Brazilian Journal of Physical Therapy最新文献

Measurement properties of the Premature i=Infant Pain Profile-Revised applied at the bedside by physical therapists in the NICU 新生儿重症监护室物理治疗师在床边应用的早产儿疼痛谱的测量特性

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2026-01-30 DOI: 10.1016/j.bjpt.2026.101576

Amanda dos Santos Erhardt , Mariana Bueno , Taís Beppler Martins , Natalia Alves Menegol , Dayane Montemezzo , Luciana Sayuri Sanada

Background

It is essential to accurately assess distress and pain in neonatal intensive care unit (NICU); however, few instruments have had their measurement properties tested for the Brazilian population.

Objective

To analyze the intra- and inter-examiner reliability, internal consistency, and responsiveness of the Brazilian Portuguese version of the Premature Infant Pain Profile-Revised (PIPP-R) scale in Brazilian neonates.

Methods

This is a methodological study conducted in the NICU. Neonates with a gestational age of 24–42 weeks who were not under the effect of muscle block or analgesia at the time of evaluation were included. Inter-examiner reliability was assessed at bedside by two trained evaluators who independently assessed the neonates at bedside and in real time using the PIPP-R. Procedures were filmed and used for intra-examiner reliability assessment after 10–14 days. The Intraclass Correlation Coefficient (ICC) was used to determine intra- and inter-examiner reliability. Responsiveness was assessed by comparing the total scores before and after painful procedures using a paired t-test, followed by an effect size analysis.

Results

A total of 119 assessments were performed on 15 neonates. The PIPP-R demonstrated excellent intra- and inter-examiner reliability (ICC > 0.9), and successfully detected changes after an acute painful procedure (p = 0.003; effect size = 0.8).

Conclusion

Excellent intra- and inter-examiner reliability, and sensitivity to changes over time were observed by using the PIPP-R at bedside, indicating that this is a suitable instrument for clinical use.

背景：准确评估新生儿重症监护病房（NICU）的窘迫和疼痛至关重要；然而，很少有仪器对巴西人口进行了测量性能测试。目的分析巴西葡萄牙语版《新生儿疼痛概况-修订》（PIPP-R）量表在巴西新生儿中的信度、内部一致性和反应性。方法在新生儿重症监护病房进行方法学研究。在评估时未受肌肉阻滞或镇痛影响的胎龄为24-42周的新生儿包括在内。两名训练有素的评估员在床边独立评估新生儿，并使用PIPP-R进行实时评估。过程被记录下来，并在10-14天后用于审查员内部可靠性评估。类内相关系数（ICC）被用来确定内部和内部的考官信度。通过使用配对t检验比较疼痛手术前后的总分来评估反应性，然后进行效应大小分析。结果共对15例新生儿进行了119次评估。PIPP-R表现出良好的检查者内部和检查者之间的信度（ICC > 0.9），并成功检测急性疼痛手术后的变化（p = 0.003；效应值= 0.8）。结论在床边使用PIPP-R可观察到良好的检查人内部和检查人之间的可靠性，以及对时间变化的敏感性，表明该仪器适合临床使用。

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引用次数: 0

Is lower limb muscle power by vertical jump a sensitive and specific measure for screening sarcopenia compared to handgrip strength and chair stand test? 与握力和椅子站立测试相比，垂直跳跃的下肢肌肉力量是筛查肌肉减少症的敏感和具体措施吗？

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2026-01-29 DOI: 10.1016/j.bjpt.2026.101579

Layla Maciel dos Santos , Regina Brena de Lima Costa , Thamyres D’Avila Monteiro Rodrigues , Ana Beatriz Chaves Vasconcelos Batista , Maria Carolina Traina Gama , Edson Silva Soares , Regis Radaelli , Cíntia Ehlers Botton

Background

Muscle power declines earlier and more sharply than strength with aging, yet it is not included in sarcopenia diagnosis, partly due to limitations in assessment methods.

