Posturography Comparison and Discriminant Analysis Between Individuals With and Without Chronic Low Back Pain.

OBJECTIVE: The aims of this study were to evaluate the center of pressure (CoP) in individuals with chronic low back pain (LBP) compared with matched controls and perform discriminant analysis to detect which CoP variables differentiate the groups. METHODS: Thirty-two participants with LBP and 33 matched controls were evaluated on a force plate in a bipedal static position for 30 seconds in 2 conditions: eyes open (EO) and eyes closed (EC). Two discriminant analyzes were performed to detect which CoP variables could discriminate between groups. RESULTS: Those with LBP had higher values (ie, poorer balance) for most variables compared with the control group. With EO, total displacement of sway (TDS) was as follows: LBP group (median [25%-75%]) 31.77 (26.39-41.79) cm, control group 27.21 (22.29-31.78) cm, P = .008 and area: LBP group 3.31 (2.33-4.68) cm2, control group 1.77 (1.3-2.71) cm2. With EC, TDS was as follows: LBP group 49.6 (39.65-68.15) cm, control group 38.77 (30.36; 45.65) cm, P = .003 and area: LBP group 4.68 (2.6-7.28) cm2, control group 2.4 (2.1-3.34) cm2. The discriminating variables in the EO condition were the TDS for the LBP group and the anteroposterior mean velocity for the control group, while in the EC condition they were mediolateral dispersion and area for the LBP group. CONCLUSION: Individuals with chronic LBP had worse postural control performance than matched controls, and it is possible to characterize those with and without LBP with CoP variables.

Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis. DESIGN: Randomized controlled trial with blinded assessor and intention-to-treat analysis. SETTING: Aquatic Physiotherapy Centre and Primary Health Care Unit. SUBJECTS: A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (Kellgren-Lawrence 1-4) of knee osteoarthritis were included. INTERVENTIONS: An eight-week treatment protocol of aquatic exercise ( n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) ( n = 29). MAIN MEASURES: Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression. RESULTS: At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) functional capacity values reduced in favour of the aquatic exercise group for both the total score MD (mean difference) = -14.2; 95% CI (confidence interval) (-18; -10.5), P = 0.04 and the pain domain MD = -3.8 points; 95% CI (-8.71; -1), P = 0.021. The total score also reduced in the follow-up: MD = -12.3 points; 95% CI (-24.7; -6.1), P = 0.017. No differences were found for the outcomes functional mobility or depression. CONCLUSION: Aquatic exercise improved pain and function after eight weeks, and function at the three-month follow-up compared to the patient-education program.

Determination of the motor unit behavior of lumbar erector spinae muscles through surface EMG decomposition technology in healthy female subjects.

INTRODUCTION: The aims of this study were to determine the motor unit behavior of the erector spinae muscles and to assess whether differences exist between the dominant/nondominant sides of the back muscles. METHODS: Nine healthy women, aged 21.7 years (SD = 0.7), performed a back extension test. Surface electromyographic decomposition data were collected from both sides of the erector spinae and decomposed into individual motor unit action potential trains. The mean firing rate for each motor unit was calculated, and a regression analysis was performed against the corresponding recruitment thresholds. RESULTS: The mean firing rate ranged from 15.9 to 23.9 pps and 15.8 to 20.6 pps on the dominant and nondominant sides, respectively. However, the early motor unit potentials of the nondominant lumbar erector spinae muscles were recruited at a lower firing rate. CONCLUSIONS: This technique may further our understanding of individuals with back pain and other underlying neuromuscular diseases. Muscle Nerve 55: 28-34, 2017.

High blood pressure and sedentary behavior in adolescents are associated even after controlling for confounding factors.

OBJECTIVE: The aim of this study was to determine whether high blood pressure (HBP) is associated with sedentary behavior in young people even after controlling for potential confounders (gender, age, socioeconomic level, tobacco, alcohol, obesity and physical activity). METHODS: In this epidemiological study, 1231 adolescents were evaluated. Blood pressure was measured with an oscillometric device and waist circumference with an inextensible tape. Sedentary behavior (watching television, computer use and playing video games) and physical activity were assessed by a questionnaire. We used mean and standard deviation to describe the statistical analysis, and the association between HBP and sedentary behavior was assessed by the chi-squared test. Binary logistic regression was used to observe the magnitude of association and cluster analyses (sedentary behavior and abdominal obesity; sedentary behavior and physical inactivity). RESULTS: HBP was associated with sedentary behaviors [odds ratio (OR) = 2.21, 95% confidence interval (CI) = 1.41-3.96], even after controlling for various confounders (OR = 1.68, CI = 1.03-2.75). In cluster analysis the combination of sedentary behavior and elevated abdominal obesity contributed significantly to an increased likelihood of having HBP (OR = 13.51, CI 7.21-23.97). CONCLUSIONS: Sedentary behavior was associated with HBP, and excess fat in the abdominal region contributed to the modulation of this association.

