Brazilian Journal of Physical Therapy最新文献_第4页

Non-linear interactions among hip and foot biomechanical factors predict foot pronation during walking in women 髋部和足部生物力学因素之间的非线性相互作用可预测女性行走时足部的前倾。

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-11-01 DOI: 10.1016/j.bjpt.2024.101136

Aline de Castro Cruz , Sérgio Teixeira Fonseca , Vanessa Lara Araújo , Juliana Melo Ocarino , Luciana De Michelis Mendonça , Renan Alves Resende , Thales Rezende Souza

Background

Interactions between hip and foot biomechanical factors may result in different magnitudes of foot pronation during walking.

Objective

To investigate non-linear interactions between hip and foot biomechanical factors and their capability to predict foot pronation during walking and identify the profiles of biomechanical factors that predict greater and lower pronation.

Methods

This is a cross-sectional study. Fifty-one women were classified into greater and lower foot pronation during walking. Biomechanical factors measured: (1) foot-ankle varus alignment, (2) hip passive stiffness, (3) isokinetic eccentric strength of hip external rotators, and (4) foot abduction angle. Classification and regression trees (CART) were used to investigate non-linear interactions that predict greater and lower foot pronation.

Results

Four main profiles of biomechanical factors were identified as related to greater and lower foot pronation. Profiles for greater pronation were: (1) varus >25.83°; (2) interaction between varus ≤25.83° and hip stiffness ≤0.09 Nm/rad kg^-1; (3) interaction between varus ≤25.83°, hip stiffness >0.09 Nm/rad kg^-1, and foot abduction >19.58° The profile for lower pronation involved an interaction among varus ≤25.83°, hip stiffness >0.09 Nm/rad kg^-1, and foot abduction ≤19.58° The model had 61 % sensitivity and 96 % specificity, with the total prediction of 78 %. The area under the ROC curve was 0.79 (p = 0.001).

Conclusion

Foot-ankle varus, hip passive stiffness, and foot abduction predicted greater and lower foot pronation. Non-linear interactions between hip and foot factors influence the magnitude of foot pronation during walking. The observed profiles help identify which combinations of biomechanical factors should be assessed in individuals with increased or reduced pronation.

背景髋部和足部生物力学因素之间的相互作用可能会导致行走时足部前伸的不同幅度：研究髋关节和足部生物力学因素之间的非线性相互作用及其预测步行时足部前倾的能力，并确定预测较大和较小前倾的生物力学因素的轮廓：这是一项横断面研究。方法：这是一项横断面研究，51 名女性在行走时被分为足前倾较大和较小两种情况。测量的生物力学因素包括：（1）足踝屈曲对齐；（2）髋关节被动僵硬度；（3）髋关节外旋肌的等速偏心力量；（4）足外展角度。分类和回归树（CART）用于研究预测足外翻较大和较小的非线性相互作用：结果：确定了与足前倾较大和较小有关的四个主要生物力学因素。足前倾幅度较大的因素有(1) 曲度>25.83°；(2) 曲度≤25.83°与髋关节僵硬度≤0.09牛米/拉德公斤-1之间的相互作用；(3) 曲度≤25.83°、髋关节僵硬度>0.09牛米/拉德公斤-1和足外展>19.58°之间的相互作用。该模型的灵敏度为 61%，特异度为 96%，总预测率为 78%。ROC 曲线下面积为 0.79（P = 0.001）：结论：足踝外翻、髋关节被动僵硬度和足外展可预测较大和较小的足前伸。髋关节和足部因素之间的非线性相互作用影响着行走时足部前伸的幅度。观察到的特征有助于确定应评估哪些生物力学因素组合会导致足前倾增加或减少。

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引用次数: 0

Do measures of central sensitization relate to movement-evoked pain in people with chronic low back pain? A longitudinal prospective study 中枢敏化测量与慢性腰痛患者的运动诱发痛有关吗？一项纵向前瞻性研究。

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-11-01 DOI: 10.1016/j.bjpt.2024.101138

Lynn Leemans , Jo Nijs , Timothy H. Wideman , Hester den Bandt , Maarten Moens , Erika Joos , David Beckwée

Background

One of the most frequent complaints among people with musculoskeletal pain is pain during physical activity, commonly referred to as movement-evoked pain. It is suggested to be associated with quantitative sensory testing measures of central pain process in individuals with musculoskeletal pain.

