Influence of Different Photobiomodulation Parameters on Multi-Potent Adipose Tissue Mesenchymal Cells In Vitro.

Objective: Investigating the effect of different parameters of photobiomodulation (PBM) with low-power laser on multi-potent mesenchymal stem cells (MSCs) derived from adipose tissue in terms of proliferation and cell death. Methods: MSCs were submitted to PBM applications with combinations of the following physical parameters: control group (no intervention), wavelengths of 660 and 830 nm; energy of 0.5, 2, and 4 J; and power of 40 and 100 mW. MSC analysis was performed using MetaXpress® software at 24, 48, and 72 h. Results: Irradiation promoted a significant increase in cell proliferation (p < 0.05), with 830 nm laser, 100 mW, with energy of 0.5, 2, and 4 J in relation to the control group at all times. PBM with 660 nm, power of 40 mW, and energy of 0.5, 2, and 4 J produced greater cell death at 24 h compared with the control group. At the time of 72 h, there was no significant difference concerning cell death. Conclusions: According to the results found, we can conclude that both wavelengths were effective; however, the 830 nm laser was more effective in terms of cell proliferation compared with the 660 nm laser. The 660 nm wavelength showed a significant increase in cell death when compared with the 830 nm laser.

In vivo attenuation profile of 660 nm and 830 nm wavelengths on human elbow skin and calcaneus tendon of different phototypes.

Physical factors and tissue characteristics determine the transmission of light through tissues. One of the significant clinical limitations of photobiomodulation is the quantification of fluence delivered at application sites and optical penetration depth in vivo. There is also the difficulty of determining the distances of the application points to cover a uniformly irradiated area. Thus, the aim was to evaluate in vivo the influence of melanin on light transmission of the 660 nm and 830 nm laser wavelengths on skin and tendon. Thirty young individuals of both sexes were recruited, divided into two groups based on melanin index, and submitted to photobiomodulation protocols in the posterior region of the elbow (skin-skin) and the calcaneus tendon (skin-tendon-skin). The irradiation area was evaluated using a homemade linear array of five sensors. We found significant transmission power values for different melanin indexes and wavelengths (p<0.0001). Also, different equipment can generate significant differences in the transmitted power at an 830-nm wavelength. Average scattering values are 14 mm and 21 mm for 660 nm, in higher and lower melanin index, respectively. For 830 nm, values of 20 mm and 26 mm are indicated. Laser light transmission in vivo tissues is related to wavelength, beam diameter, tissue thickness, and composition, as well as melanin index. The 830-nm laser presents higher light transmission on the skin than 660 nm. The distances between the application points can be different, with higher values for 830 nm than 660 nm.

Effects of the Anchor System on Postural Balance of Women Undergoing Breast Cancer Treatment: A Clinical, Randomized, Controlled, and Crossover Trial.

OBJECTIVE: Investigate the effects of multisensory training with and without the anchor system on breast cancer survivors' postural balance and self-efficacy of falls. DESIGN: Clinical randomized, controlled, and crossover trial. SETTING: Teaching, Research, and Assistance Center in Mastectomized Rehabilitation. PARTICIPANTS: Eighty breast cancer survivors homogeneously distributed in the groups of adults and elderly affected, or not, by lymphedema. INTERVENTIONS: Participants were randomized to multisensory training with and without the anchor system involving 3 sessions per week for 12 weeks. After the 4-week washout period, the remaining therapeutic intervention was applied. MAIN OUTCOME MEASURES: The primary outcome was semi-static and dynamic balance as evaluated by baropodometry and Mini Balance Evaluation Systems Test, and the secondary outcome was self-efficacy of the fall episode as assessed by Falls Efficacy Scale - International in the pre-, post-immediate, and 4-week follow-up period. RESULTS: Both therapeutic interventions caused positive and significant effects on postural balance and self-efficacy of falls in the immediate period. The multisensory training with the anchor system induced significant functional retention in the short term, related to the clinical effect of small to moderate variation. CONCLUSIONS: Multisensory training with the anchor system is convenient for postural balance and self-efficacy for falls, regardless of age and upper limb volume, for breast cancer survivors.

Absorption and reduced scattering coefficient estimation in pigmented human skin tissue by experimental colorimetric fitting.