The effect of physical training on heart rate variability in healthy children: a systematic review with meta-analysis.

The positive effects of physical training on heart rate variability (HRV) in healthy adults are widely recognized; however, the responsiveness to training in healthy children has not yet been established. The aim of this study was to determine the influence of physical training on HRV in prepubertal healthy children. Systematic computerized searches were performed from 1950 to 2012 in the following databases: Medline, Embase, Cinahl, Lilacs, Scielo, SportDiscus, ProQuest; Web of Science; PEDro; Academic Search Premier and the Cochrane Library. The key words used were: heart rate variability, autonomic nervous system, exercise training, physical activity, continuous exercise, intermittent exercise, children, prepubescent, adolescents, and healthy. Although the database search initially identified 6,164 studies, after removing duplicates and excluding by title the number was 148, however, only 2 studies were included in this systematic review. The meta-analysis compared the experimental group (n = 29) with the control group (n = 28) for the HRV parameters: RR intervals, SDNN, RMSSD, pNN50, LF (log), HF (log), LF/HF and Total Power (log). The meta-analysis demonstrated similar HRV indices between both the experimental and control groups. In conclusion, the available results from randomized controlled trials do not support the hypothesis that physical training improves HRV in healthy children[AUQ2].

Kinematic gait analysis using inertial sensors with subjects after stroke in two different arteries.

[Purpose] The aim of the present study was described the kinematic characteristics of gait in stroke patients with two different arteries involved. [Subjects and Methods] Two patients who had suffered a basilar (A) or middle (B) cerebral artery ischemic stroke were compared with a control (C). Seventeen inertial sensors were used with acquisition rate of 120 Hz. The participants walked 3 times on a 10 meter walkway. From the raw data, the three gait cycles from the middle of each trial were chosen and analyzed. [Results] During the stance phase, patients A and B had a lower hip angle at initial contact and maximum flexion angle during load response than the control. Patient A and the control subject had similar knee angle values at initial contact, and patient B presented a flexed position in the initial phase of the gait cycle. The maximum flexion angles during loading response were also higher for patient B. The sagittal plane excursion for the ankle joint was lower for patient B in comparison with the other subjects. [Conclusion] Differences during walking between patients who had stroke in different arteries may be related to an alternative compensatory strategy. Patient A and the control subject had similar gait cycle curves at all joints, while patient B showed a rigid synergic pattern.

The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: a systematic review with meta-analysis.

OBJECTIVE: To assess the effectiveness of aquatic physical therapy in the treatment of fibromyalgia. DATA SOURCES: The search strategy was undertaken using the following databases, from 1950 to December 2012: MEDLINE, EMBASE, CINAHL, LILACS, SCIELO, WEB OF SCIENCE, SCOPUS, SPORTDiscus, Cochrane Library Controlled Trials Register, Cochrane Disease Group Trials Register, PEDro and DARE. REVIEW METHODS: The studies were separated into groups: Group I - aquatic physical therapy × no treatment, Group II - aquatic physical therapy × land-based exercises and Group III - aquatic physical therapy × other treatments. RESULTS: Seventy-two abstracts were found, 27 of which met the inclusion criteria. For the functional ability (Fibromyalgia Impact Questionnaire), three studies were considered with a treatment time of more than 20 weeks and a mean difference (MD) of -1.35 [-2.04; -0.67], P = 0.0001 was found in favour of the aquatic physical therapy group versus no treatment. The same results were identified for stiffness and the 6-minute walk test where two studies were pooled with an MD of -1.58 [-2.58; -0.58], P = 0.002 and 43.5 (metres) [3.8; 83.2], P = 0.03, respectively. CONCLUSION: Three meta-analyses showed statistically significant results in favour of the aquatic physical therapy (Fibromyalgia Impact Questionnaire, stiffness and the 6-minute walk test) during a period of longer than 20 weeks. Due to the low methodological rigor, the results were insufficient to demonstrate statistical and clinical differences in most of the outcomes.

