Brazilian Journal of Physical Therapy最新文献_第7页

Brazilian classification of physical therapy diagnosis 巴西理疗诊断分类

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101066

Bruno Prata Martinez , Roberto Mattar Cepeda , Fernando Mauro Muniz Ferreira , Francimar Ferrari Ramos , Flavia Massa Cipriani , Sibele de Andrade Melo Knaut , Elaine Caldeira de Oliveira Guirro , Cristine Homsi Jorge

Background

The Brazilian Classification of Physical Therapy Diagnosis, developed by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), has the constitutional objectives of standardizing ethical, scientific and social aspects of the Physical Therapy profession.

Objective

To describe the work process, rationale and proposal for standardization of a physical therapy diagnosis classification system in Brazil.

Methods

A working group was created to propose a standardized classification for the description and codification of physical therapy diagnoses. Some terminologies common to the International Classification of Functioning (ICF) were used to make the nomenclature of diagnoses compatible with the outcomes inherent in the field of physical therapy.

Results

The Brazilian Classification of Physical Therapy Diagnosis project culminated in a physical therapy diagnosis model consisting of terms grouped by organic systems and identifying codes. In addition, an application was developed to allow professionals to use the standardized diagnostic classification in an online system.

Conclusion

The diagnostic classification system is expected to advance the Physical Therapy profession allowing the identification of structural and/or functional alterations in a simplified and standardised manner. From a physical therapy perspective, this classification may help to consolidate the autonomy of the Brazilian physical therapists by establishing a clearer pathway between the diagnosis and interventions.

背景巴西理疗诊断分类由联邦物理治疗和职业治疗委员会（COFFITO）制定，其宪法目标是规范理疗专业的伦理、科学和社会方面。方法成立了一个工作组，负责提出描述和编纂理疗诊断的标准化分类。巴西理疗诊断分类项目最终形成了一个理疗诊断模型，该模型由按有机系统和识别代码分组的术语组成。此外，还开发了一个应用程序，使专业人员能够在在线系统中使用标准化诊断分类。结论该诊断分类系统有望推动理疗专业的发展，以简化和标准化的方式识别结构和/或功能的改变。从物理治疗的角度来看，该分类法通过在诊断和干预之间建立更清晰的路径，有助于巩固巴西物理治疗师的自主权。

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引用次数: 0

Advancing women's pelvic floor muscle function diagnosis: the EFSMAP examination and its reliability evaluation 推进妇女盆底肌肉功能诊断：EFSMAP 检查及其可靠性评估

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101067

Fernanda Saltiel , Ana Paula Gonçalves Miranda-Gazzola , Gabriella Ferreira Vieira , Elyonara Mello Figueiredo

Background

The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle function (PFMF) measurements hinder diagnostic labels.

Objective

To structure an examination of PFMF using visual observation and digital palpation and terms consistent with the ICF terminology, and to test its intra and interrater reliability/agreement.

Methods

A panel of 9 physical therapists applied Delphi method to structure the PFMF exam under ICF terminology and to verify its measurements reproducibility. For reliability and agreement, a convenience sample of women aged 51.2 ± 14.7 years had the sensitivity to pressure, pain, muscle tone, involuntary movement reaction, control of voluntary movement (contraction/relaxation), coordination, strength, and endurance examined by two raters, in the same day for interrater (n = 40), and one week apart, for intrarater reliability (n = 25). Percent agreement, linear weighted kappa, intraclass correlation coefficient, and Bland-Altman's limits of agreement were calculated (alpha = 0.05).

Results

Four round Delphi discussion structured the PFMF exam, named EFSMAP (Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/Examination of Pelvic Floor Sensory and Motor Functions), set a list of concepts and instructions targeted at reproducibility and established PFMF diagnostic labels. Reliability, except for pain and tone, were moderate to excellent (Kw= 0.67–1.0 and ICC=0.48–0.82). Agreement was substantial for most PFMF features (0.64–1.00), except pain.

Conclusions

The EFSMAP was successfully developed as a valid and reliable exam to be used in research and clinical practice; it provides labels for the diagnosis of pelvic floor muscle impairments. It might be easily adopted worldwide as it uses ICF terminology.

