conclusões A melhora da força máxima e da espessura muscular é semelhante quando o volume de repetições é equalizado considerando o número de séries e repetições. Nível de evidência I; Estudos terapêuticos, investigação dos resultados do tratamento.

RESUMEN Introducción Existen pocos estudios sobre la eficacia de modelos entrenamiento con conjuntos de alto volumen por sesión en grupos musculares específicos. Objetivos El objetivo del estudio fue investigar los efectos de diferentes repeticiones del entrenamiento de resistencia (ER) con volúmenes ecualizados en las adaptaciones musculares. Métodos Este estudio tiene diseño experimental con 47 voluntarios que realizaron ocho semanas de ER después de ser distribuidos aleatoriamente en tres grupos: diez series de tres repeticiones máximas (10x3), tres series de diez repeticiones máximas (3x10) y cinco series de seis repeticiones máximas (5x6) para cada grupo muscular por sesión de entrenamiento. La fuerza máxima (test de 1RM) y el espesor muscular (EM) fueron evaluados como conclusión. Resultados Se verificó efecto significativo (p = 0,001) sobre el tiempo en la fuerza máxima en los tres grupos, sin embargo, ninguna significancia (p> 0,05) fue observada en las interacciones entre tiempo y grupo. Se constató efecto significativo (p = 0,001) del tiempo sobre el EM para bíceps, tríceps y vasto lateral, sin diferencias significativas en las interacciones entre tiempo y grupo. Fueron encontradas correlaciones significativas entre fuerza máxima y espesor muscular después de los análisis estadísticos generales para todos los protocolos. Conclusiones La mejora de la fuerza máxima y del espesor muscular es semejante cuando el volumen de repeticiones es ecualizado considerando el número de series y repeticiones. Nivel de evidencia I; Estudios terapéuticos, investigación de los resultados del tratamiento.

Muscle Activation Differs Between Partial and Full Back Squat Exercise With External Load Equated.

Changes in range of motion affect the magnitude of the load during the squat exercise and, consequently, may influence muscle activation. The purpose of this study was to evaluate muscle activation between the partial and full back squat exercise with external load equated on a relative basis between conditions. Fifteen young, healthy, resistance-trained men (age: 26 ± 5 years, height: 173 ± 6 cm) performed a back squat at their 10 repetition maximum (10RM) using 2 different ranges of motion (partial and full) in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), semitendinosus, erector spinae, soleus (SL), and gluteus maximus (GM). In general, muscle activity was highest during the partial back squat for GM (p = 0.004), BF (p = 0.009), and SL (p = 0.031) when compared with full-back squat. There was no significant difference for rating of perceived exertion between partial and full back squat exercise at 10RM (8 ± 1 and 9 ± 1, respectively). In conclusion, the range of motion in the back squat alters muscle activation of the prime mover (GM) and stabilizers (SL and BF) when performed with the load equated on a relative basis. Thus, the partial back squat maximizes the level of muscle activation of the GM and associated stabilizer muscles.

Muscle strength, postural balance, and cognition are associated with braking time during driving in older adults.

BACKGROUND: Despite the well-known declines in driving performance with advancing age, there is little understanding of the specific factors that predict changes in key determinants such as braking time. OBJECTIVES: The aims of this study were to determine the extent to which age, muscle strength, cognition and postural balance are associated with braking performance in middle-aged and older adults. METHODS: Male and female middle-aged adults (n=62, age=39.3±7.1years) and older adults (n=102, age=70.4±5.8years) were evaluated for braking performance, as well as in several motor and cognitive performance tasks. The motor evaluation included isokinetic ankle plantar flexor muscle strength, handgrip strength, and postural balance with and without a cognitive task. The cognitive assessment included the Mini Mental State Examination. Braking performance was measured using a driving simulator. RESULTS: Older adults exhibited 17% slower braking time, lower strength, and poorer performance in the postural balance (p<0.001). For both older and middle-aged adults, significant correlates of braking time included performance in the postural balance tests, muscle strength, and cognitive function. However, after full model adjustment, only postural balance and cognitive function were significantly associated. CONCLUSION: Muscle strength, postural balance, and cognition are associated with braking time, and may affect the safety of and driving performance in older adults. These findings may help to inform specific targeted interventions that could preserve driving performance during aging.

