Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101139
Carlos Maximiliano Sánchez Medina , Claudia Gutiérrez Camacho , Anne M. Moseley , Xochiquetzalli Tejeda Castellanos , Qiuzhe Chen , Edgar Denova-Gutiérrez , Aidan G Cashin , Viridiana Valderrama Godínez , Akari Fuentes Gómez , Ana Elisabeth Olivares Hernández , Giovanni E. Ferreira
Background
Low back pain is a severe global health problem. To face this issue, testing interventions using rigorously performed randomized controlled trials is essential. However, it is unclear if a country's income level is related to the quality of trials conducted.
Objective
To compare the frequency and methodological quality of randomized controlled trials of physical therapy interventions for low back pain conducted in countries with different income levels.
Methods
This meta-epidemiological study retrieved trials from the Physiotherapy Evidence Database (PEDro), Literatura Latino Americana em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO). The methodological quality was evaluated using the 0–10 PEDro scale. Then we calculated the mean differences with a 95 % confidence interval and performed an ANOVA test with Bonferroni correction to compare the PEDro scores between income groups.
Results
We included 2552 trials; 70.4 % were conducted in high-income countries. The mean (standard deviation) PEDro score of all trials was 5.5 (0.03) out of 10. Trials from low- or lower-middle-income countries had lower methodological quality than those from upper-middle- and high-income countries, but the mean difference was small (-0.6 points (95 % CI -0.9, -0.3), and -0.7 points (95 % CI -1.1, -0.5) respectively).
Conclusion
Income level influences the methodological quality of trials of physical therapy intervention but is not the only factor. Implementing strategies to improve the methodological rigor of trials in patients with low back pain is necessary in all countries, regardless of income level.
背景：腰背痛是一个严重的全球性健康问题。面对这一问题，必须通过严格的随机对照试验来测试干预措施。然而，目前还不清楚一个国家的收入水平是否与试验的质量有关：比较在不同收入水平国家进行的腰背痛物理治疗干预随机对照试验的频率和方法质量：这项荟萃流行病学研究从物理治疗证据数据库（PEDro）、Literatura Latino Americana em Ciências da Saúde (LILACS)和科学电子图书馆在线（SciELO）中检索试验。研究方法的质量采用 PEDro 0-10 分制进行评估。然后，我们计算了带有95%置信区间的平均差异，并进行了带Bonferroni校正的方差分析检验，以比较不同收入组之间的PEDro评分：结果：我们纳入了 2552 项试验，其中 70.4% 在高收入国家进行。所有试验的 PEDro 平均分（标准差）为 5.5（0.03）分（满分 10 分）。来自低收入或中低收入国家的试验的方法学质量低于来自中上收入和高收入国家的试验，但平均差异很小（分别为-0.6分（95 % CI -0.9，-0.3）和-0.7分（95 % CI -1.1，-0.5））：结论：收入水平会影响物理治疗干预试验的方法学质量，但不是唯一的因素。无论收入水平如何，所有国家都有必要实施相关策略，提高腰背痛患者试验方法的严谨性。
{"title":"The methodological quality of clinical trials of physical therapy for low back pain varies between countries with different income levels. A meta-epidemiological study","authors":"Carlos Maximiliano Sánchez Medina , Claudia Gutiérrez Camacho , Anne M. Moseley , Xochiquetzalli Tejeda Castellanos , Qiuzhe Chen , Edgar Denova-Gutiérrez , Aidan G Cashin , Viridiana Valderrama Godínez , Akari Fuentes Gómez , Ana Elisabeth Olivares Hernández , Giovanni E. Ferreira","doi":"10.1016/j.bjpt.2024.101139","DOIUrl":"10.1016/j.bjpt.2024.101139","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain is a severe global health problem. To face this issue, testing interventions using rigorously performed randomized controlled trials is essential. However, it is unclear if a country's income level is related to the quality of trials conducted.</div></div><div><h3>Objective</h3><div>To compare the frequency and methodological quality of randomized controlled trials of physical therapy interventions for low back pain conducted in countries with different income levels.</div></div><div><h3>Methods</h3><div>This meta-epidemiological study retrieved trials from the Physiotherapy Evidence Database (PEDro), Literatura Latino Americana em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO). The methodological quality was evaluated using the 0–10 PEDro scale. Then we calculated the mean differences with a 95 % confidence interval and performed an ANOVA test with Bonferroni correction to compare the PEDro scores between income groups.</div></div><div><h3>Results</h3><div>We included 2552 trials; 70.4 % were conducted in high-income countries. The mean (standard deviation) PEDro score of all trials was 5.5 (0.03) out of 10. Trials from low- or lower-middle-income countries had lower methodological quality than those from upper-middle- and high-income countries, but the mean difference was small (-0.6 points (95 % CI -0.9, -0.3), and -0.7 points (95 % CI -1.1, -0.5) respectively).</div></div><div><h3>Conclusion</h3><div>Income level influences the methodological quality of trials of physical therapy intervention but is not the only factor. Implementing strategies to improve the methodological rigor of trials in patients with low back pain is necessary in all countries, regardless of income level.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101139"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101142
Emma J. Wijnhoud , Arnoud M.M. Edelman Bos , Annemieke I. Buizer , Heleen Beckerman
Background
In the public health domain, aerobic fitness is an important predictor of both health and disease.