Objective

To investigate the predictive association between movement-evoked pain scores and measures of central sensitization in patients with chronic nonspecific low back pain. The secondary aim was to determine whether changes in movement-evoked pain scores are associated with changes in measures of central sensitization.

Methods

In this longitudinal prospective study, 50 participants with chronic low back pain were included. Pain pressure thresholds, temporal summation of pain, descending pain modulation, and the central sensitization index were assessed as measures of central sensitization. Movement-evoked pain was evaluated using the Back Performance Scale and a 5-minute walk test.

Results

Measures of central sensitization, specifically pressure pain thresholds and temporal summation, demonstrated predictive associations with movement-evoked pain measures. In response to treatment, improvements in movement-evoked pain were associated with improvements in measures of central sensitization (i.e., pressure pain thresholds and temporal summation) and improved pressure pain thresholds in the plantar toe significantly predict movement-evoked pain measures experienced during the 5-minute walk test.

Conclusions

These results imply that movement-evoked pain is related to processes related to central modulation of pain in patients with nonspecific chronic low back pain.

背景：肌肉骨骼疼痛患者最常见的主诉之一是体育活动时的疼痛，通常称为运动诱发痛。有研究表明，运动诱发痛与肌肉骨骼疼痛患者中枢疼痛过程的定量感觉测试测量相关：研究慢性非特异性腰背痛患者的运动诱发疼痛评分与中枢敏化测量之间的预测关联。次要目的是确定运动诱发疼痛评分的变化是否与中枢敏化测量的变化有关：在这项纵向前瞻性研究中，共纳入了 50 名慢性腰背痛患者。疼痛压力阈值、疼痛时间总和、降序疼痛调节和中枢敏化指数被评估为中枢敏化的测量指标。运动诱发痛采用背部表现量表和 5 分钟步行测试进行评估：结果：中枢敏感化测量，特别是压力痛阈和时间总和，与运动诱发疼痛测量之间存在预测关联。在治疗过程中，运动诱发痛的改善与中枢敏感性测量（即压力痛阈值和时间总和）的改善相关，跖趾压力痛阈值的改善可显著预测 5 分钟步行测试中运动诱发痛的测量结果：这些结果表明，运动诱发痛与非特异性慢性腰痛患者的疼痛中枢调节过程有关。

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引用次数: 0

Development of the Brazilian version of the Performance of Upper Limb scale for children and adolescents with Duchenne muscular dystrophy 为患有杜兴氏肌肉萎缩症的儿童和青少年编制巴西版上肢表现量表

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101118

Juliana Cardoso , Giovanna Constantin Silva , Gabriela Barroso de Queiroz Davoli , Victória Araújo de Almeida , Edson Z. Martinez , Ana Claudia Mattiello-Sverzut

Background

Duchenne muscular dystrophy (DMD) is one of the most common and disabling childhood genetic diseases. The course of DMD involves progressive muscular degeneration and weakness, leading to functional decline. The Performance of the Upper Limb scale (PUL) is a specific instrument designed to assess the upper limb function of patients with DMD.

Objective

To adapt the PUL cross-culturally to Brazilian Portuguese (PUL-Br) and assess the convergent validity, structural validity, inter-rater reliability, and internal consistency for Brazilian patients with DMD

Methods

The cross-cultural adaptation involved six steps: translation to Brazilian Portuguese, Brazilian Portuguese translation synthesis, back-translation to English, back-translation synthesis, an expert committee review, and a pre-final version test (n = 12). The convergent validity of the PUL-Br was evaluated by examining its correlation to the Motor Function Measure scale (MFM) using 30 patients with DMD. Confirmatory factor analysis was conducted to assess structural validity. Intraclass correlation coefficient (ICC) verified the PUL-Br interrater reliability. Cronbach's alpha was calculated to verify internal consistency.

