Measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in individuals with chronic pain.

OBJECTIVE: To examine the measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in Brazilians with chronic pain. METHODS: Cross-sectional and longitudinal design (washout period for reliability). The study was conducted in two Brazilian states, Maranhão and São Paulo, and included Brazilian adults, irregular exercisers, former exercisers or non-exercise practitioners, aged 18 to 59 years and with chronic pain. The instruments used in this study were: the REPEAS, the Numerical Pain Rating Scale (NPRS), the Baecke Habitual Physical Activity Questionnaire (BHPAQ), the Pain Self-Efficacy Questionnaire (PSEQ), and the Roland-Morris Disability Questionnaire for general pain (RMDQ-g). The evaluation focused on structural validity, construct validity, reliability (with standard error of measurement and minimum detectable change), internal consistency, and floor and ceiling effects. RESULTS: The two-dimensional structure was tested through confirmatory factor analysis, which resulted in adequate fit indeces: chi-square values/degrees of freedom = 1.541, Tucker-Lewis Index = 0.966, comparative fit index = 0.974, root mean square error of approximation = 0.074, and standardized root mean square residual = 0.068. Additionally, satisfactory factor loadings (> 0.40) were obtained. Test-retest reliability and internal consistency were adequate for the environmental factors domain (intraclass correlation coefficient [ICC] = 0.79, Cronbach's alpha = 0.88) and the personal factors domain (ICC = 0.97, Cronbach's alpha = 0.93). In hypothesis testing for construct validity, we observed a significant correlation with magnitude below 0.30 of the environmental factors domain of the REPEAS with RMDQ-g, PSEQ and sport domain of the BHPAQ. For the personal factors domain, we observed a significant correlation with a magnitude of 0.30 to 0.50 with RMDQ-g, PSEQ, and sport domain of the BHPAQ, and below 0.30 with leisure domain of the BHPAQ. No floor or ceiling effects were found for the REPEAS domains. CONCLUSION: The REPEAS is a valid instrument with a two-dimensional internal structure consisting of 12 items. It has a reliable construct and is suitable for use in the clinical and epidemiological context for adults with chronic pain in Brazil.

The best internal structure of the Diabetes Quality of Life Measure (DQOL) in Brazilian patients.

BACKGROUND: Diabetes Mellitus (DM) is considered a chronic disease with numerous secondary complications that negatively affect the quality of life of patients. However, the specific, known and validated instruments for Brazilian Portuguese are too extensive, which often makes their use infeasible. OBJECTIVE: To validate the internal structure of the Brazilian version of the Diabetes Quality of Life (DQOL) measure. METHODOLOGY: Patients with DM type 1 or 2, between the ages of 18 and 76, were evaluated between April 2022 and May 2022. The survey was conducted online using the Google Forms platform. The original DQOL contains 46 multiple-choice questions organized into four domains. For structural validity, confirmatory factor analysis (CFA) was performed using RStudio software (Boston, MA, USA) with the packages lavaan and semPlot. RESULTS: A total of 354 subjects were evaluated. The 3-domain, 24-item version of the DQOL was the most adequate, with acceptable values for all fit indices (chi-square/GL < 3, TLI and CFI > 0.90, and RMSEA and SRMR < 0.08). CONCLUSION: The structure with three domains and 24 items is the most appropriate based on factor analysis. The Brazilian version of the DQOL with a structure of 3 domains and 24 items has adequate measurement properties that support its use in the clinical and scientific context in patients with DM.

Regular Physical Exercise Adherence Scale (REPEAS): a new instrument to measure environmental and personal barriers to adherence to regular physical exercise.