Objective
To determine aerobic fitness in children with cerebral palsy (CP) compared to typically developing (TD) peers measured with a maximal exercise test.
Methods
A systematic literature search was conducted in PubMed (MEDLINE), PsycArticles, PsycInfo, CINAHL, and SPORTDiscus (EBSCO). Original studies that reported findings on aerobic fitness expressed as peak oxygen uptake (VO2peak) during a maximal exercise test measured with a gas analysis system, in children with CP, aged 18 years or younger, were included. VO2peak values were pooled, using the generic inverse variance method, for type of maximal exercise test, Gross Motor Function Classification System (GMFCS) level, distribution of CP, and sex.
Results
Thirty-six studies with a total of 510 children with CP (GMFCS I-IV) and 173 TD peers were included. VO2peak was measured using cycle ergometer test (n = 16), treadmill exercise test (n = 13), arm crank ergometer test (n = 6), shuttle run test (n = 3), and shuttle ride test (n = 1). The overall pooled VO2peak in children with CP was 32.84 mL/kg/min (SE 1.28) and 45.02 mL/kg/min (SE 1.32) in TD peers, with a difference between CP and TD of -12.17 mL/kg/min (95 % CI: -16.70, -7.64). Subgroup analyses revealed that aerobic fitness was most compromised in children at higher GMFCS levels and boys with CP.
Conclusion
Aerobic fitness is severely compromised in children with CP. Promoting a healthy lifestyle and increasing participation in physical activities for young people with CP is recommended.
The study protocol was prospectively registered in the PROSPERO registry with reference number CRD42021292879.
{"title":"Aerobic fitness in children with cerebral palsy compared to typically developing peers: A systematic review and meta-analysis","authors":"Emma J. Wijnhoud , Arnoud M.M. Edelman Bos , Annemieke I. Buizer , Heleen Beckerman","doi":"10.1016/j.bjpt.2024.101142","DOIUrl":"10.1016/j.bjpt.2024.101142","url":null,"abstract":"<div><h3>Background</h3><div>In the public health domain, aerobic fitness is an important predictor of both health and disease.</div></div><div><h3>Objective</h3><div>To determine aerobic fitness in children with cerebral palsy (CP) compared to typically developing (TD) peers measured with a maximal exercise test.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed (MEDLINE), PsycArticles, PsycInfo, CINAHL, and SPORTDiscus (EBSCO). Original studies that reported findings on aerobic fitness expressed as peak oxygen uptake (VO<sub>2peak</sub>) during a maximal exercise test measured with a gas analysis system, in children with CP, aged 18 years or younger, were included. VO<sub>2peak</sub> values were pooled, using the generic inverse variance method, for type of maximal exercise test, Gross Motor Function Classification System (GMFCS) level, distribution of CP, and sex.</div></div><div><h3>Results</h3><div>Thirty-six studies with a total of 510 children with CP (GMFCS I-IV) and 173 TD peers were included. VO<sub>2peak</sub> was measured using cycle ergometer test (<em>n</em> = 16), treadmill exercise test (<em>n</em> = 13), arm crank ergometer test (<em>n</em> = 6), shuttle run test (<em>n</em> = 3), and shuttle ride test (<em>n</em> = 1). The overall pooled VO<sub>2peak</sub> in children with CP was 32.84 mL/kg/min (SE 1.28) and 45.02 mL/kg/min (SE 1.32) in TD peers, with a difference between CP and TD of -12.17 mL/kg/min (95 % CI: -16.70, -7.64). Subgroup analyses revealed that aerobic fitness was most compromised in children at higher GMFCS levels and boys with CP.</div></div><div><h3>Conclusion</h3><div>Aerobic fitness is severely compromised in children with CP. Promoting a healthy lifestyle and increasing participation in physical activities for young people with CP is recommended.</div><div>The study protocol was prospectively registered in the PROSPERO registry with reference number CRD42021292879.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101142"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101150
Caitlin M.P. Jones , Chung-Wei Christine Lin , Joshua Zadro , Arianne Verhagen , Mark Hancock , Raymond Ostelo
Background
The Brief Pain Inventory—Interference Subscale (BPI-IS) is a subscale of the BPI assessment tool developed to rapidly assess the impact of a person's pain on their function. It is uncertain whether it has one or two factors, and whether it has acceptable clinimetric properties in a mixed spinal pain (back and/or neck) population.