The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents.

BACKGROUND: Among adults, obesity has been positively related to bone mineral density. However, recent findings have pointed out that abdominal obesity could be negatively related to bone density. The above mentioned relationship is not clear among pediatric populations. Therefore, this cross-sectional study analyzed the relationship between thickness of abdominal adipose tissue and bone mineral variables in sedentary obese children and adolescents. METHODS: One hundred and seventy five obese children and adolescents (83 male and 92 female) with ages ranging from 6 to 16 years-old were analyzed. Bone mineral content and density were estimated by dual-energy X-ray absorptiometry and ultrasound equipment which estimated the thickness of the abdominal adipose tissue. Pubertal stage was self-reported by the participants. RESULTS: The mean age was 11.1 (SD=2.6). Thickness of the abdominal adipose tissue was negatively related to bone mineral density (r=-0.17 [r95%CI: -0.03;-0.32]), independent of gender, pubertal stage and other confounders (ß=-0.134±0.042 [ß95%CI: -0.217; -0.050]). CONCLUSIONS: In sedentary obese children and adolescents abdominal obesity is negatively related to bone mineral density, suggesting a potential link between abdominal obesity and osteoporosis.

The electromyographic activity of the multifidus muscles during the execution of two pilates exercises--swan dive and breast stroke--for healthy people.

OBJECTIVE: The purpose of this study was to compare the multifidus electromyographic activity in healthy women during the performance of the same Pilates exercise under 2 conditions. METHODS: Sixteen healthy, active, female practitioners of Pilates (mean age, 24.3; SD, 3.1 years) were assessed through surface electromyography during 2 Pilates exercises (swan dive and breast stroke). Muscle activity during the experimental tasks was recorded with 1 pair of electrodes placed bilaterally on the multifidi. Data were normalized to maximal activity recorded during dynamic activity. RESULTS: The mean of the maximal isometric voluntary contraction was 662.4 N (SD, 195). In the phase comparison, the multifidus was the most recruited on the concentric phase during both exercises, ball (P=.001) and reformer (P=.001). In the comparison between conditions, the reformer presented more activation on swan dive (P=.04) and breast stroke (P=.001). The percentages of muscle activation varied between 50% and 60%, and the greatest activation was made on the reformer condition. CONCLUSION: The findings of this study show that Pilates exercises by healthy women, under different conditions, can cause changes to the multifidus muscle activation. The condition and the phase in which the muscle was more activated were the reformer and concentric phase, respectively, for both exercises. However, the results for the percentages of activation suggest that the intensity of recruitment may not be sufficient to strengthen muscle in healthy, trained subjects.

Gait analysis of individuals with specific low back pain undergoing surgery: case series report with one and six-month follow-up.

INTRODUCTION: In addition to pain, specific low back pain is frequently accompanied by restricted range of motion (ROM) during gait. PURPOSE: To compare the behavior of kinematic and spatiotemporal gait parameters, pain, functional status, and self-efficacy, in patients with a diagnosis of herniated disk or lumbar stenosis undergoing surgery, in the pre- and postoperative periods of 1 and 6 months (PO6). METHODS: Seven participants and 11 control subjects were assessed. A kinematics system comprising 10 optoelectronic cameras was used to assess gait. The Roland-Morris questionnaire, pain intensity, and self-efficacy, over three periods, were used. RESULTS: The ROM of the pelvis, hip, and knee of the hernia group presented an increase after surgery and the stenosis group presented a reduction of values in the hip. During the stance phase, the pelvis and hip ROM of both groups remained smaller than the control group. There was improvement in pain in individuals with hernia and stenosis (effect size = 0.6 and 0.8, respectively) in the three analyzed moments; for functional status there was improvement in the first postoperative period (ES = 0.4) compared to the preoperative in those individuals with hernia; and those with stenosis had improvement at PO6 when compared to the time before the surgery (ES = 0.2). CONCLUSION: Surgical intervention modifies the spatiotemporal parameters, the ROM of the pelvis, hip, and knee in the total gait cycle, primarily in the sagittal plane, and causes alterations, particularly in the hip joint, in these individuals during the support phase.

Comparing the Pilates method with no exercise or lumbar stabilization for pain and functionality in patients with chronic low back pain: systematic review and meta-analysis.