This study aims to estimate the optical properties, absorption (µ a), and reduced scattering (µ s ') coefficients of ex vivo human skin through the individual typology angle (ITA) by only using the skin color parameters. Human skin samples were grouped according to their ITA value and measured using a colorimeter for validation. An integrating sphere and the inverse adding-doubling algorithm were applied to compute the samples µ a and µ s '. The µ a increases as the ITA decreases. An axis swap was performed to generate the µ a versus the ITA for all wavelengths between 500 nm and 800 nm with a spectral resolution of 10 nm. Linearization was performed and a correlation was found. An equation to fit µ a based solely on the ITA values was estimated. The µ s ' does not change with ITA, but it could be fit with an inverse power law as a function of the wavelength. Both equations have a coefficient of determination (R 2) higher than 0.93, indicating a good agreement with our model. An experimental model to estimate the absorption and reduced scattering coefficients of ex vivo human skin through ITA was found. The model has high agreement with the experimental data, with an R 2 between 0.932 and 0.997, and these findings may be relevant for photobiomodulation and light treatment applications to estimate the effect of the melanin on the therapy.

Analysis of the accuracy and reliability of vertical jump evaluation using a low-cost acquisition system.

BACKGROUND: The vertical jump can be analyzed based on the flight time achieved by the individual. This measurement can be obtained using a force platform or a three-dimensional infrared camera system, but such equipment is expensive and requires training for data collection and processing. Thus, this study aimed to evaluate the accuracy and reliability of using a smartphone and the Kinovea software compared with a force platform as a method of vertical jump analysis. METHODS: For this purpose, two independent evaluators analyzed videos of bipodal and unipodal vertical jumps by counting the variables among participants. The participants performed three consecutive jumps in bipodal and unipodal conditions with the dominant and non-dominant legs. RESULTS: The intra-rater analysis for bipodal jumps was found to have excellent reproducibility (ICC = 0.903 to 0.934), whereas for unipodal jumps, the reproducibility was moderate to excellent (ICC = 0.713 to 0.902). The inter-rater analysis showed that for bipodal jumps, the reproducibility is substantial to excellent (ICC = 0.823 to 0.926), while for unipodal jumps, it is moderate (ICC = 0.554 to 0.702). CONCLUSIONS: Therefore, it can be concluded that the vertical jump evaluation can be performed using the smartphone-Kinovea system. However, the same evaluator should carry out the evaluation to maintain reliable indices.

Influence of photobiomodulation therapy on the physical performance of women during the follicular phase of the menstrual cycle: A double-blind Sham-controlled randomized clinical trial.

To evaluate the effects of photobiomodulation on the physical performance of healthy women, considering the menstrual cycle. 27 physically active healthy women (age 25.68 ± 3.99 years; mass 63.76 ± 12.77 kg; height 1.65 ± 0.59 cm) during the initial follicular phase (FF1 and FF2) of the menstrual cycle underwent performance evaluations, through a supramaximal test, subjective perception of exertion, blood lactate, and evaluations in the isokinetic dynamometer. Photobiomodulation (PBM) (200J) and Sham (0J) therapy were applied 10 min before the performance evaluations on the quadriceps femoris, hamstrings, and triceps surae muscles. A significance level of 5% was adopted and the effect size was calculated by Cohen's d. It was not possible to observe a significant difference (p > 0.05) in any of the performance variables evaluated in the comparison between groups, only small effects for total distance, final subjective perception of exertion, lactate peak and lactate delta in the PBM group. PBM did not improve muscle performance, resistance to fatigue, perceived exertion, and blood lactate concentrations during a predominantly anaerobic test in healthy women during the FF of the menstrual cycle.

Intrareliability and Interreliability of Low-Cost Devices to Measure Skin Tone, Moisture, and Oiliness.

OBJECTIVE: To evaluate the intraexaminer and interexaminer reliability of low-cost commercial devices to measure skin tone, moisture, and oiliness; determine associations with the Fitzpatrick Scale; and compare results with those of widely used commercial equipment. METHODS: Researchers bilaterally collected a total of 36 samples from 18 participants. For data acquisition, two experienced raters were considered for skin index assessment. Evaluations were conducted independently, with measurements taken at two different times with an interval between them, thus enabling intrarater and interrater reliability measures. The measurements were made with two low-cost devices and compared with those acquired using standard equipment for such analyses. RESULTS: For the intraexaminer reliability results, the authors observed intraclass correlation coefficient ranging from moderate to high reliability between these tools (0.747-0.971). Regarding interexaminer reliability, intraclass correlation coefficient ranging from moderate to high (0.541-0.939) were observed. For the results of the correlations, a moderate to a large association was observed for skin tone. However, a small association for moisture was observed among the tools. CONCLUSIONS: Evaluations of skin tonality, oiliness, and moisture showed moderate to excellent intrareliability and interreliability. These methods can be applied in different environments, especially clinics, because of their low cost and ease of use.