Results

The PUL was cross-culturally adapted to Brazilian Portuguese. A strong and positive correlation was found between the PUL-Br total score and the total score on the MFM (r = 0.83; 95% CI: 0.67, 0.91). The PUL-Br showed a satisfactory fit of the data to the three-factor model, excellent inter-rater reliability (ICC: 0.94), and good internal consistency (Cronbach's: 0.91).

Conclusion

The PUL-Br is valid and reliable for assessing the upper limb function of Brazilian patients with DMD.

背景杜氏肌营养不良症（DMD）是最常见的致残性儿童遗传病之一。DMD 的病程包括进行性肌肉退化和无力，从而导致功能衰退。上肢功能量表（PUL）是一种专门用于评估 DMD 患者上肢功能的工具。目标将 PUL 跨文化改编为巴西葡萄牙语（PUL-Br），并评估其对巴西 DM 患者的收敛效度、结构效度、评分者间信度和内部一致性方法跨文化改编包括六个步骤：翻译成巴西葡萄牙语、巴西葡萄牙语翻译合成、反译成英语、反译合成、专家委员会审查和最终版本前测试（n = 12）。通过对 30 名 DMD 患者进行运动功能测量量表 (MFM) 与 PUL-Br 的相关性研究，评估了 PUL-Br 的收敛有效性。为评估结构有效性，还进行了确认性因子分析。类内相关系数 (ICC) 验证了 PUL-Br 的施测者间可靠性。计算了 Cronbach's alpha 以验证内部一致性。PUL-Br总分与MFM总分之间存在很强的正相关（r = 0.83; 95% CI: 0.67, 0.91）。PUL-Br 的数据与三因素模型的拟合度令人满意，评分者之间的可靠性极佳（ICC：0.94），内部一致性良好（Cronbach's：0.91）。

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引用次数: 0

Does risk stratification with a matched treatment pathway improve clinical outcomes for adults with acute back pain? A systematic review and meta-analysis 采用匹配治疗路径进行风险分层能否改善急性背痛成人患者的临床疗效？系统回顾和荟萃分析

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101116

Anthony Frank Chiodo, Melanie Haley

Background

Risk stratification is an approach which has been recommended across a number of international guidelines for the management of back pain.

Objective

To assess whether the use of risk stratification with a matched treatment pathway improves clinical outcomes, when compared with usual care or other interventions, in adults with acute back pain.

Methods

A comprehensive search was conducted of the databases Medline, Embase, PEDro, CINAHL and Cochrane Library in November 2022. Studies of adults with back pain of less than 3 months’ duration and who had been stratified according to their level of risk of a poor functional outcome and provided with a treatment matched to their level of risk were included. Participants with specific and/or serious spinal pathologies were excluded.

Results

Five trials involving 3519 participants were included. Meta-analysis found very-low certainty evidence that the use of a risk stratification approach with matched treatment may lead to a very small reduction in pain levels at 3–6 months compared with usual care (MD -0.62, 95 % CI -0.88, -0.36). These results did not achieve clinical significance. No difference was found for the use of risk stratification compared to usual care for disability (MD -1.52, 95 % CI -4.15, 1.11).

Conclusion

The use of risk stratification with matched treatment may be just as worthwhile as usual care for acute back pain, however the evidence is very uncertain. Further high quality research is required to confirm whether risk stratification is a useful approach for this population.