OBJECTIVE: To perform a systematic review with meta-analyses that evaluates the effectiveness of the Pilates method on the pain and functionality outcome in adults with non-specific chronic low back pain. DATA SOURCES: The search was performed in the following databases: Medline, Embase, AMED, Cinahl, Lilacs, Scielo, SportDiscus, ProQuest, Web of Science, PEDro, Academic Search Premier and the Cochrane Central Register of Controlled Trials from 1950 to 2011; the following keywords were used: 'Pilates', 'Pilates-based', 'back exercises', 'exercise therapy', 'low back pain', 'back pain' and 'backache'. REVIEW METHODS: The inclusion criteria were studies that assessed the effects of the Pilates method on patients with chronic low back pain. RESULTS: Five studies met the inclusion criteria. The total number of patients was 71 in the Pilates group and 68 in the control group. Pilates exercise did not improve functionality (standardized mean difference (SMD = -1.34; 95% confidence interval (CI) -2.80, 0.11; P = 0.07) or pain between Pilates and control groups (SMD = -1.99; 95% CI -4.35, 0.37; P = 0.10). Pilates and lumbar stabilization exercises presented no significant difference in functionality (mean difference (MD) = -0.31; 95% CI -1.02, 0.40; P = 0.39) or pain (MD = -0.31; 95% CI -1.02, 0.40; P = 0.39). CONCLUSION: The Pilates method did not improve functionality and pain in patients who have low back pain when compared with control and lumbar stabilization exercise groups.

Influence of the medial longitudinal arch of the foot in adult women in ankle isokinetic performance: a cross-sectional study.

BACKGROUND: Maintenance of the medial longitudinal arch (MLA) of the foot is fundamental during functional tasks and disorders can lead to clinical alterations. Studies have demonstrated that deficits in ankle isokinetic performance can predispose an individual to lower limb injuries. OBJECTIVES: To evaluate the muscular performance of cavus, planus, and normal feet by means of torque/body mass and the isokinetic phases, to generate 3D surface map analysis, and to verify whether there is a relationship between MLA height and arch height flexibility with isokinetic performance. METHODS: The sample consisted of 105 healthy adult women, divided into three groups: normal, cavus, and planus. Assessment in concentric mode at 30, 60, and 90 °/s in the dorsiflexion and plantarflexion of the ankle joint were analyzed during the three isokinetic phases (acceleration, sustained velocity, and deceleration). The variables total range of motion, peak of torque (PT), and angle of PT were extracted within the sustained velocity. RESULTS: In dorsiflexion at 60 °/s, the phase where the velocicty is sustained (load range phase) was higher in the planus group (MeanDifference=10.9 %; ω2p = 0.06) when compared with the cavus group. Deficits in the peak torque/body mass in dorsiflexion at 60 °/s (cavus feet: MD=-3 N.m/kg; ω2p = 0.06; and planus feet: MD=-1.1 N.m/kg; ω2p = 0.06) were also observed as well as in the 3D surface maps, when compared with the normal group. The flexibility of MLA had a negative correlation of PT at 30 °/s in cavus group. The heigth of MLA had a postive correlation with the PT for the cavus and planus group ate 60 °/s. All other results did not show differences between the groups. CONCLUSIONS: The planus groups showed a better capacity of attain and sustained the velocity in dorsiflexion in relation the cavus group. The cavus and planus group had deficts in torque in relation the normal. The correlations were weak between the measures of MLA and PT. Thereby, in general the differences between foot types showed small effect in isokinetic muscle performance measures of the plantar and dorsi flexores. TRIAL REGISTRATION: Study design was approved by the IRB (#90238618.8.0000.5231).

Evaluation of quality of life in individuals with chronic stroke who underwent aquatic exercises: A case series.

BACKGROUND: Aquatic exercises are among the treatments available to improve the quality of life after stroke. OBJECTIVES: To investigate changes in the quality of life after 8-week of aquatic exercises in post-stroke individuals. METHODS: A case series study was designed, including four male participants. Exclusive aquatic exercise was performed for 8-week, 50 minutes per session, 2×/week. Their quality of life was evaluated before and after the intervention using the Stroke Impact Scale (SIS). RESULTS: Participant 1 improved in the mobility domain, achieving a Clinically Important Difference (CID). Participant 2 improved in the strength and mobility domain, achieving CID; his stroke recovery was 6%, and it reached 50% post-intervention. Participant 3 improved in the mobility domain, achieving a CID and a Minimal Detectable Change (MDC); his stroke recovery increased from 45 to 60% post-intervention. Participant 4 improved the strength, mobility, and activities of daily living domains, achieving a CID and a MDC, but his stroke recovery remained unchanged at 80%. CONCLUSIONS: All participants achieved a CID in the mobility domain; thus, the aquatic exercise intervention was considered meaningful. Moreover, the SIS is able to evaluate aspects of the recovery process regarding health-related quality of life after stroke, as demonstrated by the results of the overall recovery after aquatic exercises.