Segmental bioelectrical impedance analysis can detect differences between the affected and non-affected limbs in individuals with hip osteoarthritis.

OBJECTIVE: To analyze the bioelectrical impedance parameters of the lower limbs of individuals with hip osteoarthritis and healthy individuals. DESIGN: Cross-sectional study. SETTING: The study was carried out at the Hip Surgery Outpatient Clinic. PARTICIPANTS: The volunteers had to be between 45 and 70 years of age, of both sexes, with a clinical and radiological diagnosis of hip osteoarthritis for at least three years, unilateral involvement, or a significant complaint in one hip. METHODS: This was a cross-sectional study. Fifty-four individuals were recruited for the study, 31 individuals with hip osteoarthritis (OA group) and 29 healthy individuals for the control group (C group). Demographic and anthropometric data were collected and then the Numerical Pain Rating Scale, WOMAC, Harris Hip Score, and bioimpedance assessment were applied. MAIN OUTCOME MEASURE(S): Electrical bioimpedance parameters. Phase angle (PhA), impedance, reactance, and muscle mass. RESULTS: There was a significant difference in phase angle (PhA), impedance, and muscle mass at 50 kHz frequency on the side affected by OA when compared to the contralateral side. In the OA group, there was a significant decrease in phase angle (PhA) -0.54 (-0.85 to -0.23) and muscle mass - 0.29 (-0.40 to -0,19), as well as an increase in impedance at the 50 kHz frequency on the side affected by OA when compared to contralateral side 21.71 (13.69 to 29.74). In the C group, there was no difference between the dominant and non-dominant sides (P > 0.05). CONCLUSION: The segmental electrical bioimpedance equipment can detect differences between limbs affected and unaffected by hip osteoarthritis.

Optical Properties of Human Skin Phototypes and Their Correlation with Individual Angle Typology.

Objective: This study aims to correlate human skin phototypes with complete optical characterization (absorption, scattering, effective attenuation, optical penetration, and albedo coefficients) based on individual typology angle (ITA) values and colorimetric parameters. Methods: A colorimeter was used to group 12, fresh, ex vivo human skin samples according to their phototype; the CIELAB color scale and ITA values were employed. An integrating sphere system and the inverse adding-doubling algorithm were applied during optical characterization, conducted from 500 to 1300 nm. Results: On the basis of ITA values and their classification, the skin samples were separated into six groups: two intermediates, two tan, and two brown. In the visible range, for lower ITA values (darker skins), the absorption and effective attenuation coefficient parameters increased, whereas the albedo and depth penetration parameters decreased. In the infrared region, all the phototypes had similar parameters. The scattering coefficient was similar for all the samples and did not change with ITA values. Conclusions: ITA analysis, a quantitative method, showed that the human skin tissue's optical properties and pigmentation colors were highly correlated.

Influence of neoprene ankle orthoses on dynamic balance during a vertical jump in healthy individuals and with sprain history: A cross-sectional study.

INTRODUCTION: A sprain describes an excessive amount of force or strain on a ligament, which may or may not lead to its rupture. Orthoses are among the most common modalities prescribed as a conservative treatment for ankle instability and sprain. OBJECTIVE: We aimed to analyse the effect of neoprene orthosis on the balance and functionality of healthy individuals and volunteers with lateral ankle sprains METHODS: We evaluated 12 healthy volunteers (control group) and 12 volunteers diagnosed with a sprain and/or instability (patient group). A total of 14 men and 10 women participated in the study, with an average age of 26.15 (± 4.40) years. The volunteers' tasks consisted of performing vertical bipodal and unipodal jumps on a force platform, which were recorded in a video from the lateral view of the lower limb for posterior evaluation of the knee and ankle angles. Mann-Whitney and Wilcoxon tests were used for comparisons, considering p < 0.05 level of significance. RESULTS: The control group presented a decrease in ground reaction force when using Orthosis during the bipodal jump (p < 0.05). A decrease in anteroposterior force displacement was also observed in the left unipodal jump (p < 0.01). The patient group presented an increase in force and moment of medial-lateral displacement for both bipodal (p < 0.02) and left unipodal jumps with Orthosis (p < 0.02). A kinematic analysis showed that the control group presented the smallest knee flexion angle (p < 0.01), while the patient group presented the smallest dorsiflexion ankle angle in the bipodal jump when using orthosis (p < 0.01). CONCLUSION: We concluded that orthosis had influence on individuals' balance and joint angles. In healthy individuals presented better balance with and without orthosis and greater flexion with orthosis in the bipodal jump, regarding to the patient group presented smaller oscillations in the unipodal jump with orthosis and showed smaller knee flexion and ankle dorsiflexion.