背景盆底肌肉损伤的准确诊断至关重要。由 9 名物理治疗师组成的小组采用德尔菲法根据 ICF 术语构建了 PFMF 检查，并验证了其测量结果的可重复性。在可靠性和一致性方面，对年龄为（51.2 ± 14.7）岁的女性进行了方便抽样调查，由两名评分者在同一天对压力敏感度、疼痛、肌张力、不自主运动反应、自主运动控制（收缩/放松）、协调性、力量和耐力进行了检查，以获得评分者之间的可靠性（n = 40），以及评分者之间相隔一周的可靠性（n = 25）。结果四轮德尔菲讨论构建了名为 EFSMAP（Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/骨盆底感觉和运动功能检查）的骨盆底感觉和运动功能检查，制定了一份概念和说明清单，旨在实现可重复性，并建立了骨盆底感觉和运动功能诊断标签。除疼痛和音调外，其他项目的可靠性均为中等至优秀（Kw= 0.67-1.0 和 ICC=0.48-0.82）。结论 EFSMAP 是一种有效、可靠的检查方法，可用于研究和临床实践；它为盆底肌肉损伤的诊断提供了标签。由于它使用了《国际功能、残疾和健康分类》的术语，因此很容易在全球范围内被采用。

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引用次数: 0

Reporting of confidence intervals, achievement of intended sample size, and adjustment for multiple primary outcomes in randomised trials of physical therapy interventions: an analysis of 100 representatively sampled trials 物理治疗干预随机试验中置信区间的报告、预期样本量的实现以及多种主要结果的调整：对 100 项代表性抽样试验的分析

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101079

David Fernández Hernando , Mark Elkins , Ana Paula Coelho Figueira Freire

Background

The physical therapy profession has made efforts to increase the use of confidence intervals due to the valuable information they provide for clinical decision-making. Confidence intervals indicate the precision of the results and describe the strength and direction of a treatment effect measure.

Objectives

To determine the prevalence of reporting of confidence intervals, achievement of intended sample size, and adjustment for multiple primary outcomes in randomised trials of physical therapy interventions.

Methods

We randomly selected 100 trials published in 2021 and indexed on the Physiotherapy Evidence Database. Two independent reviewers extracted the number of participants, any sample size calculation, and any adjustments for multiple primary outcomes. We extracted whether at least one between-group comparison was reported with a 95 % confidence interval and whether any confidence intervals were interpreted.

Results

The prevalence of use of confidence intervals was 47 % (95 % CI 38, 57). Only 6 % of trials (95 % CI: 3, 12) both reported and interpreted a confidence interval. Among the 100 trials, 59 (95 % CI: 49, 68) calculated and achieved the required sample size. Among the 100 trials, 19 % (95 % CI: 13, 28) had a problem with unadjusted multiplicity on the primary outcomes.

Conclusions

Around half of trials of physical therapy interventions published in 2021 reported confidence intervals around between-group differences. This represents an increase of 5 % from five years earlier. Very few trials interpreted the confidence intervals. Most trials reported a sample size calculation, and among these most achieved that sample size. There is still a need to increase the use of adjustment for multiple comparisons.

背景由于置信区间为临床决策提供了宝贵的信息，物理治疗行业一直在努力增加置信区间的使用。置信区间表明了结果的精确性，并描述了治疗效果测量的强度和方向。方法我们随机选取了 100 项于 2021 年发表并在《物理治疗证据数据库》（Physiotherapy Evidence Database）中编入索引的试验。两名独立审查员提取了参与者人数、样本大小计算结果以及多个主要结果的调整情况。我们还提取了至少一项组间比较是否报告了95%的置信区间，以及是否对置信区间进行了解释。只有 6% 的试验（95 % CI：3, 12）报告并解释了置信区间。在 100 项试验中，有 59 项试验（95% CI：49, 68）计算并达到了所需的样本量。结论2021年发表的物理治疗干预试验中，约有一半报告了组间差异的置信区间。这比五年前增加了5%。只有极少数试验对置信区间进行了解释。大多数试验都报告了样本量计算，其中大多数试验都达到了样本量。仍需更多地使用多重比较调整。