Objectives
To determine the clinimetric properties of the BPI-IS in a population with mixed spinal pain.
Methods
We completed a clinimetric evaluation with a test-retest design, factor analysis, and hypothesis testing. We used data collected for a randomised clinical trial including a population presenting to primary care or emergency departments with acute spinal pain (back and/or neck).
Results
Confirmatory factor analysis better supported the two-factor model of the BPI-IS (physical interference factor and affective interference factor) as compared to the one-factor model. Both one and two-factor models had acceptable reliability (high internal consistency and no evidence of floor or ceiling effects). Both models failed to reach our a-priori thresholds for acceptable construct (cross sectional) validity, and responsiveness (longitudinal validity) in either back or neck pain populations.
Conclusion
The BPI-IS has two factors and both have acceptable reliability, but tests for validity did not reach our a priori thresholds for acceptability (construct validity and responsiveness). The BPI-IS may not be suitable to measure the impact of pain on function in back and neck pain populations.
{"title":"The brief pain inventory—Interference Subscale has acceptable reliability but questionable validity in acute back and neck pain populations","authors":"Caitlin M.P. Jones , Chung-Wei Christine Lin , Joshua Zadro , Arianne Verhagen , Mark Hancock , Raymond Ostelo","doi":"10.1016/j.bjpt.2024.101150","DOIUrl":"10.1016/j.bjpt.2024.101150","url":null,"abstract":"<div><h3>Background</h3><div>The Brief Pain Inventory—Interference Subscale (BPI-IS) is a subscale of the BPI assessment tool developed to rapidly assess the impact of a person's pain on their function. It is uncertain whether it has one or two factors, and whether it has acceptable clinimetric properties in a mixed spinal pain (back and/or neck) population.</div></div><div><h3>Objectives</h3><div>To determine the clinimetric properties of the BPI-IS in a population with mixed spinal pain.</div></div><div><h3>Methods</h3><div>We completed a clinimetric evaluation with a test-retest design, factor analysis, and hypothesis testing. We used data collected for a randomised clinical trial including a population presenting to primary care or emergency departments with acute spinal pain (back and/or neck).</div></div><div><h3>Results</h3><div>Confirmatory factor analysis better supported the two-factor model of the BPI-IS (physical interference factor and affective interference factor) as compared to the one-factor model. Both one and two-factor models had acceptable reliability (high internal consistency and no evidence of floor or ceiling effects). Both models failed to reach our a-priori thresholds for acceptable construct (cross sectional) validity, and responsiveness (longitudinal validity) in either back or neck pain populations.</div></div><div><h3>Conclusion</h3><div>The BPI-IS has two factors and both have acceptable reliability, but tests for validity did not reach our a priori thresholds for acceptability (construct validity and responsiveness). The BPI-IS may not be suitable to measure the impact of pain on function in back and neck pain populations.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101150"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101145
Sizhong Wang , Jiaxu Zeng , Ramakrishnan Mani , Cathy Mary Chapple , Daniel Cury Ribeiro
Background
Mobilization with movement (MWM) is commonly used to treat patients with rotator cuff-related shoulder pain (RCRSP). However, the evidence supporting MWM efficacy for improving range of motion (ROM) and pain in patients with RCRSP is limited.
Objectives
To assess the immediate effects of MWM on the angular onset of pain in patients with RCRSP.
Methods
Sixty-three participants with RCRSP were randomized to receive 3 sets of 10 repetitions of MWM or sham MWM with a minute rest between each set. The angular onset of pain (primary outcome), and pain intensity at rest and during shoulder abduction to the onset of pain were measured at baseline, and after receiving the 1st and 3rd sets of 10 repetitions of interventions. Other secondary outcomes were measured at baseline and after receiving 3 sets of 10 repetitions of interventions or 1, 2, 3, 5, and 7 days after interventions.
Results
Compared with the sham MWM group, the MWM group had an additional improvement of 6.5° (95 % CI -0.9, 13.9) and 13.7° (95 % CI 6.3, 21.1) (from baseline) after receiving the 1st and 3rd sets of 10 repetitions of interventions, respectively.
Conclusion
MWM improves the angular onset of pain after 3 sets of 10 repetitions of MWM in patients with RCRSP. This study provides preliminary support for the use of MWM in treating patients with RCRSP and provides some guidance for clinicians to decide the MWM dosage to be used in clinical practice.