Objective

To evaluate the sensitivity and specificity of vertical jump performance, measured via a mobile app, for sarcopenia screening and compare its accuracy with established strength tests.

Methods

This cross-sectional study included 214 older adults (mean age 70.6, range 60–88 year; 84.6% women) without mobility limitations. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm (low muscle strength and mass). Jump height was measured using an app, and power was estimated using a validated equation. Sensitivity, specificity, and area under the curve (AUC) were analyzed using Receiver Operating Characteristic (ROC) curves.

Results

Sarcopenia prevalence was 4.7%, and probable sarcopenia was 12.1%. Jump height showed 50% sensitivity, 92.5% specificity, and an AUC of 0.7349. Jump power demonstrated higher discriminative ability (90% sensitivity, 82.1% specificity, AUC 0.9146), comparable to handgrip strength (90% sensitivity, 93.6% specificity, AUC 0.8824). The FTCS test showed lower accuracy when based on time (88.9% sensitivity, 45.1% specificity, AUC 0.701), while power estimation improved performance to diagnosis (77.8% sensitivity, 80.9% specificity, AUC 0.8489).

Conclusion

Vertical jump power showed high sensitivity and specificity for sarcopenia screening, suggesting its potential as a sarcopenia tool. However, among the tests evaluated, the handgrip appears to be the most accurate and most effective, because it can be applied to older adults with restricted mobility in their lower limbs.

随着年龄的增长，肌力比肌力下降得更早、更剧烈，但由于评估方法的局限性，肌力并没有被包括在肌少症的诊断中。目的评估通过移动应用程序测量的垂直跳跃性能对肌肉减少症筛查的敏感性和特异性，并将其与现有强度测试的准确性进行比较。方法本横断面研究纳入214名老年人（平均年龄70.6岁，60-88岁，84.6%为女性），无活动受限。肌少症的定义采用欧洲老年人肌少症工作组（EWGSOP2）算法（低肌肉力量和质量）。使用应用程序测量跳跃高度，使用经过验证的方程估计力量。采用受试者工作特征（ROC）曲线分析敏感性、特异性和曲线下面积（AUC）。结果肌少症患病率为4.7%，可能肌少症患病率为12.1%。跳高灵敏度为50%，特异度为92.5%，AUC为0.7349。跳跃力的鉴别能力（灵敏度90%，特异度82.1%,AUC 0.9146）高于握力（灵敏度90%，特异度93.6%,AUC 0.8824）。基于时间的FTCS检测准确性较低（敏感性为88.9%，特异性为45.1%，AUC为0.701），而功率估计提高了诊断性能（敏感性为77.8%，特异性为80.9%，AUC为0.8489）。结论垂直起跳力对骨骼肌减少症筛查具有较高的敏感性和特异性，具有作为骨骼肌减少症筛查工具的潜力。然而，在评估的测试中，手握似乎是最准确和最有效的，因为它可以适用于下肢活动受限的老年人。

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引用次数: 0

Analysis of SARC-F and SARCCalF accuracy in assessing sarcopenia risk on older adults with cardiovascular diseases admitted to a referral hospital: A cross-sectional study SARC-F和sarccf在评估转诊医院心血管疾病老年人肌肉减少风险中的准确性分析：一项横断面研究

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-26 DOI: 10.1016/j.bjpt.2025.101567

Luciana de Lima Sousa , Paloma Boni de Lima , Thais Ribas Konrad Ribeiro , Mariana de Grande dos Santos , Patrícia Azevedo Garcia

Introduction

Sarcopenia, characterized by the progressive loss of muscle mass and function, is exacerbated in older adults with cardiovascular diseases. In hospitalized older adults, quick and practical questionnaires such as the SARC-F and SARCCalF are important for early risk screening and help guide effective interventions.

Objective

To identify the prevalence of sarcopenia and sarcopenia risk, and to assess the diagnostic accuracy of the SARC-F and SARCCalF questionnaires in screening for probable and confirmed sarcopenia.