Interaction predictors of self-perception menstrual symptoms and influence of the menstrual cycle on physical performance of physically active women.

OBJECTIVE: To analyze the physical performance, self-perception menstrual symptoms, of physically active eumenorrheic women with endogenous ovarian cycle in two phases of the menstrual cycle. METHODS: Twenty-six women participated in the study (age 25.8 ± 3.9 years; height 1.64 ± 0.58 m; mass 64 ± 12.32 kg; menarche 11.69 ± 1.28 years). Assessments were performed in two phases of the menstrual cycle (MC), Early-Follicular Phase (FP) and Mid-Luteal Phase (LP), performance was assessed through total time to exhaustion (TTE), complete stages (CE), and final speed (FE), through a graded exercise test (GXT). Information on the participants' menstrual symptoms and their perceptions of the influence of MC on their performance were also collected. Data normality was assessed using the Shapiro-Wilk test. Paired analyses were conducted (t test or Wilcoxon) to examine the responses between the menstrual phases. The interaction analysis of symptom predictors was performed by multiple linear regression, with a significance level of p ≤ 0.05. RESULTS: There was no significant difference in physical performance between the phases during the GXT in TTE (mean difference 8.50; 95% CI - 11.99 to 42; p = 0.36). During FP, women with heavy flow had shorter performance in the GXT (t = - 2.5; p = 0.01), demonstrating an r2 = 0.32. In LP, for the women who reported not having the perception of the influence of the menstrual cycle on exercise, the total test time was longer (t = 2.55; p = 0.01), with an r2 = 0.45. CONCLUSION: There was no difference in physical performance between FP and LP. However, menstrual flow intensity and perception of cycle interference demonstrated a decrease in TTE.

Effects of therapeutic ultrasound and paraffin with or without vacuum massage on biomechanical properties of grafted skin after burn: a randomized controlled trial.

OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.

Correlation between the range of motion of the tibiotarsal joint and blood circulation in the lower limbs in diabetic individuals.

OBJECTIVE: The aim of this study was to evaluate the relationship between the range of motion and lower-limb hemodynamic indices in the tibiotarsal joint of individuals with diabetic neuropathy. METHODS: Twenty volunteers of both sexes, with a mean age of 61.45±7.05 years, were diagnosed with type 2 diabetes mellitus and diabetic peripheral neuropathy. Arterial blood flow was assessed using Doppler ultrasound, and the variables such as average velocity, pulsatility index, and resistivity index were also evaluated. A range of dorsiflexion and plantar flexion joint movements were assessed using digital goniometry before and after exercise. Data distribution was assessed using the Shapiro-Wilk test, followed by Pearson's correlation for normal data and Spearman's correlation for non-normal data, in order to verify the association between variables. RESULTS: A moderate correlation was found between dorsiflexion and pulse rate on two occasions before (rs=0.497) and after initial evaluation (rs=0.511). A low correlation was found between plantar flexion and mean velocity (rs=-0.357), pulsatility index (rs=0.439), and resistivity index (rs=0.328); dorsiflexion and mean velocity (rs=0.374), pulse rate (rs=0.332), and resistance index (rs=0.327) before evaluation, and peak (rs=0.346) was observed after the evaluation of blood circulation. CONCLUSION: There is a correlation between the range of motion of the tibiotarsal joint and the blood circulation of diabetics, ranging from moderate to poor for the different variables evaluated.

Intra- and inter-examiner reliability of digital images of skin donor areas in burns.