{"title":"The immediate effects of mobilization with movement on shoulder range of motion and pain in patients with rotator cuff-related shoulder pain: A randomized controlled trial (Evolution Trial)","authors":"Sizhong Wang , Jiaxu Zeng , Ramakrishnan Mani , Cathy Mary Chapple , Daniel Cury Ribeiro","doi":"10.1016/j.bjpt.2024.101145","DOIUrl":"10.1016/j.bjpt.2024.101145","url":null,"abstract":"<div><h3>Background</h3><div>Mobilization with movement (MWM) is commonly used to treat patients with rotator cuff-related shoulder pain (RCRSP). However, the evidence supporting MWM efficacy for improving range of motion (ROM) and pain in patients with RCRSP is limited.</div></div><div><h3>Objectives</h3><div>To assess the immediate effects of MWM on the angular onset of pain in patients with RCRSP.</div></div><div><h3>Methods</h3><div>Sixty-three participants with RCRSP were randomized to receive 3 sets of 10 repetitions of MWM or sham MWM with a minute rest between each set. The angular onset of pain (primary outcome), and pain intensity at rest and during shoulder abduction to the onset of pain were measured at baseline, and after receiving the 1<sup>st</sup> and 3<sup>rd</sup> sets of 10 repetitions of interventions. Other secondary outcomes were measured at baseline and after receiving 3 sets of 10 repetitions of interventions or 1, 2, 3, 5, and 7 days after interventions.</div></div><div><h3>Results</h3><div>Compared with the sham MWM group, the MWM group had an additional improvement of 6.5° (95 % CI -0.9, 13.9) and 13.7° (95 % CI 6.3, 21.1) (from baseline) after receiving the 1<sup>st</sup> and 3<sup>rd</sup> sets of 10 repetitions of interventions, respectively.</div></div><div><h3>Conclusion</h3><div>MWM improves the angular onset of pain after 3 sets of 10 repetitions of MWM in patients with RCRSP. This study provides preliminary support for the use of MWM in treating patients with RCRSP and provides some guidance for clinicians to decide the MWM dosage to be used in clinical practice.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101145"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101124
Érika P. Rampazo , Ana Laura M. de Andrade , Viviane R. da Silva , Claudio G.N. Back , Pascal Madeleine , Richard E. Liebano
Background
Photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) are used to reduce neck pain.
Objective
To investigate the immediate and 1-month post-treatment effects of 10 treatment sessions of PBM and TENS delivered over 2 weeks on pain intensity in individuals with neck pain.
Methods
Individuals with neck pain were randomized into four groups: PBM+TENS, PBM, TENS, and Sham. Primary outcome: pain intensity at rest. Secondary outcomes: pain intensity during movement, pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), cervical range of motion (ROM), psychosocial factors, drug intake for neck pain, and global perceived effect (GPE). All outcome assessments were made pre- and post-treatment. Mean differences and 95 % confidence intervals were calculated for between-group comparisons.
Results
A total of 144 participants were recruited. No significant between-group difference was observed for pain intensity at rest, TS, CPM, ROM, psychosocial factors, and drug intake. The PBM+TENS showed a reduction in pain intensity during movement and GPE compared to the PBM (MD: 1.0 points; 95 % CI: 0.0, 2.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) and Sham (MD: 2.0 points; 95 % CI: 1.0, 3.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) groups. PBM+TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase distant PPT compared to other groups.
Conclusions
The use of PBM or TENS was not effective for reducing pain intensity at rest. The combination of PBM and TENS was effective in improving pain intensity during movement, local hyperalgesia, and the GPE. TENS reduced local and distant hyperalgesia.
{"title":"The effects of photobiomodulation and transcutaneous electrical nerve stimulation on chronic neck pain: A double-blind, randomized, sham-controlled trial","authors":"Érika P. Rampazo , Ana Laura M. de Andrade , Viviane R. da Silva , Claudio G.N. Back , Pascal Madeleine , Richard E. Liebano","doi":"10.1016/j.bjpt.2024.101124","DOIUrl":"10.1016/j.bjpt.2024.101124","url":null,"abstract":"<div><h3>Background</h3><div>Photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) are used to reduce neck pain.</div></div><div><h3>Objective</h3><div>To investigate the immediate and 1-month post-treatment effects of 10 treatment sessions of PBM and TENS delivered over 2 weeks on pain intensity in individuals with neck pain.</div></div><div><h3>Methods</h3><div>Individuals with neck pain were randomized into four groups: PBM+TENS, PBM, TENS, and Sham. Primary outcome: pain intensity at rest. Secondary outcomes: pain intensity during movement, pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), cervical range of motion (ROM), psychosocial factors, drug intake for neck pain, and global perceived effect (GPE). All outcome assessments were made pre- and post-treatment. Mean differences and 95 % confidence intervals were calculated for between-group comparisons.</div></div><div><h3>Results</h3><div>A total of 144 participants were recruited. No significant between-group difference was observed for pain intensity at rest, TS, CPM, ROM, psychosocial factors, and drug intake. The PBM+TENS showed a reduction in pain intensity during movement and GPE compared to the PBM (MD: 1.0 points; 95 % CI: 0.0, 2.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) and Sham (MD: 2.0 points; 95 % CI: 1.0, 3.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) groups. PBM+TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase distant PPT compared to other groups.</div></div><div><h3>Conclusions</h3><div>The use of PBM or TENS was not effective for reducing pain intensity at rest. The combination of PBM and TENS was effective in improving pain intensity during movement, local hyperalgesia, and the GPE. TENS reduced local and distant hyperalgesia.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101124"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101144
Jéssica Costa Leite , Armele Dornelas de Andrade , Bruna T.S. Araújo , Endy Bianca Nunes da Hora , Thainá de Gomes Figueiredo , Josicléia Leôncio da Silva , Maria Inês Remígio de Aguiar , Sílvia Marinho Martins , Shirley Lima Campos , Daniella Cunha Brandão
Background
Cardiopulmonary exercise testing (CPET) is the gold standard for functional capacity assessment, although it is costly and not easily accessible. The Glittre-ADL test may be a low-cost alternative for patients with heart failure.