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引用次数: 0

Artificial intelligence and Machine Learning approaches in sports: Concepts, applications, challenges, and future perspectives 体育运动中的人工智能和机器学习方法：概念、应用、挑战和未来展望

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101083

Felipe J.J. Reis , Rafael Krasic Alaiti , Caio Sain Vallio , Luiz Hespanhol

Background

The development and application of Artificial Intelligence (AI) and Machine Learning (ML) in healthcare have gained attention as a promising and powerful resource to change the landscape of healthcare. The potential of these technologies for injury prediction, performance analysis, personalized training, and treatment comes with challenges related to the complexity of sports dynamics and the multidimensional aspects of athletic performance.

Objectives

We aimed to present the current state of AI and ML applications in sports science, specifically in the areas of injury prediction, performance enhancement, and rehabilitation. We also examine the challenges of incorporating AI and ML into sports and suggest directions for future research.

Method

We conducted a comprehensive literature review, focusing on publications related to AI and ML applications in sports. This review encompassed studies on injury prediction, performance analysis, and personalized training, emphasizing the AI and ML models applied in sports.

Results

The findings highlight significant advancements in injury prediction accuracy, performance analysis precision, and the customization of training programs through AI and ML. However, future studies need to address challenges such as ethical considerations, data quality, interpretability of ML models, and the integration of complex data.

Conclusion

AI and ML may be useful for the prevention, detection, diagnosis, and treatment of health conditions. In this Masterclass paper, we introduce AI and ML concepts, outline recent breakthroughs in AI technologies and their applications, identify the challenges for further progress of AI systems, and discuss ethical issues, clinical and research opportunities, and future perspectives.

背景人工智能（AI）和机器学习（ML）在医疗保健领域的发展和应用已经引起了人们的关注，成为改变医疗保健格局的一种前景广阔的强大资源。这些技术在损伤预测、成绩分析、个性化训练和治疗方面的潜力伴随着与运动动态的复杂性和运动成绩的多维性有关的挑战。我们还研究了将人工智能和 ML 应用于体育运动所面临的挑战，并提出了未来的研究方向。方法我们进行了全面的文献综述，重点关注与人工智能和 ML 在体育运动中的应用相关的出版物。结果研究结果表明，人工智能和 ML 在损伤预测准确性、成绩分析精确性以及训练计划定制方面取得了显著进步。然而，未来的研究需要解决一些挑战，如伦理考虑、数据质量、ML 模型的可解释性以及复杂数据的整合。在这篇大师班论文中，我们介绍了人工智能和 ML 的概念，概述了人工智能技术及其应用的最新突破，明确了人工智能系统进一步发展所面临的挑战，并讨论了伦理问题、临床和研究机会以及未来展望。

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引用次数: 0

Translation, cross-cultural adaptation, and measurement properties of the dysmenorrhea symptom interference (DSI) scale–Brazilian version 巴西版痛经症状干扰（DSI）量表的翻译、跨文化适应性和测量特性

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101065

Sara Giovanna de Melo Mantovan , Guilherme Tavares de Arruda , Thuane Da Roza , Barbara Inácio da Silva , Mariana Arias Avila , Soraia Cristina Tonon da Luz

Background

The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women.

Objective

To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions.

Methods

The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined.

Results

No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women.

Conclusion

The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.

背景痛经症状干扰（DSI）量表是一种可靠、有效、反应灵敏的工具，用于评估痛经对女性生理、心理和社交活动的干扰。方法根据现有指南对原始（美国）量表进行了翻译和文化适应性调整。在 1387 名痛经妇女中调查了 DSI-BrPt 的测量特性。通过类内相关系数（ICC）和测试-再测可靠性分析了信度。此外，还确定了结构效度、内部一致性（Cronbach's α）、跨文化效度、构架效度（与 WHODAS 2.0 和 SPS-6 评分问卷的相关性）以及下限效应和上限效应。测试-重测信度被认为是适当的（ICC >0.78），并且在犯罪和非犯罪版本中都没有系统误差。此外，DSI 与 WHODAS 2.0 有着很强的正相关。结论DSI-BrPt量表已被成功翻译并进行了跨文化调整。DSI-BrPt 量表具有充分的测量属性。该量表有效且可靠，因此是监测巴西妇女经期和两次月经之间痛经症状的适当工具。