Systematic review registration number

CRD42022379987

目标评估与常规护理或其他干预措施相比，使用风险分层和匹配治疗路径是否能改善急性背痛成人患者的临床疗效。方法 2022 年 11 月，对 Medline、Embase、PEDro、CINAHL 和 Cochrane Library 等数据库进行了全面检索。研究对象包括背痛持续时间少于 3 个月的成人，他们已根据不良功能预后的风险水平进行了分层，并接受了与其风险水平相匹配的治疗。结果共纳入五项试验，涉及 3519 名参与者。Meta 分析发现，有极低确定性的证据表明，与常规治疗相比，采用风险分层法和匹配治疗可能会在 3-6 个月后使疼痛程度有极小程度的减轻（MD -0.62，95 % CI -0.88，-0.36）。这些结果没有临床意义。在残疾方面，使用风险分层与常规护理相比没有发现差异（MD -1.52，95 % CI -4.15，1.11）。需要进一步开展高质量的研究，以确认风险分层是否是一种对该人群有用的方法。

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引用次数: 0

Diagnostic accuracy and cut-off points for vaginal manometry to differentiate between weak and strong pelvic floor muscle contraction in pregnant women 阴道测压法区分孕妇盆底肌肉收缩弱与强的诊断准确性和临界点

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101115

Bianca Manzan Reis , Jordana Barbosa-Silva , Susan Armijo-Olivo , Patricia Driusso

Background

Identifying a weak/strong pelvic floor muscle (PFM) contraction in pregnant women may help prevent and treat dysfunctions during late pregnancy and postpartum.

Objective

To determine whether the Peritron™ manometer can accurately differentiate a weak from a strong PFM contraction and the respective cut-offs for its variables in pregnant women.

Methods

This is a diagnostic accuracy study. Forty-four women in the third trimester of pregnancy participated (mean±SD age: 29±5 years). The reference test was vaginal palpation, and the index test was vaginal manometry (Peritron™ manometer). Variables assessed by vaginal manometry were rest, maximal voluntary contraction (MVC), MVC average, duration, gradient, area under the curve (AUCm), and contraction speed. The Receiver Operating Curve (AUC/ROC) was used to analyze the data and obtain cut-off points for these variables.

Results

Perfect discrimination (AUC=1.00) to differentiate between a weak/strong PFM contraction in pregnant women was observed for peak MCV (cut-off: 40.56 cmH₂O). The MVC average showed excellent discriminative ability (AUC=0.96; cut-off: 30.66 cmH₂O). The gradient variable (AUC=0.85; cut-off: 27.83 cmH₂O/s) and AUCm (AUC=0.86; cut-off: 1315.6 cm²*s) showed a good discriminative ability.

Conclusion

The best variables to discriminate between weak/strong PFM contraction in pregnant women using vaginal manometry were peak MVC, MVC average, gradient, and AUCm.

背景识别孕妇盆底肌（PFM）收缩的强弱有助于预防和治疗妊娠晚期和产后的功能障碍。方法这是一项诊断准确性研究。44 名怀孕三个月的妇女参加了研究（平均年龄为 29±5 岁）。参考测试为阴道触诊，指标测试为阴道测压（Peritron™ 压力计）。阴道测压法评估的变量包括静息、最大自主收缩（MVC）、MVC 平均值、持续时间、坡度、曲线下面积（AUCm）和收缩速度。结果观察到，MCV 峰值（临界值：40.56 cmH2O）具有区分孕妇 PFM 收缩弱/强的完美鉴别力（AUC=1.00）。MVC 平均值显示出卓越的区分能力（AUC=0.96；临界值：30.66 cmH2O）。结论使用阴道测压法区分孕妇 PFM 收缩弱/强的最佳变量是 MVC 峰值、MVC 平均值、梯度和 AUCm。