Objective
To establish a cutoff point for functional capacity of patients with heart failure using the Glittre-ADL test. We also assessed agreement, reliability, and minimal detectable change.
Methods
This cross-sectional study was conducted with 78 patients (aged 21 to 65 years) with heart failure and reduced ejection fraction (functional classes II and III of the New York Heart Association). Test-retest reliability was measured using the intraclass correlation coefficient (ICC), while receiver operating characteristic (ROC) curves were used to determine whether ADL-time, could distinguish between patients with peak oxygen consumption (VO2peak) < 16 versus those ≥ 16 ml/kg/min.
Results
A cutoff point of 255 s (76 % sensitivity [95 % CI 58, 89] and 72 % specificity [95 % CI 56, 85]) was established based on the total time spent on Glittre-ADL test; the area under the curve was 0.773 (95 % CI 0.663, 0.861; p < 0.0001). Regarding agreement, a significant correlation was found between test and retest (r = 0.83, r2 = 0.69, p < 0.001). Intraclass correlation coefficient, absolute reliability, and minimal detectable change were 0.84 (95 % CI 0.45, 0.94; p < 0.001), 3.2 %, and 8.8 % (23.1 s), respectively.
Conclusion
Glittre-ADL test showed good reproducibility in repeated tests. Thus, the cutoff point established by our study can be used in clinical practice instead of CPET to identify patients with severe heart failure.
背景：心肺运动测试（CPET）是功能能力评估的黄金标准，但成本高昂且不易获得。对于心衰患者来说，Glittre-ADL 测试可能是一种低成本的替代方法：目的：使用 Glittre-ADL 测试确定心衰患者功能能力的临界点。我们还评估了一致性、可靠性和最小可检测变化：这项横断面研究的对象是 78 名射血分数降低的心衰患者（年龄在 21 岁至 65 岁之间）（纽约心脏协会功能分级 II 级和 III 级）。使用类内相关系数（ICC）测量重测可靠性，同时使用接收器操作特征曲线（ROC）确定 ADL-时间是否能区分峰值耗氧量（VO2peak）< 16 和≥ 16 ml/kg/min 的患者：根据 Glittre-ADL 测试所花费的总时间，确定了 255 秒的分界点（灵敏度为 76% [95 % CI 58, 89] ，特异度为 72% [95 % CI 56, 85]）；曲线下面积为 0.773 (95 % CI 0.663, 0.861; p < 0.0001)。在一致性方面，测试和复测之间存在明显的相关性（r = 0.83，r2 = 0.69，p < 0.001）。类内相关系数、绝对可靠性和最小检测变化分别为 0.84 (95 % CI 0.45, 0.94; p < 0.001)、3.2 % 和 8.8 % (23.1 s)：Glittre-ADL测试在重复测试中表现出良好的重现性。结论：Glittre-ADL测试在重复测试中显示出良好的重现性，因此，我们的研究确定的临界点可在临床实践中代替CPET用于识别严重心力衰竭患者。
{"title":"Glittre-ADL test to assess functional capacity in patients with heart failure and reduced ejection fraction: Reproducibility, minimal detectable change, and cutoff point","authors":"Jéssica Costa Leite , Armele Dornelas de Andrade , Bruna T.S. Araújo , Endy Bianca Nunes da Hora , Thainá de Gomes Figueiredo , Josicléia Leôncio da Silva , Maria Inês Remígio de Aguiar , Sílvia Marinho Martins , Shirley Lima Campos , Daniella Cunha Brandão","doi":"10.1016/j.bjpt.2024.101144","DOIUrl":"10.1016/j.bjpt.2024.101144","url":null,"abstract":"<div><h3>Background</h3><div>Cardiopulmonary exercise testing (CPET) is the gold standard for functional capacity assessment, although it is costly and not easily accessible. The Glittre-ADL test may be a low-cost alternative for patients with heart failure.</div></div><div><h3>Objective</h3><div>To establish a cutoff point for functional capacity of patients with heart failure using the Glittre-ADL test. We also assessed agreement, reliability, and minimal detectable change.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted with 78 patients (aged 21 to 65 years) with heart failure and reduced ejection fraction (functional classes II and III of the New York Heart Association). Test-retest reliability was measured using the intraclass correlation coefficient (ICC), while receiver operating characteristic (ROC) curves were used to determine whether ADL-time, could distinguish between patients with peak oxygen consumption (VO<sub>2peak</sub>) < 16 versus those ≥ 16 ml/kg/min.</div></div><div><h3>Results</h3><div>A cutoff point of 255 s (76 % sensitivity [95 % CI 58, 89] and 72 % specificity [95 % CI 56, 85]) was established based on the total time spent on Glittre-ADL test; the area under the curve was 0.773 (95 % CI 0.663, 0.861; <em>p</em> < 0.0001). Regarding agreement, a significant correlation was found between test and retest (<em>r</em> = 0.83, r<sup>2</sup> = 0.69, <em>p</em> < 0.001). Intraclass correlation coefficient, absolute reliability, and minimal detectable change were 0.84 (95 % CI 0.45, 0.94; <em>p</em> < 0.001), 3.2 %, and 8.8 % (23.1 s), respectively.</div></div><div><h3>Conclusion</h3><div>Glittre-ADL test showed good reproducibility in repeated tests. Thus, the cutoff point established by our study can be used in clinical practice instead of CPET to identify patients with severe heart failure.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101144"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101135