{"title":"Translation, cross-cultural adaptation, and measurement properties of the dysmenorrhea symptom interference (DSI) scale–Brazilian version","authors":"Sara Giovanna de Melo Mantovan , Guilherme Tavares de Arruda , Thuane Da Roza , Barbara Inácio da Silva , Mariana Arias Avila , Soraia Cristina Tonon da Luz","doi":"10.1016/j.bjpt.2024.101065","DOIUrl":"https://doi.org/10.1016/j.bjpt.2024.101065","url":null,"abstract":"<div><h3>Background</h3><p>The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women.</p></div><div><h3>Objective</h3><p>To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions.</p></div><div><h3>Methods</h3><p>The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined.</p></div><div><h3>Results</h3><p>No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women.</p></div><div><h3>Conclusion</h3><p>The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.</p></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 3","pages":"Article 101065"},"PeriodicalIF":3.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263749","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

Cross-cultural adaptation of the Rotterdam Transition Profile to Brazilian Portuguese: measuring autonomy in participation of Brazilian youth with cerebral palsy 根据巴西葡萄牙语对鹿特丹过渡概况进行跨文化调整：衡量巴西脑瘫青少年参与的自主性

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-05-01 DOI: 10.1016/j.bjpt.2024.101080

Gabriela Rovai , Camila Araújo Santos Santana , Marina de Brito Brandão , Ana Carolina de Campos

Background

Autonomy in participation of young adults with cerebral palsy (CP) is not well understood due to the lack of appropriate instruments, especially for the Brazilian population. The Rotterdam Transition Profile (RTP) categorizes autonomy in Participation (education, employment, finances, housing, leisure, intimate relationships, sexuality, transportation) and Health Services (care demands, services and aids, and rehabilitation services) domains.

Objectives

To cross-culturally adapt the RTP for use in Brazil, and to describe the levels of autonomy in participation and associated factors of Brazilian youth with CP.

Methods

RTP was translated and content validity was investigated through an expert panel (n = 4 researchers and n = 4 clinicians); 30 adolescents and young adults with CP provided data for construct validity and internal consistency analysis. To analyze influencing factors, 56 youth with CP, mean age 25 years (SD = 6.9 years), with good cognitive level remotely responded to the RTP, sociodemographic information, and functional classifications (gross motor, manual ability).

Results

Following translation, content and construct validity were established, with changes made to improve the clarity of items. Cronbach's alpha (0.82) was considered good and test-reliability was fair to good for most items. High levels of autonomy were found in the areas of Leisure and Rehabilitation, with the lowest proportion of participants with autonomy in Housing, Intimate Relationships, and Finances. Autonomy in participation was associated with age, gross motor and manual ability classifications, and with context-related factors.

Conclusion

The Brazilian Portuguese version of the RTP was considered valid and reliable. Findings will support transition planning for young people with CP.

背景由于缺乏适当的工具，尤其是针对巴西人群的工具，人们对脑瘫（CP）青壮年的参与自主性了解不多。鹿特丹过渡档案（RTP）对参与（教育、就业、财务、住房、休闲、亲密关系、性生活、交通）和健康服务（护理需求、服务和辅助工具、康复服务）领域的自主性进行了分类。方法翻译 RTP，并通过专家小组（n = 4 名研究人员和 n = 4 名临床医生）对其内容有效性进行调查；30 名患有 CP 的青少年和年轻成人为构建有效性和内部一致性分析提供数据。为了分析影响因素，56 名认知水平良好、平均年龄为 25 岁（SD = 6.9 岁）的患有脊髓灰质炎的青少年远程回答了 RTP、社会人口学信息和功能分类（粗大运动、徒手能力）。Cronbach'sα（0.82）被认为是良好的，大多数项目的测试可靠性为一般到良好。休闲和康复领域的自主程度较高，住房、亲密关系和财务领域的自主程度最低。参与自主性与年龄、粗大运动能力和动手能力分类以及环境相关因素有关。研究结果将有助于为患有脑瘫的青少年制定过渡计划。