Methods

Cross-sectional study with older adults admitted to the emergency department of a public hospital for cardiovascular diseases between January and September 2023. Sarcopenia was assessed based on muscle strength (handgrip dynamometry), muscle mass (calf circumference), and physical performance (gait speed). The risk of sarcopenia was estimated using the SARC-F and SARCCalF questionnaires. Statistical analyses included Mann-Whitney U tests and ROC curves.

Results

In a sample of 160 participants, the prevalence of sarcopenia was 21.3%. The SARCCalF identified 42.5 % of older adults at risk and the SARC-F 32.5 %. The SARCCalF demonstrated greater accuracy in identifying confirmed sarcopenia (AUC=0.85 [95%CI: 0.79, 0.91]) and low muscle strength (AUC=0.71 [95%CI: 0.62, 0.79]) when compared to the SARC-F.

Conclusion

The prevalence of sarcopenia was lower than expected in the study population. The SARCCalF was better able to identify older adults at risk of sarcopenia and demonstrated greater diagnostic accuracy than the SARC-F in detecting probable and confirmed sarcopenia, standing out as a more effective screening tool for this population.

以肌肉质量和功能进行性丧失为特征的肌肉减少症在老年心血管疾病患者中加重。在住院的老年人中，快速实用的问卷调查（如SARC-F和sarccf）对于早期风险筛查很重要，有助于指导有效的干预措施。目的了解骨骼肌减少症的患病率和骨骼肌减少症的风险，评估SARC-F和sarccf问卷在筛查可能和确诊的骨骼肌减少症中的诊断准确性。方法对2023年1月至9月在某公立医院急诊科就诊的心血管疾病老年人进行横断面研究。肌肉减少症的评估基于肌肉力量（握力测量）、肌肉质量（小腿围）和身体表现（步态速度）。使用SARC-F和sarccf问卷评估肌肉减少症的风险。统计分析采用Mann-Whitney U检验和ROC曲线。结果160名参与者中，肌肉减少症患病率为21.3%。SARCCalF确定42.5%的老年人有风险，而SARC-F为32.5%。与SARC-F相比，SARCCalF在识别确诊的肌肉减少症（AUC=0.85 [95%CI: 0.79, 0.91]）和低肌力（AUC=0.71 [95%CI: 0.62, 0.79]）方面表现出更高的准确性。结论研究人群中肌肉减少症的患病率低于预期。SARCCalF能够更好地识别有肌少症风险的老年人，并且在检测可能和确诊的肌少症方面比SARC-F显示出更高的诊断准确性，作为该人群更有效的筛查工具而脱颖而出。

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引用次数: 0

User experiences of DiTA (dita.org.au): A database of studies of diagnostic test accuracy DiTA的用户体验：诊断测试准确性研究的数据库

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-25 DOI: 10.1016/j.bjpt.2025.101568

Mark A. Kaizik , Aron S. Downie , Mark J. Hancock , Robert D. Herbert

Background: The DiTA database indexes primary studies and systematic reviews of the accuracy of diagnostic tests related to physical therapy; however, its usability has not been previously assessed.

Objective: (i) To assess the usability (layout, navigation, functionality, content) of DiTA

for typical users working within physical therapy; (ii) to report the volume of user interaction with DiTA.

Methods: A Think Aloud usability testing protocol was employed with 25 participants during screenshare teleconference interviews while performing DiTA search tasks. Participants then completed the System Usability Scale (SUS) online. Participants’ comments and interpretations from transcribed interviews were coded into four usability categories. Anonymous data on website user behaviour since DiTA’s inception were collected. The main outcome measures were frequency of comments per category with interpretations made during interviews, and SUS usability scores.

Results: Participants most often commented about content (49 % of total), typically with positive sentiment. Participants also frequently commented on DiTA’s functionality typically with negative sentiment. Misinterpretations during search tasks were commonly coded into the functionality category. The SUS score of 70.9 was above the usability benchmark for similar platforms. Participants thought they could learn to use DiTA quickly. Since its launch in 2019, DiTA has averaged 88 visits per day, accessed from almost every country in the world, with most users coming from Brazil.