{"title":"Diagnostic accuracy and cut-off points for vaginal manometry to differentiate between weak and strong pelvic floor muscle contraction in pregnant women","authors":"Bianca Manzan Reis , Jordana Barbosa-Silva , Susan Armijo-Olivo , Patricia Driusso","doi":"10.1016/j.bjpt.2024.101115","DOIUrl":"10.1016/j.bjpt.2024.101115","url":null,"abstract":"<div><h3>Background</h3><div>Identifying a weak/strong pelvic floor muscle (PFM) contraction in pregnant women may help prevent and treat dysfunctions during late pregnancy and postpartum.</div></div><div><h3>Objective</h3><div>To determine whether the Peritron™ manometer can accurately differentiate a weak from a strong PFM contraction and the respective cut-offs for its variables in pregnant women.</div></div><div><h3>Methods</h3><div>This is a diagnostic accuracy study. Forty-four women in the third trimester of pregnancy participated (mean±SD age: 29±5 years). The reference test was vaginal palpation, and the index test was vaginal manometry (Peritron™ manometer). Variables assessed by vaginal manometry were rest, maximal voluntary contraction (MVC), MVC average, duration, gradient, area under the curve (AUCm), and contraction speed. The Receiver Operating Curve (AUC/ROC) was used to analyze the data and obtain cut-off points for these variables.</div></div><div><h3>Results</h3><div>Perfect discrimination (AUC=1.00) to differentiate between a weak/strong PFM contraction in pregnant women was observed for peak MCV (cut-off: 40.56 cmH<sub>2</sub>O). The MVC average showed excellent discriminative ability (AUC=0.96; cut-off: 30.66 cmH<sub>2</sub>O). The gradient variable (AUC=0.85; cut-off: 27.83 cmH<sub>2</sub>O/s) and AUCm (AUC=0.86; cut-off: 1315.6 cm²*s) showed a good discriminative ability.</div></div><div><h3>Conclusion</h3><div>The best variables to discriminate between weak/strong PFM contraction in pregnant women using vaginal manometry were peak MVC, MVC average, gradient, and AUCm.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101115"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314703","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}

引用次数: 0

HealthyTrailsBR – The prevalence of running-related injuries and cramps, and the description of personal and running characteristics in Brazilian trail runners: a cross-sectional study HealthyTrailsBR - 巴西越野跑者与跑步有关的受伤和抽筋发生率以及个人和跑步特征描述：横断面研究

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101117

Fernanda Rizzo , Caio Sain Vallio , Luiz Hespanhol

Background

Physical activity in natural environments, such as trail running, is a way to nurture physical and mental health. However, running has an inherent risk of musculoskeletal injuries.

Objectives

To investigate the prevalence of running-related injuries (RRI) and cramps, and to describe the personal and training characteristics of Brazilian trail runners.

Methods

A total of 1068 trail runners were included in this observational cross-sectional study. The participants had at least six months of trail running experience. The data were collected between April 2019 and February 2020 through an online and self-reported survey.

Results

The point prevalence of RRIs was 39.2 % (95 % credible interval [CrI]: 36.3, 42.1). The body region with the highest point prevalence was the knee. The 12-month period prevalence of RRIs was 69.2 % (95 %CrI: 66.4, 72.0). The body region with the highest 12-month period prevalence was the lower leg. 1- and 12-month period prevalence of cramps was 19.5 % (95 %CrI: 17.1, 21.9) and 36.0 % (95 %CrI: 33.0, 38.8), respectively. Triceps surae was the muscle most affected by cramps.

Conclusions

Two in 5 (40 %) trail runners reported being injured at the time of data collection, and about 2 of 3 reported previous RRIs in the last 12 months. The most prevalent injured body regions were the knee and the lower leg. One in 5 trail runners reported cramps in the last month, increasing to 36 % in the last 12 months. Knowing better the characteristics of the population and the burden of health conditions may inform better decisions regarding implementation actions toward trail running practice.