OBJECTIVE: To create, develop, and validate a scale that identifies the environmental and personal barriers that make it difficult to adhere to the practice of physical exercise on a regular basis in a population of Brazilian adults. METHODS: We include adult individuals, aged 18-59 years, practitioners or former practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In the development and validation phases of the process, 6 specialists in the field of the health assessed the content validity: firstly, the specialists were asked to freely list the questions they would ask to investigate the barriers to adherence to regulating physical activity. Secondly, after compiling all the suggestions listed and eliminating suggestions with similar content, the items suggested in the first round were sent to the specialists so that an evaluation of all questions using a 5-point Likert scale and the content validity coefficient was calculated. We then evaluated the structural validity, construct validity, reliability, internal consistency, and ceiling and floor effects of the Regular Physical Exercise Adherence Scale (REPEAS). RESULTS: Sixteen items were proposed to measure the factors that make it difficult to adhere to the regular practice of physical exercise. The internal structure of the REPEAS initially tested was based on the theoretical proposal of creating the instrument with two domains. After the structural analysis, we used the modification indices to identify the redundant items of the instrument. Consequently, the final version of the REPEAS after factor analysis had 12 items. Thus, the structure with 2 domains and 12 items presented adequate fit indices. With regard to construct validity, the REPEAS scores were compared in two distinct groups: irregular practitioners/ex-practitioners versus regular practitioners of physical exercise, in which a significant difference could be observed between groups (p < 0.001) for both the domains. Acceptable reliability was observed for the environment and personal domains, with ICC values of 0.86 and 0.94, in the same order. For internal consistency, Cronbach's alpha value was 0.908 (environmental domain) and 0.915 (personal domain), these values being adequate for the REPEAS. CONCLUSION: The REPEAS is a scale with a valid two-dimensional internal structure, consisting of 12 items, reliable and with a valid construct, which supports its use in the clinical, epidemiological, and research contexts in Brazil.

The best structure of the Tampa Scale for Kinesiophobia for patients with chronic low back pain has two domains and nine items.

PURPOSE: To identify the best internal structure of the Tampa Scale for Kinesiophobia in chronic low back pain patients. DESIGN: Questionnaire validation study was designed for this study. SETTING: This study was conducted in physical therapy facility. SUBJECTS: Respondents reporting chronic low back pain (≥3 points on the 11-point Numerical Pain Rating Scale). MAIN MEASURES: We included participants of both sexes, with a self-report of low back pain ≥3 months and with pain intensity ≥3 on the 11-point Numerical Pain Rating Scale; participants also answered the Roland-Morris Disability Questionnaire and the Pain-Related Catastrophizing Thoughts Scale for low back pain disability and catastrophizing, respectively. The dimensionality and number of items of the Tampa Scale for Kinesiophobia were evaluated using the confirmatory factor analysis. Criterion validity was assessed using Spearman's correlation coefficient using the original version of the 17-item Tampa Scale for Kinesiophobia as the gold standard. RESULTS: A total of 122 participants were included, with mean values of low back pain duration ≥48 months, pain intensity >5 and disability >8. Tampa Scale for Kinesiophobia structure with two domains and nine items was the most suitable, with adequate values in all fit indices (Chi-square/degree of freedom <3, Comparative Fit Index and Tucker-Lewis Index >0.90, and root mean square error of approximation <0.08) and lower Akaike information criterion and Bayesian information criterion values. We observed a high correlation between the 17-item Tampa Scale for Kinesiophobia and the activity avoidance domain (rho = 0.850, P < 0.001) and somatic focus domain (rho = 0.792, P < 0.001) of the nine-item Tampa Scale for Kinesiophobia. CONCLUSION: Tampa Scale for Kinesiophobia structure with two domains (activity avoidance and somatic focus) and nine items is the most suitable for patients with chronic low back pain.

Cross-cultural adaptation, reliability and validation of the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese in patients with cerebral palsy.