Sara Souto-Miranda , Eduardo Brazete Cruz , Diogo Pires , Fernando Ribeiro , Nuno Cordeiro , Cristina Jácome
Background
Physical therapy is an ever-evolving profession. To improve research efficiency, it is crucial to identify knowledge gaps and establish research priorities.
Objective
To review priorities for physical therapy research, and to summarize the evidence into a global research agenda. As a secondary aim we sought to compare the priorities across studies.
Methods
We conducted a scoping review with searches in PubMed, Web of Science, and Google Scholar to gather studies and grey literature. Studies were included if they involved physical therapists, physical therapy researchers, patients, or policymakers who determined a research agenda or conducted a study on priority setting in physical therapy research. Content analysis was performed by two independent reviewers to gather research priorities into main topics for a global research agenda.
Results
Twenty-five records were included, most being original articles (n = 19), from high-income countries (n = 25). Nine studies established generic priorities for physical therapy research, while the remaining were dedicated to physical therapy specific fields. A total of 551 priorities were established since 2000 for general physical therapy and 7 specific physical therapy areas. A global research agenda was established with 9 priority categories for future research. Cost and effectiveness studies were the more frequently prioritized research priorities.
Conclusion
This review synthesized the literature on priorities for physical therapy research and provided a global physical therapy research agenda. These 9 priority categories can now be used to design future physical therapy studies and channel research efforts into questions that are relevant for multiple stakeholders and nationalities.
{"title":"Priorities in physical therapy research: A scoping review","authors":"Sara Souto-Miranda , Eduardo Brazete Cruz , Diogo Pires , Fernando Ribeiro , Nuno Cordeiro , Cristina Jácome","doi":"10.1016/j.bjpt.2024.101135","DOIUrl":"10.1016/j.bjpt.2024.101135","url":null,"abstract":"<div><h3>Background</h3><div>Physical therapy is an ever-evolving profession. To improve research efficiency, it is crucial to identify knowledge gaps and establish research priorities.</div></div><div><h3>Objective</h3><div>To review priorities for physical therapy research, and to summarize the evidence into a global research agenda. As a secondary aim we sought to compare the priorities across studies.</div></div><div><h3>Methods</h3><div>We conducted a scoping review with searches in PubMed, Web of Science, and Google Scholar to gather studies and grey literature. Studies were included if they involved physical therapists, physical therapy researchers, patients, or policymakers who determined a research agenda or conducted a study on priority setting in physical therapy research. Content analysis was performed by two independent reviewers to gather research priorities into main topics for a global research agenda.</div></div><div><h3>Results</h3><div>Twenty-five records were included, most being original articles (<em>n</em> = 19), from high-income countries (<em>n</em> = 25). Nine studies established generic priorities for physical therapy research, while the remaining were dedicated to physical therapy specific fields. A total of 551 priorities were established since 2000 for general physical therapy and 7 specific physical therapy areas. A global research agenda was established with 9 priority categories for future research. Cost and effectiveness studies were the more frequently prioritized research priorities.</div></div><div><h3>Conclusion</h3><div>This review synthesized the literature on priorities for physical therapy research and provided a global physical therapy research agenda. These 9 priority categories can now be used to design future physical therapy studies and channel research efforts into questions that are relevant for multiple stakeholders and nationalities.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101135"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101140
Guilherme S. Nunes , Diênifer Zilmer Rodrigues , Maria Ruzafa-Martinez , Penney Upton , Clarissa Medeiros da Luz , Fernanda Romaguera , Anna Julia M Dangui , Bruna Wageck
Background
While several instruments assess evidence-based practice (EBP) competencies, few are available for the Brazilian population, particularly healthcare students.