背景在自然环境中进行体育锻炼，如越野跑，是促进身心健康的一种方式。目的调查与跑步有关的损伤（RRI）和抽筋的发生率，并描述巴西越野跑者的个人和训练特点。方法共有 1068 名越野跑者参加了这项横断面观察研究。参与者至少有六个月的越野跑经验。结果RRI的点患病率为39.2%（95%可信区间[CrI]：36.3, 42.1）。发病率最高的身体部位是膝关节。12 个月期间的 RRI 患病率为 69.2%（95 % 可信区间 [CrI]：66.4, 72.0）。12 个月期间发病率最高的身体部位是小腿。1个月和12个月期间的抽筋发生率分别为19.5%（95%CrI：17.1，21.9）和36.0%（95%CrI：33.0，38.8）。结论每 5 名越野跑者中就有 2 人（40%）报告在收集数据时受伤，每 3 人中就有 2 人报告在过去 12 个月中受过伤。最常见的受伤部位是膝盖和小腿。每 5 名越野跑运动员中就有 1 人在过去一个月中报告过抽筋，而在过去 12 个月中这一比例上升到了 36%。更好地了解人群特征和健康状况的负担，可以为越野跑实践的实施行动提供更好的决策依据。

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引用次数: 0

Modified Fresno test to assess Physical therapists' use of evidence-based practice: measurement properties of the Brazilian-Portuguese short version 评估理疗师使用循证实践的改良弗雷斯诺测试：巴西-葡萄牙语简版的测量特性

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101112

Anderson Martins da Silva , Dafne Karen da Silva Vieira Rosa , Rosimeire Simprini Padula

Background

The modified Fresno test is a questionnaire developed to evaluate Evidence-Based Practice among physical therapists. A previous study has indicated that a shorter version with 9 items would be more appropriate for Brazilian physical therapists.

Objectives

To test the measurement properties of the modified Fresno test - Brazilian-Portuguese short version.

Methods

To analyze the reliability of the modified Fresno test - Brazilian-Portuguese short version by two raters (intra and inter-rater) in a sample of 133 physical therapists. The intraclass correlation coefficient (ICC_2,1) and standard error of measurement (SEM) was used to assess the test-retest reliability. Internal consistency was tested using the Cronbach's alpha coefficient. An expert committee analyzed content validity using the content validity index (CVI). Confirmatory factor analysis (CFA) using the principal components method was used to assess construct validity. Responsiveness was estimated using effect size, and ceiling and floor effects were also investigated.

Results

Inter-rater and intra-rater reliability were, respectively: ICC= 0.93 (95 % CI 0.91, 0.95); rater 1 - ICC= 0.95 (95 % CI 0.94, 0.97); rater 2 - ICC= 0.98 (95 % CI 0.98, 0.99). The agreement was very good (values ≤ 5 %). Internal consistency was good for most instrument items (≥ 0.80). The CVI showed agreement among the expert committee members (0.96). The Cronbach's alpha coefficients calculated for the corrected item total showed values greater than 0.40. In the CFA, the “model 2” showed acceptable indices (≥ 0.90). Responsiveness was classified as very small. No ceiling and floor effects.

Conclusion

The Fresno Modified Test - Brazilian-Portuguese short version has good to excellent reliability. CFA showed that the fit indices were adequate to be used in the population of interest.

背景经修订的弗雷斯诺测试是为评估物理治疗师循证实践而开发的问卷。方法在 133 名物理治疗师样本中，由两名评分者（评分者内部和评分者之间）分析改良版弗雷斯诺测试--巴西-葡萄牙语简版的可靠性。采用类内相关系数（ICC2,1）和测量标准误差（SEM）来评估重测可靠性。内部一致性采用 Cronbach's alpha 系数进行测试。专家委员会使用内容效度指数（CVI）对内容效度进行了分析。采用主成分法进行的确认性因子分析（CFA）评估了构建效度。使用效应大小对反应性进行了估计，并对上限和下限效应进行了调查：ICC= 0.93 (95 % CI 0.91, 0.95)；评分者 1 - ICC= 0.95 (95 % CI 0.94, 0.97)；评分者 2 - ICC= 0.98 (95 % CI 0.98, 0.99)。一致性非常好（数值小于 5%）。大多数工具项目的内部一致性良好（≥ 0.80）。专家委员会成员对 CVI 的同意度为 0.96。校正后的项目总数的 Cronbach's alpha 系数大于 0.40。在 CFA 中，"模型 2 "显示了可接受的指数（≥ 0.90）。响应度被归类为非常小。结论《弗雷斯诺改良测验--巴西-葡萄牙语简易版》具有良好至卓越的可靠性。CFA 显示，拟合指数足以用于相关人群。

