ABSTRACT
BACKGROUND: The main cause for attrition of military training is musculoskeletal injuries to the knee, such as patellofemoral pain (PFP). OBJECTIVE: The purpose of this systematic review was to identify which factors increase the risk of occurrence of PFP in military personnel. STUDY DESIGN: Systematic review with meta-analysis. DATA SOURCES: Searches were performed in Medline/PubMed, CINAHL, Embase, SPORTDiscus, Web of Science, Scopus, and OpenGray. STUDY SELECTION: We included studies that were prospective cohorts including military personnel and had at least one variable assessing a risk factor for PFP. DATA EXTRACTION: Extraction was performed by the same two independent evaluators and the data was separated between the military personnel who developed PFP and those who did not. DATA SYNTHESIS: Meta-analyses were performed using standardized mean differences (SMD) and 95% confidence intervals (95%CI) and the levels of recommendation were determined. RESULTS: From 11 articles, this review grouped 7,518 military personnel, of which 572 developed PFP, characterizing a prevalence of 7.61%. We found moderate evidence that isokinetic knee extensor weakness predicts PFP in the military (SMD -0.69, 95%CI -1.02, -0.35). A higher frontal plane knee projection angle (FPKPA) during single-leg squat was also identified as a risk factor for PFP in this population (SMD 0.55, 95%CI 0.14, 0.97) with moderate level of evidence. We found moderate evidence that sex, body mass index, isometric knee extensors strength, and isokinetic knee flexors strength do not predict PFP in military personnel. Finally, there is strong evidence that age and body mass do not predict PFP in this population. CONCLUSIONS: Deficits in isokinetic knee extensor strength and a greater FPKPA are risk factors for PFP in military personnel. Since these are modifiable factors, these aspects should be considered in injury prevention interventions in the military.
ABSTRACT
The objective of this review was to evaluate the effect of exercise on pain intensity, function, and quality of life in individuals with gluteal tendinopathy. Searches were carried out in PUBMED, EMBASE, CINAHL, Cochrane Library, and PEDro databases. Randomized or quasi-randomized controlled trials were included. Five studies met the eligibility criteria, comparing exercise-based interventions with minimal interventions and/or corticosteroid injections. Three studies, involving 383 participants, were included in the quantitative analysis. Meta-analyses showed that exercise is superior to minimal intervention for function in short-term [mean difference (MD) = 10.24; 95% confidence interval (95%CI) = 5.98, 14.50) and long-term (MD = 6.54; 95%CI = 1.88, 11.21]). However, no difference was observed for quality of life in the short [standardized mean difference (SMD) = 0.33; 95%CI = -0.29, 0.94] and long-term (SMD = 0.11; 95%CI = -0.16, 0.37). The effect of exercise was no different from that of corticosteroid injections for pain intensity in the short (MD = 1.25; 95%CI = -3.56, 6.05) and long-term (MD = -1.37; 95%CI = -3.72, 0.98]). In conclusion, exercise is superior to minimal interventions for function in the short- and long-term in individuals with gluteal tendinopathy. Exercise and corticosteroid injections had similar effects on pain intensity, however, exercise showed a higher treatment success rate when compared to corticosteroid injections in this population. The GRADE analysis revealed that the certainty of the evidence ranges from low to very low, therefore, large high-quality randomized controlled trials are recommended.PROSPERO registration number: CRD42021242853.
ABSTRACT
Introdução: A fotogrametria computadorizada tem sido considerada uma tecnologia alternativa à exposição radiográfica para a avaliação postural. Objetivos: Analisar a confiabilidade inter e intraexaminador da fotogrametria computadorizada, utilizando-se o software AutoCAD® R12. Métodos: Participaram 15 escolares, submetidos a uma sessão de fotos, após demarcação de pontos anatômicos de interesse para análises das variáveis posturais lineares e angulares. As mesmas fotos foram analisadas por dois avaliadores distintos, e pelo mesmo avaliador após 07 dias da primeira análise, para verificar a confiabilidade interexaminador e intraexaminador respectivamente, por meio da Coeficiente de Correlação Intraclasse (CCI). Resultados: As análises intraexaminador demonstraram níveis elevados de confiabilidade para a maioria das medidas lineares e angulares (CCI≥0,70). Enquanto nas análises interexaminador, observou-se discrepância em algumas mensurações, principalmente em vista posterior (CCI<0,70). Conclusão: A fotogrametria a partir do uso do software AutoCAD® R12, é uma ferramenta com boa confiabilidade intraexaminador para análise postural, porém é necessário mais estudo para verificar a confiabilidade interexaminador.
Introduction: The computerized photogrammetry has been considered an alternative technology to radiographic exposure for postural assessment. Objectives: To analyze inter and intra-rater reliability of the computerized photogrammetry, using AutoCAD® R12 software. Methods: Participants were 15 students, which were photographed after demarcation of anatomical points of interest for analyzes of linear and angular postural variables. The same photos were analyzed by two different evaluators, and by the same evaluator after 07 days of the first analysis to assess the inter-rater reliability and intra-rater respectively, through the intraclass correlation coefficient (ICC). Results: The intra-rater analyzes demonstrated high levels of reliability for most linear and angular measurements (ICC≥0.70). While the inter-analyzes, there was some discrepancy in measurements, especially in posterior view (ICC<0.70). Conclusion: Photogrammetry from the use of AutoCAD ® R12 software is a tool with good intra-rater reliability for postural analysis, but more studies are needed to verify inter-rater reliability.
