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A Brazilian Association of Women´s Health Physical Therapy (ABRAFISM) guideline on the terminology of pelvic floor muscle function and assessment
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-02-05 DOI: 10.1016/j.bjpt.2025.101173
Patricia Driusso , Cristine Homsi Jorge , Ana Jéssica dos Santos Sousa , Daniela Fantin Carro , Leticia Maciel de Freitas , Simone Botelho , Luiz Gustavo Oliveira Brito , Maria Augusta Tezelli Bortolini , Jorge Milhem Haddad , Maria Palharini Volpato , Cássio Riccetto , Ana Carolina Rodarti Pitangui , Néville Ferreira Facchini de Oliveira , Elizabeth Alves Ferreira

Background

There has been many efforts and updates over the years to develop a consensus for English terminology related to the pelvic floor (PF). There is a similar need to standardize physical therapy related PF terminology in Brazil.

Objective

To propose a guideline in Brazilian Portuguese language on the terminology related to the female PF function and assessment.

Methods

The Brazilian Association of Physical Therapy in Women's Health (ABRAFISM) established a working group (Steering committee) responsible for conducting a systematic review on PF terminology, propose definitions in Portuguese, and manage the developmental stages. A systematic review of international consensus was conducted and the terms related to the PF were identified, listed, and defined in Portuguese. A Delphi method was used to reach a consensus on the definitions by querying a panel of expert professionals with clinical and research experience in the PF field. This panel included 19 physical therapists from all Brazilian regions and two physicians. The Delphi process included the following steps: evaluation of proposed terms by the panel of experts; review of suggestions made by the panel of experts, modification of terms based on those suggestions, and a new round of evaluation of the modified terms until reaching an 80 % agreement.

Results

Two rounds were necessary for terms related to anatomy and signs/symptoms of the PF, while a 90 % consensus for terms related to assessment of the PF muscles was achieved in the first round.

Conclusion

A final Brazilian-Portuguese guideline with consensus terminology on anatomy, symptoms, signs, and terms related to assessment of PF muscles was developed.
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引用次数: 0
Reply to letter to editor for article: ‘‘Development, reliability, and validity of the mobility assessment scale in hospitalized patients (HMob).’’
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-02-04 DOI: 10.1016/j.bjpt.2025.101175
Isis Resende Ramos , Iura Gonzalez Nogueira Alves , Mansueto Gomes Neto , Bruno Prata Martinez
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引用次数: 0
Pain revolution in the public health system: Active coping strategies for chronic pain unit
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-31 DOI: 10.1016/j.bjpt.2025.101176
Federico Montero-Cuadrado , Laura Barrero-Santiago , Manuel Santos-Bermejo

Background

Chronic pain represents a global health challenge demanding a transition from traditional biomedical to patient-centered biopsychosocial models. This masterclass explores active coping strategies for effective chronic pain management within healthcare systems. It describes the Unit of Active Coping Strategies for Chronic Pain (UAAD – Unidad de Afrontamiento Activo para el Dolor) in Primary Care in Valladolid, Spain, as a successful example of implementing a biopsychosocial care model for treating chronic pain.

Objective

To provide tools that allow the application of active coping strategies in the treatment of patients with chronic pain and how to implement the UAAD units in other healthcare systems.

Methods

This masterclass describes the UAAD's innovative approach, starting with its comprehensive and personalized methodology. This includes a referral system, a thorough assessment encompassing biological, psychological, and social factors, and a functional categorization system. These elements guide personalized treatment plans delivered through group and individual programs grounded in therapeutic exercise and pain science education. Four key pillars are highlighted: clinical care, teaching, resource management, research and dissemination.

Conclusion

Embracing this model empowers healthcare providers to address the growing burden of chronic pain. It also enables patients to take an active role in their recovery and self-management.
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引用次数: 0
Letter to the editor about the article “Development, reliability, and validity of the mobility assessment scale in hospitalized patients (HMob)” 致编辑的信,内容涉及文章 "住院患者行动能力评估量表(HMob)的开发、可靠性和有效性"。
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-30 DOI: 10.1016/j.bjpt.2025.101174
Paola Andrea Chavarro-Ortiz , Víctor Hugo Arboleda-Campo , Esther Cecilia Wilches-Luna
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引用次数: 0
Physical therapy assistance in labor: A systematic review and meta-analysis
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-23 DOI: 10.1016/j.bjpt.2024.101169
Alexandre Delgado , Andrea Lemos , Geyson Marinho , Renato S. Melo , Filipe Pinheiro , Melania Amorim

Background

Physical therapy assistance during labor may provide physical and emotional support to the expectant mother. Through specific techniques, physical therapists may help alleviate pain, improve mobility, and facilitate a safer and more comfortable delivery.