The effects of foot morphology and anthropometry on unipodal postural control

The maintenance of posture is a constant challenge for the body, as it requires rapid and accurate responses to unforeseen disturbances, which are needed to prevent falls and maintain balance. The purpose of the present study was to compare different types of plantar arch in relation to postural balance, and analyze the relationships between variations the plantar arch and anthropometric characteristics of the feet with unipedal static balance. We evaluated 100 men and women between the ages of 20 and 40 years old, to determine anthropometry and posturography with a force platform. There was a weak correlation between plantar arches and anthropometric measurements and postural balance, except for the length of the male foot, which showed a correlation between increased size and poorer static balance. We conclude that the type of plantar arch does not influence postural balance, and of the anthropometric factors, only foot length was related to postural balance.

Relation between the Sensory and Anthropometric Variables in the Quiet Standing Postural Control: Is the Inverted Pendulum Important for the Static Balance Control?

UNLABELLED: The aim of this study was to evaluate the relation between the sensory and anthropometric variables in the quiet standing. METHODS: One hundred individuals (50 men, 50 women; 20-40 years old) participated in this study. For all participants, the body composition (fat tissue, lean mass, bone mineral content, and bone mineral density) and body mass, height, trunk-head length, lower limb length, and upper limb length were measured. The center of pressure was measured during the quiet standing posture, the eyes opened and closed with a force platform. Correlation and regression analysis were run to analyze the relation among body composition, anthropometric data, and postural sway. RESULTS: The correlation analysis showed low relation between postural sway and anthropometric variables. The multiple linear regression analyses showed that the height explained 12% of the mediolateral displacement and 11% of the center of pressure area. The length of the trunk head explained 6% of displacement in the anteroposterior postural sway. During eyes closed condition, the support basis and height explained 18% of mediolateral postural sway. CONCLUSION: The postural control depends on body composition and dimension. This relation is mediated by the sensory information. The height was the anthropometric variable that most influenced the postural sway.

Static and dynamic postural control in low-vision and normal-vision adults.

OBJECTIVE: This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions. METHODS: Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over. RESULTS: The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001). CONCLUSION: These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces.

Static and dynamic postural control in low-vision and normal-vision adults

OBJECTIVE: This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions. METHODS: Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over. RESULTS: The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001). CONCLUSION: These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces. .

Heart rate response to exercise and cardiorespiratory fitness of young women at high familial risk for hypertension: effects of interval vs continuous training.

Exercise training is an effective intervention for treating and preventing hypertension, but its effects on heart rate (HR) response to exercise and cardiorespiratory fitness (CRF) of non-hypertensive offspring of hypertensive parents (FH+) has not been studied. We compared the effects of three times per week equal-volume high-intensity aerobic interval (AIT) and continuous moderate-intensity exercise (CME) on HR response to exercise and CRF of FH+. Forty-four young FH+ women (25.0 ± 4.4 years) randomized to control (CON; n = 12), AIT (80-90% of VO(2MAX); n = 16), or CME (50-60% of VO(2MAX); n = 16) performed a graded exercise test (GXT) before and after 16 weeks of follow-up to evaluate HR response to exercise and several parameters of CRF. Resting, maximal, and reserve HR did not change after the follow-up in all groups. HR recovery (difference between HR(MAX) and HR at 1 minute of GXT recovery phase) improved only after AIT (11.8 ± 4.9 vs. 20.6 ± 5.8 bpm, p < 0.01). Both exercise programmes were effective for improving CRF parameters, but AIT was more effective than CME for improving oxygen consumption at the respiratory compensation point (VO(2RCP); 22.1% vs. 8.8%, p = 0.008) and maximal effort (VO(2MAX); 15.8% vs. 8.0%, p = 0.036), as well as tolerance time (TT) to reach anaerobic threshold (TT(AT); 62.0 vs. 37.7, p = 0.048), TT(RCP) (49.3 vs. 32.9, p = 0.032), and TT(MAX) (38.9 vs. 29.2, p = 0.042). Exercise intensity was an important factor in improving HR recovery and CRF of FH+women. These findings may have important implications for designing exercise-training programmes for the prevention of an inherited hypertensive disorder.