Conclusion: Typical users rated DiTA’s usability as above average, commenting frequently on its content and most often positively. DiTA's functionality was often misinterpreted during search tasks. Nevertheless, participants believed DiTA could be learnt quickly.

背景：DiTA数据库索引了与物理治疗相关的诊断测试准确性的初步研究和系统综述；然而，它的可用性之前没有被评估过。目的：(i)评估data的可用性（布局、导航、功能、内容），以供从事物理治疗的典型用户使用；（ii）报告用户与电讯管理局的互动次数。方法：采用Think Aloud可用性测试协议对25名参与者进行屏幕共享电话会议访谈，同时执行DiTA搜索任务。然后参与者在线完成系统可用性量表（SUS）。参与者的评论和对记录访谈的解释被编码为四个可用性类别。收集了自DiTA成立以来有关网站用户行为的匿名数据。主要的结果度量是每个类别的评论频率以及在访谈中做出的解释，以及SUS可用性得分。结果：参与者最常评论内容（占总数的49%），通常是积极的情绪。参与者还经常对DiTA的功能发表负面评论。搜索任务中的误解通常被编码到功能类别中。SUS得分为70.9，高于类似平台的可用性基准。参与者认为他们可以很快学会使用DiTA。自2019年推出以来，DiTA平均每天有88次访问，几乎来自世界上每个国家，其中大多数用户来自巴西。结论：典型用户将DiTA的可用性评为高于平均水平，经常对其内容进行评论，并且通常是积极的。DiTA的功能在搜索任务中经常被误解。尽管如此，与会者认为DiTA可以很快学会。

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引用次数: 0

The experience of neck pain in people with migraine: A qualitative study 偏头痛患者颈部疼痛的经历：一项定性研究。

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-23 DOI: 10.1016/j.bjpt.2025.101565

Milena Dietrich Deitos Rosa , Lidiane Lima Florencio , Jene Caroline Silva Marçal , Fabíola Dach , Domingo Palacios-Ceña , Debora Bevilaqua-Grossi

Background

Neck pain is a common symptom in individuals with migraine, often leading to a more severe clinical presentation. However, despite the established relationship, uncertainties remain regarding its impact on patients.

Objective

To explore the relevance of neck pain in patients with migraine by describing their perceptions, beliefs, and coping strategies.

Methods

This qualitative, descriptive, and exploratory study followed the COREQ and SRQR criteria. Twenty-seven individuals with an average age of 35.4 years, diagnosed with migraine according to the third edition of the International Classification of Headache Disorders, and self-reporting neck pain were interviewed using a semi-structured questionnaire. Thematic analysis was used to identify, organize, and describe the data. The entire process of coding, categorization, and theme development was conducted using Excel.

Results

Three main themes were identified: pain characteristics, pain triggers, and coping strategies. Patients described their pain with varying characteristics and associated emotions. Although the pain caused discomfort, it did not interfere with daily activities. Opinions differed regarding the cause of neck pain and the strategies for managing it.

Conclusion

Neck pain is prevalent and a relevant symptom for patients with migraine. They expressed differing opinions and uncertainties about its real cause and appropriate management. These findings underscore the importance of assessing the craniocervical system in clinical practice, providing appropriate guidance and treatment, and encouraging informed decision-making

背景：颈部疼痛是偏头痛患者的常见症状，通常会导致更严重的临床表现。然而，尽管建立了关系，但其对患者的影响仍不确定。目的：通过描述偏头痛患者的感知、信念和应对策略，探讨颈部疼痛的相关性。方法：本定性、描述性和探索性研究遵循COREQ和SRQR标准。采用半结构化问卷对27名平均年龄35.4岁、根据第三版《国际头痛疾病分类》诊断为偏头痛并自述颈部疼痛的患者进行了访谈。主题分析用于识别、组织和描述数据。整个编码、分类、主题开发的过程都是使用Excel进行的。结果：确定了三个主要主题：疼痛特征，疼痛触发因素和应对策略。病人用不同的特征和相关的情绪来描述他们的疼痛。虽然疼痛引起不适，但并不影响日常活动。关于颈部疼痛的原因和治疗策略，意见不一。结论：颈部疼痛是偏头痛患者普遍存在的相关症状。他们对真正的原因和适当的管理表达了不同的意见和不确定性。这些发现强调了评估颅颈系统在临床实践中的重要性，提供适当的指导和治疗，并鼓励知情决策。