Effects of sports bra and footwear on vertebral posture during walking and running.

Little attention has been given to factors which affects women running, such as proper footwear and breast support and their effects on spine. The objective of study was to analyse the influence of different breast support and footwear on vertebral posture during walking and running. Seventeen women (x¯ = 23.51; SD = 3.70 years) performed a treadmill walking (5 km/h) and running (7 and 10 km/h) with different footwear (barefoot, minimalist and traditional) and breast support (bare breast, everyday bra and sports bra) conditions. Spine movements were analyzed using three cameras in grayscale video mode, positioned behind the participant to register reflective markers fixed in the vertebrae. From the 3D coordinates of the trunk markers we computed, for the whole gait cycle (C) and for the average gait posture (neutral curve-NC) the maximal (M) thoracic (T) kyphosis and lateral flexion, and the maximal lumbar (L) lordosis and lateral flexion. Frontal plane: bare breast presented higher lumbar NC than the everyday bra and sports bra, higher MLC than the sports bra and lower MTC than the everyday bra and sports bra. Barefoot presented higher MTC than minimalist. Sagittal plane: bare breast presented lower MTC than the sports bra. Barefoot presented higher lumbar NC than the minimalist and traditional footwear and higher MLC than the minimalist and traditional ones. The sports bra increased curvatures in the thoracic spine that were rectified during bare breast conditions. In addition, both footwears were able to maintain the natural curvatures of the spine in the lumbar.

Sports bra but not sports footwear decreases breast movement during walking and running.

Running is a modality that has a large number of adepts, including women. Therefore, it is important to understand how sportswear can help women, with special attention to the breast movement. The aim of this study was to analyse the effect of different combinations of breast support and footwear on the breast movement during walking and running. Twenty women performed treadmill walking (5 km/h) and running (7 and 10 km/h) combining different footwear (barefoot, minimalist, and traditional) and breast support conditions (bare breast, everyday bra, and sports bra). Three-dimensional data from breast and trunk markers were tracked for 10 stride cycles. Relative breast displacement was calculated and derived for velocity. An interaction effect was observed between support, footwear, and speed conditions. The bare breast conditions presented differences from the other conditions in the majority of the kinematic variables, presenting higher breast displacement and velocity values. On the other hand, the sports bra conditions presented the lowest values for the kinematics variables. In the vertical component of breast displacement during running (10 km/h) we verified that the sports bra presented reductions of 56% and 43% in relation to the bare breast and everyday bra conditions, respectively. Despite this, no differences were found between footwear within each breast support condition. A sports bra is efficient to decrease breast movement. In addition, neither of the tested footwear was able to decrease these movements.

Assessment of measurement properties of the Brazilian-Portuguese version of the low back activity confidence scale (LoBACS) in patients with chronic low back pain.

The Low Back Activity Confidence Scale (LoBACS) assesses the self-efficacy to perform activities in individuals with chronic low back pain (CLBP). As self-efficacy appears to directly influence the patient's functional capacity and prognosis, it is important to develop a scale that evaluates this attribute to guide treatment strategy and monitor the clinical course of patients. This study aimed to evaluate the reliability, construct validity, and responsiveness of the Brazilian version of the LoBACS. The scale was applied to 112 male and female patients (age, 18-65 years) with specific and nonspecific CLBP. For evaluating the interobserver reliability, the scale was applied twice on the first evaluation day by two trained evaluators (A and B). Within 48-72 h of the first evaluation, assessor A reapplied the scale to evaluate intraobserver reliability (test-retest), which was analyzed by intraclass correlation coefficient (ICC). The first LoBACS applied in the baseline evaluation was also used to assess the construct validity of the scale by factor analysis. For responsiveness, the scale was applied 5 times at 2-week intervals and the change in scores was analyzed by the repeated measures ANOVA. Although factor analysis indicated three subscales, they did not present acceptable values of convergent and divergent validity. Reliability ranged from good to excellent, with ICC values of .90 (95% CI, .84; .93) and .85 (95% CI, .77; .91) for inter- and intraobserver variability for total score. Moreover, the total score was responsive in all comparisons, with no floor or ceiling effects. Thus, only the total score of the Brazilian version of LoBACS proved to be reliable, valid, and responsive.