Objective
To perform a cross-cultural translation of the Student Evidence-Based Practice Questionnaire (S-EBPQ) and Evidence-Based Practice Evaluation Competence Questionnaire (EBP-COQ) into Brazilian Portuguese; to adapt and validate the Brazilian Portuguese versions for use with healthcare students from diverse courses; and to assess the measurement properties of the translated and adapted versions.
Methods
Four hundred forty-two healthcare students were included, and three versions were tested: S-EBPQ-BR, EBP-COQ-BR for nursing students, and EBP-COQ-BR for healthcare students. We assessed internal consistency, reliability, construct validity, responsiveness, and ceiling/floor effects. For reliability, participants completed the questionnaires twice, one week apart. For responsiveness, they completed them after participating in an educational program.
Results
No issues were identified with understanding or applicability. For overall scores, the translated questionnaires demonstrated strong internal consistency (Cronbach's alpha=0.87-0.92), good to moderate reliability (ICC3,1=0.63-0.88), construct validity with moderate to very strong correlations to the Evidence-Based Practice Questionnaire (r=0.43-0.89), no ceiling or floor effects, and adequate responsiveness with significant pre- and post-educational program score differences. For subscales, the majority of them demonstrated satisfactory measurement properties, except for S-EBPQ-BR attitude (low internal consistency, poor reliability, and ceiling effect), EBP-COQ attitude (inadequate construct validity), and EBP-COQ skills (inadequate construct validity).
Conclusion
The Brazilian Portuguese versions of S-EBPQ and EBP-COQ exhibit strong measurement properties, including high internal consistency, adequate reliability, valid construct validity, and responsiveness. However, some subscales present suboptimal internal consistency, reliability, and construct validity.
{"title":"Brazilian Portuguese version of questionnaires assessing evidence-based practice competencies in healthcare students: Translation, cross-cultural adaptation, and measurement properties","authors":"Guilherme S. Nunes , Diênifer Zilmer Rodrigues , Maria Ruzafa-Martinez , Penney Upton , Clarissa Medeiros da Luz , Fernanda Romaguera , Anna Julia M Dangui , Bruna Wageck","doi":"10.1016/j.bjpt.2024.101140","DOIUrl":"10.1016/j.bjpt.2024.101140","url":null,"abstract":"<div><h3>Background</h3><div>While several instruments assess evidence-based practice (EBP) competencies, few are available for the Brazilian population, particularly healthcare students.</div></div><div><h3>Objective</h3><div>To perform a cross-cultural translation of the Student Evidence-Based Practice Questionnaire (S-EBPQ) and Evidence-Based Practice Evaluation Competence Questionnaire (EBP-COQ) into Brazilian Portuguese; to adapt and validate the Brazilian Portuguese versions for use with healthcare students from diverse courses; and to assess the measurement properties of the translated and adapted versions.</div></div><div><h3>Methods</h3><div>Four hundred forty-two healthcare students were included, and three versions were tested: S-EBPQ-BR, EBP-COQ-BR for nursing students, and EBP-COQ-BR for healthcare students. We assessed internal consistency, reliability, construct validity, responsiveness, and ceiling/floor effects. For reliability, participants completed the questionnaires twice, one week apart. For responsiveness, they completed them after participating in an educational program.</div></div><div><h3>Results</h3><div>No issues were identified with understanding or applicability. For overall scores, the translated questionnaires demonstrated strong internal consistency (Cronbach's alpha=0.87-0.92), good to moderate reliability (ICC<sub>3,1</sub>=0.63-0.88), construct validity with moderate to very strong correlations to the Evidence-Based Practice Questionnaire (r=0.43-0.89), no ceiling or floor effects, and adequate responsiveness with significant pre- and post-educational program score differences. For subscales, the majority of them demonstrated satisfactory measurement properties, except for S-EBPQ-BR attitude (low internal consistency, poor reliability, and ceiling effect), EBP-COQ attitude (inadequate construct validity), and EBP-COQ skills (inadequate construct validity).</div></div><div><h3>Conclusion</h3><div>The Brazilian Portuguese versions of S-EBPQ and EBP-COQ exhibit strong measurement properties, including high internal consistency, adequate reliability, valid construct validity, and responsiveness. However, some subscales present suboptimal internal consistency, reliability, and construct validity.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101140"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Dysfunctional Voiding Score Symptoms (DVSS) questionnaire is commonly used to evaluate dysfunctional voiding and incontinence (DVI).