OBJECTIVE: The main objective of this study was to evaluate intra- and inter-rater reliability in the analysis of digital images of donor areas for skin in burn patients using the CaPAS plugin in the ImageJ®. METHODS: Donor sites were reviewed by two independent reviewers in duplicate. The capture of images was standardized on the same device and distance (with a millimeter ruler), without a flash. The evaluators were trained to capture the images and use the plugin. RESULTS: We selected 70 images from donor areas, from men and women between 18 and 60 years old. In the analysis of intra-examiner reliability, eight of the nine variables exhibited excellent reliability (0.985-0.998) and one (entropy) exhibited good reliability (0.525). The same was true for the inter-examiner analysis: excellent reliability for eight variables (0.824-0.993) and good reliability for entropy (0.501). CONCLUSIONS: The CaPAS plugin has proven to be a reliable tool for use in research in skin donor areas in burns, as demonstrated by its excellent intra- and inter-examiner reliability values. This is a pioneering study in the quantitative assessment of skin donor areas in burn patients using the CaPAS plugin.

Relationship between lymphedema after breast cancer treatment and biophysical characteristics of the affected tissue.

The treatment of breast cancer is often complicated by lymphedema of the upper limbs. Standard lymphedema evaluation methodologies are not able to measure tissue fibrosis. The ultrasound aspects related to tissue microstructures of lymphedema are neglected in clinical evaluations. The objective of this study was to identify and measure the degree of impairment, topography, and biophysical alterations of subcutaneous lymphedema tissue secondary to the treatment of breast cancer by ultrasonography. Forty-two women at a mean age of 58 (±9.7) years, with unilateral lymphedema due to breast cancer treatment, were evaluated. The upper limbs were divided into affected (affected by lymphedema) and control (contralateral limb). Each limb was subdivided into seven areas, defined by perimetry, evaluated in pairs. The biophysical characteristics thickness, entropy, and echogenicity were evaluated by ultrasonography. The results showed a significant difference in the echogenicity and thickness variables between the affected and unaffected upper limb, in all the extent of the upper limb, while entropy showed no significant difference. The findings indicate that the data presented were consistent both in identifying and measuring the degree of impairment and biophysical changes in the subcutaneous tissue of lymphedema secondary to the treatment of breast cancer.

Early Neuromuscular Electrical Stimulation in Addition to Early Mobilization Improves Functional Status and Decreases Hospitalization Days of Critically Ill Patients.

OBJECTIVES: To evaluate the impact of the additional use of early neuromuscular electrical stimulation (NMES) on an early mobilization (EM) protocol. DESIGN: Randomized controlled trial. SETTING: ICU of the Clinical Hospital of Ribeirão Preto, University of São Paulo, Brazil. PATIENTS: One hundred and thirty-nine consecutive mechanically ventilated patients were included in the first 48 hours of ICU admission. INTERVENTIONS: The patients were divided into two groups: EM and EM+NMES. Both groups received EM daily. In the EM+NMES group, patients additionally received NMES 5 days a week, for 60 minutes, starting in the first 48 hours of ICU admission until ICU discharge. MEASUREMENTS AND MAIN RESULTS: Functional status, muscle strength, ICU and hospital length of stay (LOS), frequency of delirium, days on mechanical ventilation, mortality, and quality of life were assessed. Patients in the EM+NMES group presented a significant higher score of functional status measured by the Functional Status Score for the ICU scale when compared with the EM group in the first day awake: 22 (15-26) versus 12 (8-22) (p = 0.019); at ICU discharge: 28 (21-33) versus 18 (11-26) (p = 0.004); and hospital discharge: 33 (27-35) versus 25 (17-33) (p = 0.014), respectively. They also had better functional status measured by the Physical Function Test in the ICU scale, took less days to stand up during the ICU stay, and had a significant shorter hospital LOS, lower frequency of ICU-acquired weakness, and better global muscle strength. CONCLUSIONS: The additional application of early NMES promoted better functional status outcomes on the first day awake and at ICU and hospital discharge. The patients in the EM+NMES group also took fewer days to stand up and had shorter hospital LOS, lower frequency of ICU-acquired weakness, and better muscle strength. Future studies are still necessary to clarify the effects of therapies associated with EM, especially to assess long-term outcomes.

Reliability of quantitative sensory testing on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain.

OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.

Laser light sources for photobiomodulation: The role of power and beam characterization in treatment accuracy and reliability.