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引用次数: 0

Comparing the effects of different physical therapy modalities with physical exercise in improving the walking function of patients with peripheral vascular disease: A Network Meta-analysis 比较不同物理治疗方式与体育锻炼对改善周围血管疾病患者行走功能的影响：一项网络荟萃分析

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.bjpt.2025.101562

Guan-Cheng Zhu , Jun-Hui Ong , Ching-Hsia Hung

Background

Peripheral vascular disease (PVD) causes significant pain and disability in patients. Current conservative treatment for PVD is often limited to physical exercise. However, several recent studies have investigated the effects of physical therapy modalities in patients with PVD.

Objective

This systematic review and network meta-analysis (NMA) aimed to compare the effects of different physical therapy modalities and physical exercise in improving the walking function of patients with PVD.

Methods

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, NMA extension. We searched six databases for relevant randomized clinical trials (RCTs) published between 2013–2023. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB2). MetaInsight and R were used to conduct the NMA.

Results

We analyzed 21 studies in the NMA. The results showed that shockwave therapy (SMD = 1.41, 95 %CI (0.58, 2.24)) and vacuum therapy (SMD = 0.72, 95 %CI (0.16, 1.29)) were effective independently in improving the walking function of patients with PVD. Combined hydrotherapy and exercise programs also performed better than exercise-only programs (SMD = 0.74, 95 %CI (0.38, 1.09)). While electrotherapy yielded a significant effect when performed independently (SMD = 1.43, 95 %CI (0.53, 2.33)), but was not effective when combined with exercise.

Conclusion

Our findings suggest that shockwave and vacuum therapy can be used as a treatment for patients with PVD who have difficulties participating in physical exercise. Hydrotherapy could assist patients participating in physical exercise programs to achieve better outcomes.

This study was registered in the PROSPERO database CRD42023461442.

背景：外周血管疾病（PVD）引起患者明显的疼痛和残疾。目前PVD的保守治疗通常仅限于体育锻炼。然而，最近的一些研究调查了物理治疗方式对PVD患者的影响。目的：本系统综述和网络荟萃分析（NMA）旨在比较不同物理治疗方式和体育锻炼对改善PVD患者行走功能的影响。方法：本研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，NMA扩展。我们检索了6个数据库，检索了2013-2023年间发表的相关随机临床试验（RCTs）。使用Cochrane随机试验风险偏倚工具第2版（RoB2）评估偏倚风险。使用MetaInsight和R进行NMA。结果：我们分析了21项NMA研究。结果显示，冲击波治疗（SMD = 1.41, 95% CI(0.58, 2.24)）和真空治疗（SMD = 0.72, 95% CI(0.16, 1.29)）分别能有效改善PVD患者的行走功能。联合水疗和运动方案也比单独运动方案效果更好（SMD = 0.74, 95% CI(0.38, 1.09)）。而电疗在单独进行时产生显著效果（SMD = 1.43, 95% CI(0.53, 2.33)），但与运动联合时无效。结论：我们的研究结果表明冲击波和真空疗法可以作为PVD患者参加体育锻炼困难的一种治疗方法。水疗可以帮助参加体育锻炼项目的患者取得更好的效果。本研究已在PROSPERO数据库CRD42023461442中注册。

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引用次数: 0

Total work equalization: a mathematical strategy for the comparison of different exercises in clinical trials 总工作量均衡：临床试验中不同练习比较的数学策略。