Objective

To perform a systematic review of the literature to assess the potential benefits and risks of physical therapy assistance during labor.

Methods

A search was conducted in the MEDLINE/PubMed, LILACS, PEDro, EMBASE, CINAHL, CENTRAL, Web of Science, and SCOPUS databases, with no restrictions on dates or language. The terms "Physical therapy assistance" and "Labor" were used. Randomized and quasi-randomized clinical trials comparing a group receiving physical therapy assistance during labor with a control group receiving standard care were included. The Cochrane tool (RoB 2.0) was used to assess the Risk of Bias, and the certainty of evidence was evaluated using the GRADE system. Quantitative analysis was performed through meta-analyses.

Results

Twelve studies involving 984 pregnant women were included. There was an increase frequency of vaginal deliveries (RR: 1.10, 95% CI 1.04, 1.17; 9 studies; I2, 2%; T2, 0.00; p = 0.42) and a reduction in cesarean sections (RR: 0.52, 95% CI 0.35, 0.76; 9 studies; I2, 0%; T2, 0.00; p = 0.65) for the physical therapy group, findings based on high-certainty evidence. There was also a reduction in the duration of the first stage of labor (MD: -99.01 min, 95% CI -153.35, -44.66; 7 studies; I2, 88%; T2, 4546.40; p = 0.00001), duration of the second stage (MD: – 11.29 min, 95% CI -18.94, -3.64; 6 studies; I2, 53%; T2, 45.01; p = 0.06) and frequence of perineal lacerations (RR: 0.49, 95% CI 0.25, 0.96; 4 studies; I2, 0%; T2, 0.00; p = 0.70) for the intervention group, findings based on moderate-certainty evidence. There was also a reduction in pain by 1.46 points on the Visual Analog Scale (MD: -1.46, 95% CI -2.52, -0.41; 7 studies; I2, 100%; T2, 1.90; p < 0.00001), findings based on low-certainty evidence, a decrease in analgesic use (RR: 0.90, 95% CI 0.83, 0.99; 2 studies; I2, 0%; T2, 0.00; p = 0.44), and maternal anxiety by 7.65 points on the State-Trait Anxiety Inventory (MD: -7.65, 95% CI -11.27, -4.03; 2 studies; I2, 88%; T2, 5.99; p = 0.005) for the intervention group. There was no difference in the other maternal and fetal outcomes.

Conclusion

Physical therapy assistance during labor provides a number of benefits to the mother.
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引用次数: 0
Examining heterogeneity and reporting of mirror therapy intervention for phantom limb pain: A scoping review
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-23 DOI: 10.1016/j.bjpt.2024.101165
Matthieu Guémann , Kevin Arribart

Background

Mirror therapy shows promise in the treatment of phantom limb pain but lacks robust evidence.

Objectives

To address this gap, we conducted a scoping review aiming to comprehensively explore the landscape of mirror therapy practice, gather details about the session content, and offer recommendations for future research.

Method

We searched seven databases for published work from 1995 to May 2023. Two independent reviewers selected, assessed, and extracted data from eligible articles. Articles, regardless of study design, were considered eligible if they investigated mirror therapy as an intervention for phantom limb pain.

Results

A total of 44 articles were included, comprising 16 randomized control trials, 14 prospective cohort studies, 15 case reports, and 3 protocols. These studies collectively involved 942 patients, with male patients representing 70 % of the participants. Lower limb amputation, primarily attributed to trauma, accounted for 88 % of the included patients. Pain intensity was predominantly assessed by a visual analog scale (61 %). However, there was a notable absence of detailed descriptions regarding mirror therapy sessions, particularly concerning the number of exercises, duration per exercise, and repetitions. Typically, sessions lasted 15 min each, conducted once daily. The exercises primarily focused on motor exercises targeting the distal part of the limb.