Age does not affect exercise intensity progression among women.

It has been recommended that the intensity of exercise training (ET) should progress slowly with lower increments in older than in young people. However, scientific evidence supporting this recommendation is lacking. Our aim was to examine possible influences of age on exercise intensity progression in healthy women. Seventeen young (29.1 ± 5.7 years) and 16 older women (64.5 ± 4.5 years) underwent 13 weeks of ET consisting of cycle ergometry (CE, 65-75% of reserve heart rate), whole-body resistance exercise (RE, 60% of 1 repetition maximum [1RM]), and stretching. Muscle strength was assessed before and after ET by the 1RM. Cycle ergometry and RE workloads were recorded for each exercise session, and increases of 5-10% were made whenever adaptation occurred. Absolute muscle strength after ET improved (p < 0.001) in both groups, and there were no significant differences between groups. Relative exercise intensity progression was not significantly different between groups for RE (Pearson's correlation = 0.98 ± 0.01), but it was greater in older women for CE (p = 0.047). The ET was safe because no injuries or major muscle pain was observed in either group. These results suggest that healthy older women are capable of exercising and increasing exercise intensity in the same way as young women.

Avaliaçåo isocinética no joelho do atleta / Isokinetic evaluation of athletesï knee

A avaliaçäo isocinética tem sido usada nas últimas três décadas como método para se determinar o padräo funcional da força e do equilíbrio muscular. No nosso meio cresceu nos últimos 10 anos. É possível quantificar valores absolutos do torque, do trabalho e da potência de grupos musculares, bem como valores relativos, ou seja, da proporçäo agonista/antagonista de tais grupos. Outro recurso valioso consiste como método auxiliar na reabilitaçäo das lesöes esportivas. O exame é realizado com velocidade angular constante e prederminada, seja lenta, intermediária e/ou rápida. O joelho é a articulaçäo em que se observa maior aplicaçäo e estudos isocinéticos. Na prática esportiva, temos por um lado a importância da proporçäo do equilíbrio muscular agonista/antagonista, ou seja, do equilíbrio flexor/extensor representado, respectivamente, pelos isquiotibiais/quadríceps. De outro, a comparaçäo dos valores absolutos da funçäo muscular entre os lados direito e esquerdo, quer seja para o quadríceps, ou para os isquiotibiais. Resultados alterados estäo relacionados, geralmente, às lesöes esportivas ou suas seqüelas. De interesse para o atleta e para a equipe multidisciplinar é poder dispor de um método de avaliaçäo funcional muscular objetivo e seguro, que forneça dados confiáveis e reprodutíveis. Aspecto relevante, que forneça dados confiáveis e reprodutíveis. Aspecto relevante reside no fato do resultado do teste isocinético poder ser útil nos critérios de retorno a atividade esportiva pós-lesäo. Este artigo de revisäo consiste em abordar alguns aspectos práticos da avaliçäo isocinética no joelho e sua utilizaçäo para os indivíduos que realizam atividade física

Avaliaçäo isocinética no joelho do atleta / Isokinetic evaluation of athletesï knees

A avaliação isocinética tem sido usada nas últimas três décadas como método para se determinar o padrão funcional da força e do equílibrio muscular. No nosso meio cresceu nos últimos 10 anos. É possível quantificar valores absolutos do torque, do trabalho e da potência de grupos musculares, bem como valores relativos, ou seja, da proporção agonista/antagonista de tais grupos. Outro recurso valioso consiste em ser método auxiliar na reabilitação das lesões esportivas. O exame é realizado com velocidade angular constante e predeterminada, seja lenta, intermediária e/ou rápida. O joelho é a articulação em que se observa maior aplicação e estudos isocinéticos. Na prática esportiva, temos por um lado a importância da proporção do equilíbrio muscular agonista/antagonista, ou seja, do equilíbrio flexor/extensor representado, respectivamente, pelos isquiotibiais/quadríceps. De outro, a comparação dos valores absolutos da função muscular entre os lados direito e esquerdo, quer seja para o quadríceps, ou para os isquiotibiais. Resultados alterados estão relacionados, geralmente, às lesões esportivas ou suas seqüelas. De interesse para o atleta e para a equipe multidisciplinar é poder dispor de um método de avaliação funcional muscular objetivo e seguro, que forneça dados confiáveis e reprodutíveis. Aspecto relevante reside no fato do teste isocinético pode ser útil nos critérios de retorno à atividade esportiva pós-lesão. Este artigo de revisão consiste em abordar alguns aspectos práticos da avaliação isocinética no joelho e sua utilização pra os indivíduos que realizam atividade física