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引用次数: 0

FUNCTIONAL INDEPENDENCE, EXERCISE CAPACITY AND EXERTIONAL DESATURATION AFTER NON-CRITICAL COVID-19 IN NON VACCINED PATIENTS: SHORT AND MEDIUM-TERM IMPACTS 未接种疫苗的患者在接种非危重症 covid-19 后的功能独立性、运动能力和体力消耗：短期和中期影响

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100658

Breno Caldas Ribeiro , Soany de Jesus Valente Cruz , Eder Gabriel S Ferreira , Luiz Fábio M Falcão , Saul Rassy Carneiro , Laura Maria Tomazi Neves

Background

Studies point to the persistence of symptoms in patients with non-critical COVID-19 after hospitalization, pointing to impairments in functionality, exercise capacity and effort desaturation, which characterize the need for continuity of management and treatment after acute illness.

Objectives

To evaluate functional independence, exercise capacity, and effort desaturation after non-critical COVID-19 after hospital discharge.

Methods

A cross-sectional study included adult individuals with a noncritical COVID-19 diagnosis who were hospitalized for at least 24 hours between 30 and 180 days after hospital discharge. Participants were classified into 3 groups: G1M - one month after hospital discharge, G3M - three months after hospital discharge, and G6M - six months after charge. A digital form with clinical and sociodemographic questionnaire, modified MRC scale, Barthel Index, and London Chest Activity of Daily Living Scale was applied, in addition to the 6-minute Walk Test in G3M and G6M. The significance value was p<0.05.

Results

We included 64 individuals (G1M=18, G3M=25, G6M=21). There was a significant difference in Barthel Index between G1M and G6M (p=0.007). G3M walked 420m vs 442m of G6M (p=0.25). 48% of participants in G3M and 52% in G6M walked a distance less than 80% of predicted; 28% of G3M participants had >=4% drop in SpO2, vs 19.05% in G6M (p=0.478). There was a high prevalence of persistent symptoms, with a significant association between dyspnea (p=0.001), cough (p=0.038) and angina (p=0.001) and decreased functional independence.

Conclusion

After non-critical COVID-19, decreased functional independence was observed, with significant improvement 6 months after hospital discharge, in addition to decreased exercise capacity, the occurrence of desaturation on exertion, and high prevalence of persistent symptoms with no improvement 6 months after hospitalization.

Implications

Patients with persistent symptoms after COVID-19 should be evaluated and treated in pulmonary rehabilitation clinics. The changes caused by non-critical COVID-19 remain in the short and medium term, as in critical COVID-19.

背景研究表明，非重症 COVID-19 患者在出院后症状持续存在，功能、运动能力和体力饱和度受损，这说明急性病后需要进行持续管理和治疗。参与者分为 3 组：G1M - 出院后一个月，G3M - 出院后三个月，G6M - 收费后六个月。除了对 G3M 和 G6M 进行 6 分钟步行测试外，还采用了包含临床和社会人口学问卷、改良 MRC 量表、Barthel 指数和伦敦胸部日常生活活动量表的数字表格。结果我们纳入了 64 人（G1M=18 人，G3M=25 人，G6M=21 人）。G1M 和 G6M 的 Barthel 指数有明显差异（p=0.007）。G3M 走了 420 米，而 G6M 只走了 442 米（P=0.25）。48% 的 G3M 参与者和 52% 的 G6M 参与者的步行距离低于预测值的 80%；28% 的 G3M 参与者的 SpO2 下降了>=4%，而 G6M 为 19.05%（p=0.478）。持续症状的发生率很高，呼吸困难（p=0.001）、咳嗽（p=0.038）和心绞痛（p=0.001）与功能独立性下降之间存在显著关联。结论 COVID-19 非危重症患者出院 6 个月后，除了运动能力下降、出现用力时饱和度降低、持续症状发生率高且出院 6 个月后症状无改善外，还观察到患者功能独立性下降，且出院 6 个月后症状有明显改善。与危重症 COVID-19 一样，非危重症 COVID-19 引起的变化在短期和中期仍然存在。