A review on muscle activation behaviour during gait in shallow water and deep-water running and surface electromyography procedures.

BACKGROUND: Surface electromyography (sEMG) can provide information on muscle activation patterns during gait. OBJECTIVES: To characterize electromyographic activity during gait in shallow water and during deep-water running compare to on land and to review and analyse underwater surface-electromyographic (sEMG) procedures. SEARCH METHODS: Eight databases (MEDLINE, EMBASE, WEB OF SCIENCE, SPORT Discus, CINAHL, SCOPUS, SCIELO, and LILACS) were searched from their inception to the December of 2019. SELECTION CRITERIA: The selected studies had to be related to electromyographic analysis of gait in an aquatic environment. DATA COLLECTION AND ANALYSIS: The studies that met the inclusion criteria were reviewed by two independent reviewers and divided into four groups. RESULTS: Ten studies met the inclusion criteria. Lower muscle activation was found with treadmill water walking compared to treadmill land walking. With deep-water running, the leg muscles (tibialis anterior and gastrocnemius lateralis) have lower muscle activation when compared to on land running, but the trunk and thigh muscles have higher activation. CONCLUSION: If gait is performed on an aquatic treadmill, the muscles assessed had lower muscle activation when compared to land. During deep-water running activities, lower activation of the distal leg muscles and a higher activation thigh muscles were found when compared to on land. Studies did not follow standard processes in sEMG procedures.

Evaluation of the Omron MX3 Plus monitor for blood pressure measurement in adolescents.

This study analyzed the accuracy/agreement of the Omron MX3 monitor on 165 adolescents. Blood pressure was measured by the automatic monitor connected in Y with the mercury column (three consecutive and simultaneous measures). The independent measures were analyzed, and the mean differences between systolic and diastolic measures for both methods were calculated and compared with British Hypertension Society (BHS) and Association for the Advancement of Medical Instrumentation (AAMI) criteria. The automatic monitor received the highest degree of BHS recommendations for systolic and diastolic blood pressures according to the BHS. The median (25th and 75th) difference between the observer and the monitor measurements was -2 (-6 and 1) mmHg for systolic and 0 (-3 and 1) mmHg for diastolic pressures. The monitor also satisfies the AAMI standard for the studied population. In conclusion, the Omron MX3 Plus monitor can be considered reliable and valid for clinical practice and is in accordance with BHS and AAMI criteria.

PROPOSAL AND TEST-RETEST RELIABILITY OF A SCALE FOR CERVICAL, THORACIC, AND LUMBAR SPINE PAIN IN BRAZILIAN YOUNG PEOPLE.

OBJECTIVE: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. METHODS: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. RESULTS: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). CONCLUSIONS: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people.

Association between soy and green tea (Camellia sinensis) diminishes hypercholesterolemia and increases total plasma antioxidant potential in dyslipidemic subjects.

OBJECTIVE: To evaluate the hypolipemic and antioxidant effects of soy and green tea alone and/or in association in dyslipidemic subjects. METHODS: One hundred dyslipidemic individuals were allocated into four groups. The soy group ingested 50 g of soy (kinako) daily, and the green tea group ingested 3 g of green tea in 500 mL of water per day. A third group ingested 50 g of soy and 3 g of green tea daily, and the control group had a hypocholesterolemic diet. Evaluations were performed at baseline and after 45 and 90 d. Plasma levels of total cholesterol, high-density lipoprotein, and triacylglycerols were evaluated by automated methods. Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald equation. LDL was isolated by ultracentrifugation. Total plasma antioxidant capacity and plasma levels of total lipid hydroperoxides and those linked to LDL were evaluated by chemiluminescence. The results were expressed as median values and their 25th to 75th percentiles, with a 5% level of significance. RESULTS: No significant difference occurred in LDL, high-density lipoprotein cholesterol, and triacylglycerol levels across groups. However, a statistically significant difference in total cholesterol occurred within the soy/green tea group 45 and 90 d after intervention. No statistically significant difference occurred in plasma levels of lipid hydroperoxides or those linked to LDL in any of the groups studied. All the groups that used soy and/or green tea presented increased total plasma antioxidant potential. CONCLUSION: Soy and green tea, alone or in combination, increased the total antioxidant potential of hypercholesterolemic patients, whereas only the combination decreased total cholesterol levels.