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引用次数: 0

The importance of nutritional factors on the road toward multimodal lifestyle interventions for persistent pain 营养因素在多模式生活方式干预顽固性疼痛道路上的重要性

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101119

Ömer Elma , Jo Nijs , Anneleen Malfliet

引用次数: 0

“I feel more confident”: a mixed methods evaluation of the influence of Good Life with osteoarthritis Denmark (GLA:D®) on physical activity participation, capability, barriers, and facilitators in people with knee osteoarthritis "我感觉更自信了"：采用混合方法评估丹麦骨关节炎患者的美好生活（GLA:D®）对膝关节骨关节炎患者的体育活动参与度、能力、障碍和促进因素的影响

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101113

Emily C. Bell , Paul O'Halloran , Marcella F. Pazzinatto , Jason A. Wallis , Kay M. Crossley , Joanne L. Kemp , Zuzana Perraton , Christian J. Barton

Background

A mixed methods study which aimed to evaluate the influence of Good Life with osteoArthritis Denmark (GLA:D®) on physical activity participation, including perceived capability, barriers, and facilitators in people with knee osteoarthritis.

Objective

Quantify changes in physical activity participation at 3- and 12-months for people with knee osteoarthritis who participated in an education and exercise-therapy program (GLA:D®).

Methods

A mixed-methods study involving 44 participants with knee osteoarthritis who completed GLA:D®. Guided by the Theoretical Domains Framework, 19 were interviewed, with transcripts analysed using reflexive thematic analysis. University of California Los Angeles physical activity scores were dichotomised as ‘more’ (≥7) or ‘less’ active (≤6), and compared between baseline and 3- and 12-months using McNemar's test. Motivation and confidence to exercise (0–10 scale); fear of knee joint damage with exercise (yes/no); and Knee Osteoarthritis Outcome Scores (KOOS) were evaluated.

Results

Four overarching themes were identified: prior to GLA:D® 1) fear of knee joint damage, and scarcity of exercise and physical activity information prior to GLA:D®; and following GLA:D® 2) varied exercise-therapy and physical activity participation; 3) facilitators including reduced fear of knee damage, increased confidence, routine, strategies, and support; and 4) ongoing barriers including persistent knee pain, comorbidities, cost, and lack of opportunity and motivation. There was no difference in the proportion of ‘more’ active participants between baseline (41%) and at 3-months (37%, p = 0.774) or 12-months (35%, p = 0.375). The proportion with fear of damage reduced from baseline (50%) to 3-months (5%) and 12-months (21%). Self-reported motivation (9.1/10) and confidence (9.1/10) to exercise at 3-months were high, and all KOOS subscales improved from baseline to 3-months (effect sizes = 0.41–0.58) and 12-months (effect sizes = 0.29–0.66).

Conclusion

Varied and often inadequate physical activity participation following GLA:D® indicates more targeted interventions to address ongoing barriers may be required.