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引用次数: 0

NORMATIVE VALUES FOR ISOMETRIC MUSCLE STRENGTH OF HIP FLEXORS WITH HAND-HELD DYNAMOMETER IN UNIVERSITY ATHLETES 用手持式测力计测量大学生运动员屈髋肌等长肌力的标准值

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100679

Carolina Holz Nonnenmacher , Laura Bortolozzo Leitão , Daniela Pacheco dos Santos Haupenthal , Alessandro Haupenthal

Background

Establishing normative strength data can assist professionals in guiding post-injury rehabilitation and be a criterion for deciding discharge for sports return.

Objectives

To establish reference values for isometric hip flexor muscle strength in college athletes.

Methods

This was a cross-sectional observational study. The athletes were submitted to an isometric muscle strength evaluation of the hip flexors through a hand-held dynamometer (Medeor Medtech Tecnologia em Saúde Industria e Comercio Ltda). The athletes remained in dorsal decubitus position on a stretcher, with the tested leg flexed 10 cm above the surface to start the test. The dynamometer was positioned on the anterior part of the leg, above the talotibial joint line. The lever arm was defined as the distance, in meters (m), between the anterior superior iliac spine and the dynamometer application point. The athletes performed three isometric contractions of 5 seconds, with a rest interval of 30 seconds between repetitions. If there was a discrepancy greater than 10% in the first three repetitions, a fourth repetition was performed. The isometric force data were expressed in kilogram-force (Kg/f) and converted to newton (N) for the calculation of torque (N.m). The normality of the data was verified using the Shapiro-Wilk test. The mean and standard deviation were calculated, followed by and by independent samples t-test. A significance level of (p > 0.05) was adopted.

Results

Thirteen female athletes (22 ± 2.19 years; 1.63 ± 0.06 m and 63.5 ± 16.9 kg) and 14 male athletes (23.85 ± 6.97 years; 1.75 ± 0.06 m and 72.8 ± 8.6 kg) participated in the study, totaling 27 college athletes. The athletes were classified according to the International Physical Activity Questionnaire (IPAQ) as Very Active (29.62%), Active (55.55%) and Irregularly Active (14.81%). Male athletes produced significantly more torque (109.36 ± 43.70 N.m; CI 84.12 - 134.59 N.m) when compared to female athletes (73.05 ± 14.26 N.m; CI 64.43 - 81.67 N.m).

Conclusion

This study provides a normative database on isometric hip flexor strength measured with a hand-held dynamometer. In general, differences in strength were present between the sexes, with men showing higher torque values compared to women.

Implications

The isokinetic dynamometer is the gold standard instrument for quantifying muscle strength. However, it is not accessible to all athletes. Therefore, we sought an alternative for the quantification of muscle strength in an affordable way. These data provide a description of hip flexor muscle strength in college athletes in order to assist professionals in post-injury rehabilitation, and to be a discharge criterion for sports return.

背景建立标准力量数据可以帮助专业人员指导受伤后的康复，也是决定运动员是否出院重返赛场的标准。目的建立大学生运动员髋屈肌等长肌力的参考值。通过手持式测力计（Medeor Medtech Tecnologia em Saúde Industria e Comercio Ltda）对运动员的髋屈肌进行等长肌力评估。运动员在担架上保持背卧位，受测腿屈曲高出地面 10 厘米开始测试。测力计放置在腿的前部，距胫关节线上方。杠杆臂的定义是髂前上棘与测力计施力点之间的距离，单位为米（m）。运动员进行三次等长收缩，每次 5 秒钟，两次之间休息 30 秒钟。如果前三次重复的差异超过 10%，则进行第四次重复。等长力数据以公斤力（Kg/f）表示，并转换为牛顿（N），以计算扭矩（N.m）。数据的正态性通过 Shapiro-Wilk 检验进行验证。计算平均值和标准差，然后进行独立样本 t 检验。结果13 名女运动员（22±2.19 岁；1.63±0.06 米；63.5±16.9 千克）和 14 名男运动员（23.85±6.97 岁；1.75±0.06 米；72.8±8.6 千克）共 27 名大学生运动员参加了研究。根据国际体力活动问卷（IPAQ），这些运动员被分为非常活跃（29.62%）、活跃（55.55%）和不太活跃（14.81%）。男性运动员产生的扭矩（109.36 ± 43.70 N.m；CI 84.12 - 134.59 N.m）明显高于女性运动员（73.05 ± 14.26 N.m；CI 64.43 - 81.67 N.m）。总体而言，男女之间的力量存在差异，男性的扭矩值高于女性。然而，并非所有运动员都能使用它。因此，我们寻找了一种经济实惠的量化肌肉力量的替代方法。这些数据提供了大学生运动员髋屈肌肌力的描述，以帮助专业人员进行伤后康复，并作为重返运动场的出院标准。