PURPOSE: Daily clinical use of therapeutic light sources can lead to changes in light emission stability with potentially significant consequences for usage in photomedicine treatment. The aim of this study was to evaluate the average and maximum power and to describe the beam diameter of different low-power laser photobiomodulation devices in clinical use in Brazil. METHODS: The power and light-emitting beam diameter of twenty-four therapeutic devices with an average age of 11±5 years, with an average weekly use of fewer than thirty minutes, were measured. RESULTS: The analyzed power varied between 2% to 134% of the values declared by the manufacturers. Differences in beam diameter of between 38% and 543% of the nominal values were also observed. It is also noteworthy that even between the same brand and model, differences in diameter were obtained. Finally, differences were observed in the power output after one and three minutes of sequential emission for 830 nm and 904 nm (p < 0.05), but not when comparing the difference between wavelengths in factor time. CONCLUSION: There is a need for a shared effort on the part of laser manufacturers to improve standardization and consistency of laser output power and beam diameters. At the same time, medical laser operators should also consider development of standardized protocols for maintenance and monitoring equipment performance over time to correct for fluctuations that could ultimately impact on treatment outcomes.

Psychometric properties of the Brazilian short-version of the Northwick Park Neck Pain Questionnaire.

OBJECTIVE: To translate, cross-culturally adapt and assess measurement properties of the translated version of the Northwick Park Neck Pain Questionnaire into Brazilian Portuguese. DESIGN: Cross-sectional study. SETTINGS: University healthcare facility and online. PARTICIPANTS: People with chronic neck pain (n = 178). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants answered the translated version of Northwick Park Neck Pain Questionnaire, the Neck Disability Index, the Numerical Rating Scale for pain, the Tampa Scale for Kinesiophobia and the Pain Catastrophizing Scale. Seven to ten days after that, a subset of 84 participants answered the Northwick Park Neck Pain Questionnaire again. The structural (exploratory and confirmatory factor analyses) and construct validities, internal consistency, reliability and concordance were assessed. Level of significance was set at 5%. RESULTS: Participants' (35.6 ± 13.5 years old) with symptoms duration of 54.4 ± 60.4 months scored 25.5 ± 14.0 on the Brazilian Northwick Park Neck Pain Questionnaire and 11.9 ± 5.8 on the Neck Disability Index. The structural analysis showed that the short version of the Northwick Park Neck Pain Questionnaire has an adequate structure to measure disability due to neck pain. Correlations with other questionnaires were between 0.268 and 0.678, Cronbach's alfa was 0.76, intraclass correlation coefficient was 0.96, standard error of measurement was 2.74 and minimal detectable change was 7.60. CONCLUSION: The short version of the Northwick Park Neck Pain Questionnaire is valid and reliable to be used in patients with chronic neck pain, as it presented adequate measurement properties of structural and construct validity, reliability and concordance.

Correlation between the range of motion of the tibiotarsal joint and blood circulation in the lower limbs in diabetic individuals

SUMMARY OBJECTIVE: The aim of this study was to evaluate the relationship between the range of motion and lower-limb hemodynamic indices in the tibiotarsal joint of individuals with diabetic neuropathy. METHODS: Twenty volunteers of both sexes, with a mean age of 61.45±7.05 years, were diagnosed with type 2 diabetes mellitus and diabetic peripheral neuropathy. Arterial blood flow was assessed using Doppler ultrasound, and the variables such as average velocity, pulsatility index, and resistivity index were also evaluated. A range of dorsiflexion and plantar flexion joint movements were assessed using digital goniometry before and after exercise. Data distribution was assessed using the Shapiro-Wilk test, followed by Pearson's correlation for normal data and Spearman's correlation for non-normal data, in order to verify the association between variables. RESULTS: A moderate correlation was found between dorsiflexion and pulse rate on two occasions before (rs=0.497) and after initial evaluation (rs=0.511). A low correlation was found between plantar flexion and mean velocity (rs=-0.357), pulsatility index (rs=0.439), and resistivity index (rs=0.328); dorsiflexion and mean velocity (rs=0.374), pulse rate (rs=0.332), and resistance index (rs=0.327) before evaluation, and peak (rs=0.346) was observed after the evaluation of blood circulation. CONCLUSION: There is a correlation between the range of motion of the tibiotarsal joint and the blood circulation of diabetics, ranging from moderate to poor for the different variables evaluated.