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.bjpt.2025.101564

André Pontes-Silva , André Luiz Lopes

Greater amounts of human movement involve greater amounts of physical work and, consequently, greater metabolic energy expenditure. Therefore, when comparing the effects of different exercise interventions, it is imperative to understand, delineate, and assess the cumulative effort induced by each exercise intervention tested. However, few clinical trials use an exercise program that controls for this variable in their intervention. This methodological flaw raises an important question: is it possible to determine which type of exercise is effective (for a given outcome) without knowing which type of exercise tested produced the most total work? The answer is simple: no! Because different exercises produce similar musculoskeletal adaptations, the difference is in the total work. Therefore, we aimed to present a way of comparing different types of physical exercise: the total work equalization.

更多的人体运动涉及更多的体力劳动，因此，更多的代谢能量消耗。因此，在比较不同运动干预的效果时，有必要了解、描述和评估每种运动干预所引起的累积努力。然而，很少有临床试验在干预中使用控制这一变量的锻炼计划。这种方法上的缺陷提出了一个重要的问题：在不知道哪种运动产生的总工作量最大的情况下，是否有可能确定哪种运动（对于给定的结果）是有效的？答案很简单：不！因为不同的运动产生相似的肌肉骨骼适应，不同的是总工作量。因此，我们旨在提出一种比较不同类型体育锻炼的方法：总功均衡。

引用次数: 0

Independent risk factors associated with a history of exercise associated muscle cramps (EAMC) among 21460 cycling race entrants (SAFER XXXVI): a descriptive cross-sectional study 21460名自行车比赛参赛者（SAFER XXXVI）中与运动相关性肌肉痉挛（EAMC）病史相关的独立危险因素：一项描述性横断面研究

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.bjpt.2025.101559

Carey Pohl , Martin Schwellnus , Nicola Sewry , Pieter Boer , Esme Jordaan , Carel Viljoen

Background

There is limited research on cyclists with a history of exercise associated muscle cramps (hEAMC) defined as muscle cramping (painful, spontaneous, sustained spasm of a muscle) during or after cycling.

Objective

To determine the epidemiology, clinical characteristics, and risk factors associated with hEAMC in cyclists taking part in a mass participation cycling event.

Methods

21,460 race entrants from the 2016 Cape Town Cycle Tour completed an online questionnaire, which is based on the guidelines for recreational exercise participation from the European Association of Cardiovascular Prevention and Rehabilitation [EACPR]. The main outcome measures were: the lifetime prevalence hEAMC (%; 95% confidence intervals), independent risk factors (adjusted for age and sex) associated with hEAMC (history of chronic disease, history of allergies, history of chronic medication use, history of medication use before and during race, history of cycling injuries, and cycling training/racing variables). Poisson regression was used to calculate the prevalence (%) of the variables of interest, with 95% confidence intervals.

Results

The retrospective lifetime prevalence of hEAMC was 30.51%. EAMC in cyclists affects mainly the quadriceps muscles and occurs in the 4th quarter during a race. Novel independent risk factors associated with an increased risk of hEAMC in cyclists were: increased number of years participating as a recreational cyclist (PR=1.03 per 5 years increase; p<0.0001), a higher chronic disease composite score (PR=1.36 times increased risk for every 2 additional chronic diseases; p<0.0001), a history of any allergies (PR=1.18; p<0.0001), medication use before or during event (PR=1.41; p<0.0001) a history of an acute (PR=1.30; p<0.0001) and gradual onset injury (PR=1.29; p<0.0001).

Conclusion

Our study identified novel independent risk factors associated with a hEAMC. These results, in combination with other known risk factors, could assist future targeted prevention programmes and the management of EAMC in recreational cyclists.