A eficácia dos bons resultados do tratamento cirúrgico a longo prazo do pé torto congênito idiopático / Effective and long term good results of the surgical treatment of the idiopatic congenital clubfoot

Os pés tortos congênitos idiopáticos considerados resistentes ao tratamento conservador spo sistematicamente operados. Os autores questionam a eficácia do tratamento cirúrgico quanto ao aspecto morfológico e funcional a longo prazo. Através da avaliaçäo clínica, radiográfica e podobarométrica, avaliam objetivamente o resultado. Concluem que os bons resultados, a longo prazo, do ponto de vista do objetivo, apresentam 35 por cento de deformidade residual assintomática.

Síndromes dolorosas miofasciais da regiäo cervical: disgnóstico e tratamento / Painful myofascial syndromes of the cervical region: diagnosis and treatment

As síndromes dolorosas cronicas de origem miofacial da regiao cervical sao muito freqüentes na pratica clínica e como tal devem ser reconhecidas. Suas características mais comuns sao: dores localizadas nas regioes craniana, cervical, periescapular e membros superiores, muitas vezes bizarras, nao podendo ser referidas a estruturas anatomicas ou irradiaçao radicular; de carater cronico (duraçao do quadro maior que três meses); resistentes aos tratamentos analgésicos convencionais; exames complementares normais ou com alteraçoes que nao correspondem à intensidade e localizaçao do quadro algico em si. Sao pacientes ansiosos e com incapacidade funcional para suas atividades diarias normais. O diagnóstico é clínico e depende da anamnese cuidadosa, buscando identificar os fatores desencadeantes e mantenedores do quadro doloroso, de um exame físico detalhado, principalmente pela palpaçao e busca dos pontos-gatilhos ativos e latentes e local da dor referida, e também por exclusao das outras patologias. O tratamento se baseia na identificaçao dos pontos-gatilhos e atuaçao direta sobre os mesmos, através das infiltraçoes com anestésicos locais, "sprays congelantes", medidas de medicina física e medicaçao analgésica de açao periférica e central.

Clinical fundaments for rehabilitation treatment in spinal cord injury

Spinal cord injury leads to a severe disabling syndrome, which most often sffects the young. The major etiologic factor in spinal cord injuries is trauma. Patients rehabilitation is started in the acute phae, soon after the trauma occurs, mainly through preventive care against the formation of pressure sores, deformities of the palsy segments, proper vesical and bowel emptying and care with vasomoter alterations. The rehabilitation process continues at a specialized rehabilitation center, searching the best functional performance of each patient, according to the type and level of the spinal cord injury. This work shows fundaments for the rehabilitaiton tratment

Cinesioterapia na osteoartrose / Kinesiotherapy in osteoarthrosis

A osteoartrose é uma doença potencialmente incapacitante pelas alteraçöes degenerativas e inflamatórias. A relativa imobilizaçäo gerada pela dor e modificaçöes intra-articulares leva a alteraçöes secundárias dos músculos, tendöes, ligamentos e cápsulas articular, que podem ser minimizadas se uma correta abordagem cinesioterápica for realizada nestes pacientes. Este artigo de revisäo bibliográfica relaciona as alteraçöes estruturais encontradas na osteoartrose, os princípios fisiológicos dos exercícios terapêuticos e a prescriçäo adequada destes exercicíos nos pacientes com osteoartrose