Conclusion

The practice of mirror therapy was characterized by poor description, showed significant heterogeneity, and a lack of standardized protocols, which contributes to an overall low level of evidence. Addressing these gaps in practice description and standardization is crucial for improving reproducibility and strengthening the evidence base for the prescription of mirror therapy.
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引用次数: 0
Conceptual framework for the associations between trunk and lower limb muscle parameters and physical performance in community-dwelling older women 社区老年妇女躯干和下肢肌肉参数与身体表现之间关系的概念框架。
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.bjpt.2024.101143
Daniela Cristina Carvalho de Abreu , Melise Jacon Peres-Ueno , Jaqueline Mello Porto

Background

Muscle status plays an important role in the achievement of good physical performance. However, which muscle group and muscle parameters are associated with different physical tasks is not well defined.

Objective

To determine the association between trunk and lower limb muscles and physical performance in community-dwelling older women.

Methods

118 older women, underwent an evaluation of physical performance, i.e., gait speed, Timed Up and Go (TUG), 5-times stand-to-sit (5TSST), forward and lateral step, and tandem gait, as well as a muscle performance evaluation with an isokinetic dynamometer to obtain the peak torque (PT), rate of torque development (RTD), and torque steadiness (TS) of the trunk, hip, knee, and ankle.

Results

There were associations between physical performance and muscle variables. However, each physical task was associated with different muscle parameters. Gait speed is the motor task that requires the least muscle strength (i.e., PT), whereas 5TSST, forward and lateral steps require PT, RTD, and TS of different muscle groups. Lower limb muscles RTD also plays a role in TUG and gait speed performance. The ability to control a submaximal torque is mainly required for forward and lateral stepping tasks. The PT of trunk muscles is also important for better performance of clinical tests.

Conclusion

This conceptual framework may be a guide for the understanding of the association between physical performance and trunk and lower limb muscle functional parameters in older women and may help future longitudinal research to confirm causality and assist physical therapists in decision-making.
背景:肌肉状态在取得良好的运动成绩中起着重要的作用。然而,哪些肌肉群和肌肉参数与不同的身体任务相关并没有很好的定义。目的:探讨社区老年妇女躯干和下肢肌肉与运动能力的关系。方法:对118名老年妇女进行了身体性能评估,包括步态速度、计时起走(TUG)、5次站坐(5TSST)、向前和侧向步、串联步态,并使用等速测功机进行肌肉性能评估,以获得躯干、髋关节、膝关节和踝关节的峰值扭矩(PT)、扭矩发展率(RTD)和扭矩稳定性(TS)。结果:体能表现与肌肉变量之间存在关联。然而,每项体力任务都与不同的肌肉参数相关。步态速度是需要最少肌肉力量(即PT)的运动任务,而5TSST,向前和侧步需要不同肌肉群的PT, RTD和TS。下肢肌肉RTD也在TUG和步态速度表现中发挥作用。控制次最大扭矩的能力主要需要向前和横向步进任务。躯干肌肉的PT对临床试验的更好表现也很重要。结论:这一概念框架可能为理解老年妇女身体机能与躯干和下肢肌肉功能参数之间的关系提供指导,并可能有助于未来的纵向研究来确认因果关系并协助物理治疗师决策。
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引用次数: 0
Translation, cross-cultural adaptation, and measurement properties of the prolapse and incontinence knowledge quiz (PIKQ-Br) for Brazilian women with urinary incontinence 巴西女性尿失禁脱垂和尿失禁知识测验(PIKQ-Br)的翻译、跨文化适应和测量特性
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.bjpt.2024.101155
Carla Coutinho da Silva , Rodrigo Cappato de Araújo , Danielly Alves Amorim , Ana Eliza Rios de Araújo Mathias , Ana Carolina Rodarti Pitangui

Background

The Prolapse and Incontinence Knowledge Quiz (PIKQ) was developed to assess women's knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI).

Objective

To perform the translation, cross-cultural adaptation, and measurement properties of the PIKQ for Brazilian women with UI (PIKQ-Br).

Methods

The measurement properties were tested for validity (content and face, structural, and hypotheses testing) and reliability (internal consistency, test-retest, and measurement error) in 130 women with UI from Recife, Brazil. Hypotheses testing for construct validity was assessed by Spearman's correlation coefficients. The standard error of measurement and the smallest detectable change were used to determine the measurement error. The structural validity was examined using a confirmatory factor analysis. Test-retest reliability and internal consistency were determined using the intraclass correlation coefficient (ICC) and Cronbach's alpha.