研究背景：对于有运动相关性肌肉痉挛（hEAMC）病史的骑车者的研究有限，hEAMC定义为骑车期间或之后的肌肉痉挛（肌肉疼痛、自发、持续的痉挛）。目的探讨参加大众参与自行车赛事的自行车运动员hEAMC的流行病学、临床特征及相关危险因素。方法21460名参加2016年开普敦自行车巡回赛的参赛者根据欧洲心血管预防和康复协会（EACPR）的娱乐运动参与指南完成了一份在线问卷。主要结局指标为：hEAMC的终生患病率（%，95%可信区间）、与hEAMC相关的独立危险因素（经年龄和性别调整）（慢性病史、过敏史、慢性用药史、比赛前和比赛期间用药史、骑行损伤史和骑行训练/比赛变量）。使用泊松回归计算感兴趣变量的患病率（%），置信区间为95%。结果hEAMC的回顾性终生患病率为30.51%。骑车者的EAMC主要影响四头肌，发生在比赛中的第四节。与骑行者hEAMC风险增加相关的新的独立危险因素是：作为休闲骑行者参加骑行的年数增加（PR=1.03 / 5年增加；p<0.0001），较高的慢性疾病综合评分（PR=1.36倍，每增加2个慢性疾病的风险增加；p<0.0001），任何过敏史（PR=1.18; p<0.0001），活动前或期间使用药物（PR=1.41; p<0.0001），急性史(PR=1.30；p =1.29; p = 0.0001)和渐发性损伤（p = 0.0001）。结论：我们的研究发现了与hEAMC相关的新的独立危险因素。这些结果，结合其他已知的风险因素，可以帮助未来有针对性的预防规划和管理休闲骑自行车者的EAMC。

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引用次数: 0

Blockade of opioid receptors prevents the effect of exercise on neuropathic pain in mice, promoting immunoregulation in the brainstem and prefrontal cortex 阻断阿片受体可阻止运动对小鼠神经性疼痛的影响，促进脑干和前额叶皮层的免疫调节

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.bjpt.2025.101561

Fernanda Belle , Elisa Mitkus Flores Lins , Josiel Mileno Mack , Francielly Suzaine da Silva , Ludmilla Solange Gelain , Verônica Vargas Horewicz , Guilherme de Azevedo Traebert , Alexandre Carlos Buffon , Deborah de Camargo Hizume-Kunzler , Daniel Fernandes Martins , Franciane Bobinski

Background

Physical exercise is widely recognized for reducing neuropathic pain. However, the interaction between the immune and opioidergic systems in supraspinal structures is still not fully understood.

Objective

To evaluate the impact of opioid receptor blockade on the effects of low-intensity exercise on the sensory, cognitive, and emotional aspects of neuropathic pain after sciatic nerve injury.

Methods

Male Swiss mice (2 months old) were submitted to sciatic nerve crush and divided into sedentary or exercised groups. The exercised groups performed treadmill running for two weeks, with or without naloxone pre-treatment to block opioid receptors. Sensory responses were assessed using the von Frey test, while cognitive and emotional-like behaviors were evaluated through the Mechanical Conflict-Avoidance System (MCAS) and open field test, respectively. Cytokine levels (IL-4, IL-10) and brain-derived neurotrophic factor (BDNF) were quantified in the brainstem and prefrontal cortex by ELISA.

Results

Exercise reduced mechanical hypersensitivity and improved performance in cognitive and exploratory tasks. These effects were prevented by naloxone administration. Exercise also increased IL-4, IL-10, and BDNF levels in supraspinal regions, while naloxone reversed these changes, indicating the involvement of μ-opioid receptors in exercise-induced immunomodulation.

Conclusion

Low-intensity exercise promotes analgesia and neuroimmune regulation in neuropathic pain through supraspinal μ-opioid receptor activation. The blockade of these receptors abolishes the beneficial effects of exercise, reinforcing the interaction between opioidergic and immune systems in pain modulation.