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引用次数: 0

SCREENING FOR FRAILTY, NUTRITION AND MUSCLE STRENGTH OF HOSPITALIZED ELDERLY 对住院老人进行体弱、营养和肌肉力量筛查

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100624

Ana Luiza de Arruda Camargo , Fernanda dos Santos Lima , Marcelo Olímpio de Oliveira , Elaine Gomes da Silva , Patrícia Vigano Contri Degiovani , Adriana Sanches Garcia-Araujo

Background

The increase in life expectancy in recent years has brought a scenario of multimorbidities and the presence of geriatric syndromes, such as frailty, making the elderly vulnerable to decompensation and hospitalizations. In addition, nutritional status and muscle strength have a significant association with frailty, so their characterization in the hospitalized elderly population is extremely relevant since such conditions are accompanied by adverse clinical outcomes, increasing the length of hospitalization and mortality. From this, it is possible to program multidisciplinary strategies and outline the best individualized intervention for these patients, aiming at an early discharge and higher quality of life.

Objectives

To evaluate the presence of frailty, nutritional status, and muscle strength of hospitalized elderly.

Methods

This is a prospective, observational, and cross-sectional study in which patients hospitalized in the ward of a University Hospital over 60 years of age were evaluated. Data were collected from medical records and characterization of the sample. Patients were assessed for frailty screening (Fried criteria), nutritional assessment through mini nutritional assessment (MAN) and handgrip strength.

Results

Partial data from 51 study participants were analyzed. Regarding frailty, according to Fried's criteria, 90.2% of the patients were classified as frail, 9.8% as pre-frail, and none as non-frail. The MAN scores reveal that, in relation to nutritional status, 19.6% are at risk of malnutrition and 43.13% are malnourished. Regarding muscle strength, 66.66% of men and 76.9% of women had muscle weakness, with the mean of men of 27.6 ±11.43 (76.66% of predicted) and of women of 19.3 ±5.76 (83.91% of predicted).

Conclusion

Hospitalized elderly are mostly fragile and have nutrition deficits and peripheral muscle weakness.

Implications

Faced with the presence of frailty, nutritional deficit, and muscle weakness, future intervention studies deserve attention to minimize damage to the independence and functionality of the elderly.

背景近年来，预期寿命的延长带来了多病并发症和老年综合症（如虚弱）的出现，使老年人很容易出现失代偿和住院。此外，营养状况和肌肉力量与虚弱也有很大关系，因此，对住院老年人群的营养状况和肌肉力量进行特征描述是非常重要的，因为这些情况会导致不良的临床结果，增加住院时间和死亡率。目标评估住院老年人是否存在虚弱、营养状况和肌肉力量。方法这是一项前瞻性、观察性和横断面研究，对在一所大学医院病房住院的 60 岁以上患者进行评估。数据来自医疗记录和样本特征描述。研究人员对患者进行了虚弱筛查（弗里德标准）、通过迷你营养评估（MAN）进行营养评估以及手握力评估。在体弱方面，根据弗里德的标准，90.2%的患者被归类为体弱者，9.8%的患者被归类为前期体弱者，没有患者被归类为非体弱者。MAN 评分显示，在营养状况方面，19.6% 的患者有营养不良的风险，43.13% 的患者营养不良。在肌肉力量方面，66.66% 的男性和 76.9% 的女性存在肌肉无力问题，其中男性的平均值为 27.6 ±11.43（预测值的 76.66%），女性的平均值为 19.3 ±5.76（预测值的 83.91%）。