背景一项混合方法研究，旨在评估丹麦骨关节炎患者的美好生活（GLA:D®）对参与体育锻炼的影响，包括膝关节骨关节炎患者的感知能力、障碍和促进因素。方法一项混合方法研究，涉及 44 名完成 GLA:D® 的膝关节骨关节炎患者。在理论领域框架的指导下，对 19 名参与者进行了访谈，并采用反思性主题分析法对访谈记录进行了分析。加利福尼亚大学洛杉矶分校的体育锻炼得分被二分为 "更积极"（≥7 分）或 "较不积极"（≤6 分），并使用 McNemar 检验比较了基线与 3 个月和 12 个月的情况。对运动动机和信心（0-10 分制）、运动对膝关节损伤的恐惧（是/否）和膝关节骨性关节炎结果评分（KOOS）进行了评估。结果确定了四个重要主题：GLA:D® 前 1) 害怕膝关节损伤，GLA:D® 前缺乏运动和体育锻炼信息；GLA:D® 后 2) 参与不同的运动疗法和体育锻炼；3) 促进因素包括减少对膝关节损伤的恐惧、增强信心、常规、策略和支持；4) 持续障碍包括持续膝关节疼痛、合并症、费用以及缺乏机会和动力。在基线（41%）和 3 个月（37%，P = 0.774）或 12 个月（35%，P = 0.375）期间，"更积极 "参与者的比例没有差异。担心受损的参与者比例从基线（50%）到 3 个月（5%）和 12 个月（21%）有所下降。结论GLA:D®治疗后，患者参与体育锻炼的情况各不相同，而且往往不足，这表明可能需要采取更有针对性的干预措施来解决持续存在的障碍。

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引用次数: 0

Replacing sedentary time or light physical activity with moderate physical activity is associated with a lower prevalence of back pain: a cross-sectional study using isotemporal analysis 用适度体力活动替代久坐或轻度体力活动与腰痛患病率降低有关：一项采用等时分析的横断面研究：等时替代与腰背痛发病率。

IF 3.1 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-09-01 DOI: 10.1016/j.bjpt.2024.101123

Crystian B.S. Oliveira , Tatiana M Damato , William R. Tebar , Guilherme H.D. Grande , Rubens V.C. Vidal , Gerson Ferrari , Bruna T.C. Saraiva , Diego G.D. Christofaro

Background

Evidence shows that lack of physical activity and sedentary time are associated with higher prevalence of low back pain (LBP).

Objective

To investigate the association between replacing sedentary time and light physical activity with a higher physical activity level with the prevalence of LBP.

Methods

Two hundred and sixty-six individuals from a city in southeastern Brazil were recruited to this cross-sectional study. Sedentary behavior and physical activity level were evaluated using an ActiGraph GT3X tri-axial accelerometer during 7 days. The prevalence of LBP was assessed using the Nordic questionnaire. Isotemporal substitution using logistic regression analyses were performed to investigate the association between replacing an activity with another in the prevalence of LBP.

Results

Replacing time spent in sedentary behavior with moderate physical activity slightly reduced the prevalence of LBP (odds ratio [OR]= 0.97; 95% CI: 0.95, 0.98). In addition, replacing time spent in light physical activity with moderate physical activity also slightly reduced the prevalence of LBP (OR= 0.97; 95% CI: 0.95, 0.98). There was no association for replacing sedentary time and light or moderate physical activity with vigorous physical activity on the prevalence of LBP.

Conclusions

The results suggest a small protective effect for LBP when replacing time in sedentary activities or light physical activity with moderate physical activity.

背景：有证据表明，缺乏体力活动和久坐不动与腰背痛（LBP）发病率较高有关：调查以较高的体力活动水平取代久坐时间和轻体力活动与腰背痛发病率之间的关系：这项横断面研究从巴西东南部的一个城市招募了 266 人。使用 ActiGraph GT3X 三轴加速度计对他们 7 天内的久坐行为和体力活动水平进行了评估。使用北欧调查问卷评估了枸杞多糖症的患病率。使用逻辑回归分析法进行了等时替代分析，以研究用一种活动替代另一种活动与枸杞痛患病率之间的关联：结果：以适度的体力活动取代久坐不动的时间，可略微降低枸杞痛的患病率（几率比 [OR]= 0.97; 95% CI: 0.95, 0.98）。此外，用中等强度的体力活动取代轻度体力活动也会略微降低枸杞痛的患病率（OR= 0.97；95% CI：0.95，0.98）。用剧烈运动替代久坐时间和轻度或中度体力活动与肺结核患病率没有关系：结论：研究结果表明，以中等强度的体力活动取代久坐不动或轻度体力活动对枸杞多糖症的发生率有轻微的保护作用。

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