Results

The structural validity was analyzed with a single factor and 12 questions, revealing the goodness-of-fit was inappropriate (TLI=0.60; RMSEA=0.07). The two factors and 10-question version presented adequate values and factor loading (>0.30), except questions 1, 7, and 8 in PIKQ-POP. Positive and moderate correlations for hypotheses testing were observed for PIKQ-UI-10 (rho=0.439). Positive and weak correlations were observed for PIKQ-POP-10 (rho=0.278). Cronbach's alpha coefficients for PIKQ-UI-10 were 0.718 and 0.710 for PIKQ-POP-10. Both scales showed excellent reliability (ICC>0.93). The PIKQ-UI-10 and PIKQ-POP-10 had SEM values of 0.24 and 0.31 and SDC of 0.66 and 0.85, respectively.

Conclusions

The PIKQ-Br with 10 questions and two-factor presented adequate measurement properties, and can be a useful instrument to assess women's knowledge about UI and POP.
背景:脱垂和尿失禁知识测验(PIKQ)旨在评估女性对盆腔器官脱垂(POP)和尿失禁(UI)的知识。目的:研究巴西UI女性PIKQ (PIKQ- br)的翻译、跨文化适应和测量特性。方法:对来自巴西累西腓的130名女性UI患者进行了效度检验(内容和面、结构和假设检验)和信度检验(内部一致性、重测和测量误差)。构念效度的假设检验采用Spearman相关系数进行评估。采用测量标准误差和最小可检测变化来确定测量误差。采用验证性因子分析检验结构效度。采用类内相关系数(ICC)和Cronbach’s alpha测定重测信度和内部一致性。结果:结构效度分析为单因素12题,拟合优度不合适(TLI=0.60;RMSEA = 0.07)。除了PIKQ-POP的1、7、8题外,两个因子和10题版本的值和因子负载都足够(>0.30)。在假设检验中,PIKQ-UI-10呈正相关和中度相关(rho=0.439)。PIKQ-POP-10存在正相关和弱相关(rho=0.278)。PIKQ-UI-10的Cronbach α系数为0.718,PIKQ-POP-10的Cronbach α系数为0.710。两种量表均具有极好的信度(ICC>0.93)。PIKQ-UI-10和PIKQ-POP-10的SEM值分别为0.24和0.31,SDC值分别为0.66和0.85。结论:10题双因子PIKQ-Br量表具有较好的测量性能,可作为评价女性UI和POP知识的有效工具。
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引用次数: 0
Test-retest reliability and internal structure of the Brazilian version of the impact on participation and autonomy (IPA-Br4) for individuals with physical disabilities 巴西版肢体残疾人参与和自主影响(IPA-Br4)的重测可靠性和内部结构。
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.bjpt.2024.101152
Ana Amélia Moraes Antunes , Graciandre Almeida Neves , Bianca Pantuzza Santana Rojas , Daniela Virgínia Vaz

Background

Participation is considered a central outcome of rehabilitation and needs to be appropriately assessed from a perspective that values individual values and preferences. The Brazilian version of the Impact on Participation and Autonomy (IPA-Br4) is the only adequate instrument to assess participation from a subjective perspective in Brazil.

Objective

To investigate the test-retest reliability and internal structure (structural validity and internal consistency) of the digital version of IPA-Br4 for individuals with physical disabilities.

Methods

Test-retest reliability was assessed with Intraclass Correlation Coefficients (ICC), structural validity with Confirmatory Factor Analysis (CFA), and internal consistency with Cronbach α.

Results

Thirty (43.25 ± 10.6 years old, 63.3% female) and 130 (47.51 ± 15.73 years old, 58.5% male) individuals participated in the test-retest reliability and structural validity assessments, respectively. ICCs for each domain were: Autonomy indoors = 0.84; Family role = 0.87; Social life and relationships = 0.87; Autonomy outdoors = 0.84. The CFA model for four factors showed appropriate fit with factor loadings indicating that all items loaded onto their respective factors, with magnitudes > 0.30 (p < 0.05). All Cronbach α values (internal consistency) were above 0.82.