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引用次数: 0

PHOTOBIOMODULATION MAY REVERSE CELLULAR SENESCENCE BY INDUCING CELL PROLIFERATION AND PRESERVING NUCLEAR SIZE 光生物调节可通过诱导细胞增殖和保持核大小来逆转细胞衰老

IF 3.4 3区医学 Q1 ORTHOPEDICS

Brazilian Journal of Physical Therapy

Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100598

Alan Christhian Bahr , Luana Suéling Lenz , Elizama de Gregório , Guido Lenz , Patrick Türck , Pedro Dal Lago

Background

Cellular senescence is an irreversible state of cell cycle arrest, thus being characterized by decreased cell proliferation and increased nucleus area, often acting as a tumor suppressor program. Photobiomodulation (PBM) has been used in several conditions to increase the mitochondrial response, promoting nuclear changes and cell proliferation. However, the effects of PBM on cells are still unclear.

Objectives

To verify the efficacy of photobiomodulation on cell senescence processes.

Methods

We utilized A172 glioblastoma cells transduced with H2B-mCherry by lentivirus to nuclear tagging. Treatment was done with GaAIAs Laser (850nm). Cells were divided by intensity into the following groups: C= Control, L1= 1J/cm², L2= 2.2J/cm², L3= 3J/cm², L9= 9J/cm², L15= 15J/cm², L21= 21J/cm², nuclear evaluation was performed at experimental times (0h, 24h, 48h and 72h). For data analysis, two-way ANOVA with the Tukey post hoc test was used. Differences were significant when p<0.05.

Results

PBM on intensities of 1J/cm², 2.2J/cm², 3J/cm², 9J/cm² e 15J/cm² showed a lower increase at the nuclear size when compared with time 0h and 72h in the control group. All intensities (1, 2.2, 3, 9, 15, and 21 J/cm²) promoted cellular proliferation after 72 hours, while 15J/cm² presented an accentuated increase compared to groups L1, L2.2, and L3.

Conclusion

PBM enhanced cellular proliferation while causing a reduced nuclear increase in glioblastoma cells.

Implications

In this study, we found that the laser decreased the cellular senescence state from the evaluation of the morphological parameters, thus increasing cell proliferation and decreasing the nuclear area; therefore, it is an important therapeutic tool against the cellular aging process.

背景细胞衰老是一种不可逆的细胞周期停滞状态，因此以细胞增殖减少和细胞核面积增大为特征，通常是一种肿瘤抑制程序。光生物调节（PBM）已被用于多种情况，以增加线粒体反应，促进核变化和细胞增殖。方法我们利用慢病毒转导的 H2B-mCherry A172 胶母细胞瘤细胞进行核标记。使用 GaAIAs 激光（850 纳米）对细胞进行处理。细胞按强度分为以下几组：C= 对照组，L1= 1J/cm²，L2= 2.2J/cm²，L3= 3J/cm²，L9= 9J/cm²，L15= 15J/cm²，L21= 21J/cm²，在实验时间（0h、24h、48h 和 72h）进行核评估。数据分析采用双向方差分析和 Tukey 后检验。结果与对照组的 0h 和 72h 相比，强度为 1J/cm²、2.2J/cm²、3J/cm²、9J/cm² 和 15J/cm² 的 PBM 显示核大小的增加较少。所有强度（1、2.2、3、9、15 和 21 J/cm²）在 72 小时后都促进了细胞增殖，而与 L1、L2.2 和 L3 组相比，15J/cm² 的增殖更为显著。意义在这项研究中，我们发现从形态学参数的评估来看，激光可降低细胞的衰老状态，从而增加细胞增殖并减少细胞核面积；因此，激光是对抗细胞衰老过程的重要治疗工具。

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引用次数: 0