体育锻炼被广泛认为可以减轻神经性疼痛。然而，棘上结构中免疫系统和阿片能系统之间的相互作用仍未完全了解。目的探讨阿片受体阻断对低强度运动对坐骨神经损伤后神经性疼痛的感觉、认知和情绪方面的影响。方法将2月龄的瑞士小白鼠进行坐骨神经压迫实验，分为运动组和久坐组。运动组在跑步机上跑步两周，有或没有纳洛酮预处理来阻断阿片受体。感官反应采用von Frey测试，认知行为和情感行为分别采用机械冲突避免系统（MCAS）和开放场测试进行评估。ELISA法测定大鼠脑干和前额叶皮层细胞因子（IL-4、IL-10）和脑源性神经营养因子（BDNF）水平。结果运动降低了机械过敏，提高了认知和探索性任务的表现。纳洛酮可预防这些影响。运动还增加了棘上区IL-4、IL-10和BDNF的水平，而纳洛酮逆转了这些变化，表明μ-阿片受体参与了运动诱导的免疫调节。结论低强度运动通过激活棘上μ-阿片受体促进神经性疼痛的镇痛和神经免疫调节。这些受体的阻断消除了运动的有益作用，加强了阿片能和免疫系统在疼痛调节中的相互作用。

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引用次数: 0

Type of health locus of control predicting pain, function, and global perceived effect in patients with chronic low back pain receiving active versus passive interventions: an observational study 慢性腰痛患者接受主动与被动干预的健康控制点类型预测疼痛、功能和整体感知效应：一项观察性研究

IF 3.2 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2025-12-18 DOI: 10.1016/j.bjpt.2025.101560

Ivan de Araujo Barros , Arthur de Sá Ferreira , Thaís de Souza Horsth , Thamires de Jesus Holmes , Anna Amalheiro dos Santos , Luciana Crepaldi Lunkes

Introduction

Chronic nonspecific low back pain (CNLBP) is the leading cause of disability worldwide. The health locus of control (HLC) refers to the individual's perception of control over their health, which can be internal (personal control), external (control attributed to others), or chance (determined by luck, fate, or chance).

Objective

To investigate whether the HLC predicts pain, functional ability, and global perceived effect in patients with CNLBP treated with active versus passive interventions.

Methods

Longitudinal observational study following two different treatments groups delivered by physical therapists: active group (exercise-based intervention) and passive group (manual therapy-based intervention). The HLC was assessed with the Multidimensional Health Locus of Control Scale (MHLCS), pain with the Pain Numerical Rating Scale (PNRS), functional ability with the Patient-Specific Functional Scale (PSFS), and global perceived effect by the Global Perceived Effect Scale (GPES). The relationship between the types of HLC at baseline and after the intervention was analyzed by the Chi-square test, and the prediction of outcomes by linear regression (p < 0.05).

Results

Fifty-eight individuals participated, with a mean age of 51.2 (5.6) years. There was no impact of baseline HLC on pain, functional ability, or global perceived effect (p > 0.05), and there were no significant changes in HLC at the endpoint of observation (p = 0.75).

Conclusion

HLC was not a predictor for the evaluated outcomes, with no significant changes between baseline and the endpoint of observation.

慢性非特异性腰痛（CNLBP）是全球致残的主要原因。健康控制点（health locus of control， HLC）是指个体对自身健康控制的感知，这种控制可以是内部（个人控制）、外部（归因于他人的控制）或偶然（由运气、命运或机会决定）。目的探讨HLC是否能预测CNLBP患者接受主动和被动干预后的疼痛、功能能力和整体感知效果。方法采用纵向观察研究方法，观察由物理治疗师提供的两个不同治疗组：主动组（以运动为基础的干预）和被动组（以手工治疗为基础的干预）。采用多维健康控制点量表（MHLCS）、疼痛评定量表（PNRS）、功能能力评定量表（PSFS）和整体感知效应量表（GPES）对患者的整体感知效应进行评估。采用卡方检验分析干预前后HLC类型的关系，采用线性回归预测结果（p < 0.05）。结果58人参与，平均年龄51.2（5.6）岁。基线HLC对疼痛、功能能力或整体感知效果无影响（p > 0.05），观察终点时HLC无显著变化（p = 0.75）。结论hplc不是评估结果的预测因子，在基线和观察终点之间没有显著变化。

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引用次数: 0