Objectives
To translate and culturally adapt the DVSS questionnaire into Spanish (DVSS-Sp) in pediatric population and to assess its psychometric properties.
Methods
The process of translation and cultural validation were done. To obtain evidence of validity and reliability, we evaluated the fit of different factor models and calculated internal consistency coefficients. Also, the diagnostic capacity of the DVSS-Sp scale was assessed through a logistic regression analysis and a receiver operating characteristic (ROC) curve. Accordingly, a total sample of 248 participants was recruited (204 with a diagnosis of DVIs and 44 with no medical problems).
Results
The cross-cultural adaptation showed an adequate correspondence with the original version. The DVSS-Sp was configured with 2 factors: Overactive Bladder (OB) symptoms (items 1, 2, 6, and 7) and Dysfunctional Elimination (DE) symptoms (items 3, 4, 8, and 9), showing excellent goodness-of-fit indices. The relationship between the factors OB and DE was low. The reliability of the OB factor was α = 0.68, ω = 0.71, and the DE factor was α = 0.56, ω = 0.57. A logistic regression analysis suggests a good diagnostic capacity of the DVSS-Sp scale. Additionally, ROC analysis showed a cut-off score of 3.5 on the DVSS-Sp scale, where the specificity was 0.907, and the sensitivity was 0.636.
Conclusion
The results of this study support the use of the DVSS-Sp for assessing DVIs in Spanish-speaking children.
{"title":"Translation, cross-cultural adaptation, and psychometric properties of the Spanish version of the dysfunctional voiding score symptoms (DVSS-Sp) questionnaire in a pediatric chilean sample","authors":"Alejandra Budinich-Almarza , Agustín Molina-Martinez , Barbara Burgos-Mansilla , Macarena Sola-Aylwin , Belén Sanchez-Antonucci , Claudio Bascour-Sandoval","doi":"10.1016/j.bjpt.2024.101133","DOIUrl":"10.1016/j.bjpt.2024.101133","url":null,"abstract":"<div><h3>Background</h3><div>The Dysfunctional Voiding Score Symptoms (DVSS) questionnaire is commonly used to evaluate dysfunctional voiding and incontinence (DVI).</div></div><div><h3>Objectives</h3><div>To translate and culturally adapt the DVSS questionnaire into Spanish (DVSS-Sp) in pediatric population and to assess its psychometric properties.</div></div><div><h3>Methods</h3><div>The process of translation and cultural validation were done. To obtain evidence of validity and reliability, we evaluated the fit of different factor models and calculated internal consistency coefficients. Also, the diagnostic capacity of the DVSS-Sp scale was assessed through a logistic regression analysis and a receiver operating characteristic (ROC) curve. Accordingly, a total sample of 248 participants was recruited (204 with a diagnosis of DVIs and 44 with no medical problems).</div></div><div><h3>Results</h3><div>The cross-cultural adaptation showed an adequate correspondence with the original version. The DVSS-Sp was configured with 2 factors: Overactive Bladder (OB) symptoms (items 1, 2, 6, and 7) and Dysfunctional Elimination (DE) symptoms (items 3, 4, 8, and 9), showing excellent goodness-of-fit indices. The relationship between the factors OB and DE was low. The reliability of the OB factor was α = 0.68, ω = 0.71, and the DE factor was α = 0.56, ω = 0.57. A logistic regression analysis suggests a good diagnostic capacity of the DVSS-Sp scale. Additionally, ROC analysis showed a cut-off score of 3.5 on the DVSS-Sp scale, where the specificity was 0.907, and the sensitivity was 0.636.</div></div><div><h3>Conclusion</h3><div>The results of this study support the use of the DVSS-Sp for assessing DVIs in Spanish-speaking children.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101133"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.bjpt.2024.101141
Rodrigo Pegado , Nilson N.Mendes Neto , Lucas Camargo , Kevin Pacheco-Barrios , Felipe Fregni
{"title":"Looking for the future: Gaps in research and clinical rehabilitation for chronic chikungunya arthralgia","authors":"Rodrigo Pegado , Nilson N.Mendes Neto , Lucas Camargo , Kevin Pacheco-Barrios , Felipe Fregni","doi":"10.1016/j.bjpt.2024.101141","DOIUrl":"10.1016/j.bjpt.2024.101141","url":null,"abstract":"","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101141"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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