Conclusion

The digital version of IPA-Br4 has adequate test-retest reliability and internal structure to be used with adults with physical disabilities.
背景:参与被认为是康复的核心成果,需要从重视个人价值和偏好的角度进行适当评估。巴西版的 "参与和自主影响"(IPA-Br4)是从主观角度评估巴西参与情况的唯一适当工具:调查数字版 IPA-Br4 对肢体残疾人的重测可靠性和内部结构(结构有效性和内部一致性):方法:用类内相关系数(ICC)评估重测可靠性,用确证因子分析(CFA)评估结构有效性,用克朗巴赫α评估内部一致性:分别有 30 人(43.25±10.6 岁,63.3% 为女性)和 130 人(47.51±15.73 岁,58.5% 为男性)参加了重复测试信度和结构效度评估。各领域的 ICC 分别为室内自主 = 0.84;家庭角色 = 0.87;社会生活和人际关系 = 0.87;室外自主 = 0.84。四个因子的 CFA 模型显示出适当的拟合度,因子载荷表明所有项目都载入了各自的因子,且幅度大于 0.30(p < 0.05)。所有 Cronbach α 值(内部一致性)均高于 0.82:数字版IPA-Br4具有足够的测试重复可靠性和内部结构,可用于肢体残疾成年人。
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引用次数: 0
Physical functions assessed by lower limb performance-based and self-reported outcome measures for knee musculoskeletal conditions: A scoping review 通过下肢表现和膝关节肌肉骨骼状况自我报告的结果测量来评估身体功能:范围回顾。
IF 3.1 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-01-01 DOI: 10.1016/j.bjpt.2024.101166
Andrés Pierobon , Will Taylor , Richelle Caya , Federico Villalba , Santiago Soliño , Pablo Oscar Policastro , Richard Siegert , Ben Darlow

Background

Physical function assessment is key for the management of knee musculoskeletal conditions. There are a wide variety of self-reported outcome measures (SROMs) and performance-based outcome measures (PBOMs) to assess physical function of individuals with knee conditions. However, the content of these measures has not been explored.

Objective

To explore the range and frequency of physical functions assessed by lower limb PBOMs and SROMs for people with knee osteoarthritis (OA), anterior cruciate ligament (ACL) injuries, and patellofemoral pain (PFP).

Methods

A scoping review was conducted. We included development or measurement properties studies of knee functional outcome measures for populations with knee OA, ACL injuries, and PFP. We extracted the physical functions assessed in each measure. Each identified physical function was linked to a code from the International Classification of Functioning, Disability and Health (ICF) framework.

Results

4146 articles were screened. A total of 143 articles were included. The median number of physical functions assessed was nine for SROMs and one for PBOMs. The three most assessed physical functions were climbing stairs, walking short distances, and standing up from sitting. Climbing stairs was the most assessed physical function in measures for knee OA and PFP populations, whereas jumping was in measures for the ACL-injured population.

Conclusion

SROMs assess a broader range of physical functions, whereas PBOMs focus on discrete activities. ACL and PFP measures evaluated more challenging physical functions than knee OA measures. Current physical function outcome measures are not well suited to assess performance in knee OA populations with mild or diverse levels of impairment.
背景:身体功能评估是膝关节肌肉骨骼疾病管理的关键。目前有多种自我报告结果测量法(SROM)和基于表现的结果测量法(PBOM)来评估膝关节疾病患者的身体功能。然而,这些测量方法的内容尚未得到探讨:目的:探讨膝关节骨性关节炎(OA)、前交叉韧带(ACL)损伤和髌股关节疼痛(PFP)患者的下肢PBOM和SROM所评估的身体功能的范围和频率:方法:我们进行了一次范围审查。我们纳入了针对膝关节 OA、前交叉韧带损伤和 PFP 患者的膝关节功能结果测量的开发或测量特性研究。我们提取了每项测量所评估的身体功能。每项确定的身体功能都与《国际功能、残疾和健康分类》(ICF)框架中的代码相关联:结果:共筛选出 4146 篇文章。共纳入 143 篇文章。SROM评估的身体功能中位数为9项,PBOM为1项。评估最多的三种身体机能是爬楼梯、短距离行走和坐立。在针对膝关节OA和PFP人群的测量中,爬楼梯是评估最多的身体功能,而在针对前交叉韧带损伤人群的测量中,跳跃是评估最多的身体功能:结论:SROM 评估的身体机能范围更广,而 PBOM 则侧重于离散活动。与膝关节OA测量相比,前交叉韧带和膝关节功能障碍测量评估的身体功能更具挑战性。目前的身体功能结果测量并不适合评估轻度或不同程度损伤的膝关节OA人群的表现。
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引用次数: 0
期刊
Brazilian Journal of Physical Therapy
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