BACKGROUND: The purpose of this study was to translate, cross-culturally adapt and validate the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese. METHODS: The translation and cross-cultural adaptation was carried out in accordance with international recommendations. The FAQ was applied to a sample of 102 patients diagnosed with cerebral palsy (CP). Construct validity was assessed using Spearman's correlation coefficient (rho), and the FAQ score was correlated with the Functional Mobility Scale (FMS) and Gross Motor Function Classification Scale (GMFCS). A subsample of 50 patients was used to assess reliability using intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable difference (MDD). Ceiling and floor effects were also evaluated. RESULTS: The Brazilian version of the FAQ showed excellent test-retest reliability by the assessment of the physiotherapist (ICC = 0.99) and respondent (ICC = 0.97), as well as excellent inter-examiner reliability (ICC = 0.94). The SEM was 0.23 (physiotherapist), 0.47 (respondent) and 0.64 (inter-examiner), while the MDD was 0.64 (physiotherapist), 1.29 (respondent) and 1.76 (inter-examiner). The classification of gross motor function showed a high correlation with the FAQ applied by the physiotherapist (rho = -0.89) and by the respondent (rho = -0.87). The FMS-5 m was highly correlated with the FAQ applied by the physiotherapist and the respondent (rho = 0.88 and rho = 0.87, respectively). The FMS-50 and FMS-500 presented very high correlation with the FAQ applied by the physiotherapist (rho = 0.91 for both) and high correlation with the FAQ applied by the respondent (rho = 0.89 and rho = 0.88, respectively). The Brazilian version of the FAQ did not present the ceiling and floor effects. CONCLUSION: The FAQ presented adequate psychometric properties in patients with CP, indicating that it is possible to use it as a measure of functional gait mobility in Brazil.

Short-term heart rate variability at rest in individuals with temporomandibular disorder: a comparative analysis.

OBJECTIVE: Compare heart rate variability (HRV) indices in participants with and without myogenic temporomandibular disorder (TMD). Secondarily, we correlated HRV indices with pain and quality of life variables. METHODS: This is a comparative observational cross-sectional study. Individuals of both genders with and without a history of TMD were included. Short-term heart rate variability was assessed using a Polar V800. Central sensitization was assessed using the Central Sensitization Inventory. Pain through the numeric pain scale and the impact of oral health on quality of life using the OHIP-14 questionnaire. RESULTS: A total of 80 participants were enrolled in the study: most individuals included in both groups were young adults, women and slightly overweight. We observed a decrease in HRV in the TMD group (p < 0.01) when compared to the control group. In addition, we observed a greater impact of oral health on quality of life, central sensitization in addition to high resting pain scores (p < 0.01). We observed significant correlation between the LF index of HRV and the FAI score (r = 0.311; p = 0.05). The NPS, CSI and OHIP-14 scores did not correlate with any of the HRV indices (p > 0.05). CONCLUSION: The short-term HRV in individuals with TMD is significantly lower when compared to a control group. Furthermore, there seems to be a relationship between the severity of the dysfunction and the HRV variables. CLINICAL RELEVANCE: Using portable and low-cost devices, the HRV can be easily collected and analyzed, without the need for an arsenal of equipment such as the conventional electrocardiogram. This measure can contribute to the therapy adopted and identify individuals prone to unfavorable outcomes involving ANS modulation.

Translation, cross-cultural adaptation and validation of the Work Role Functioning Questionnaire 2.0 into Brazilian Portuguese in a general population.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an instrument that measures the difficulties perceived by workers in meeting work demands, given their physical or emotional health, but it has not yet been adapted for Brazil. Thus, this study aimed to translate, cross-culturally adapt and assess the psychometric properties of the WRFQ 2.0 into Brazilian Portuguese. METHODS: This is an observational study. Initially, translation and cross-cultural adaptation into Brazilian Portuguese was carried out. After that, this version was submitted to an evaluation of its internal structure. The internal consistency and test-retest reliability were assessed. To determine the construct validity, Spearman's correlation coefficient (rho) was used to determine the magnitude of correlation between the WRFQ 2.0 and the Work Ability Index (WAI), Numerical Pain Rating Scale (NPRS) and Self -Estimated Functional Inability because of Pain (SEFIP-work). RESULTS: The internal structure with five domains and 27 items presented adequate fit indices for the Brazilian version of the WRFQ 2.0. Adequate correlations of the five domains of the WRFQ 2.0 with the NPRS, WAI and SEFIP-work were found (rho ranged between 0.145 and 0.338). The test-retest reliability of the WRFQ 2.0 ranged from substantial to excellent (intraclass correlation coefficient ≥ 0.785) and internal consistency was adequate (Cronbach's alpha ≥ 0.852). CONCLUSION: The Brazilian Portuguese version of the WRFQ 2.0 presents valid internal structure with five domains and 27 items, adequate construct based on correlations with other instruments, and acceptable test-retest reliability and internal consistency.

Measurement properties of the Brazilian version of the Copenhagen Neck Functional Disability Scale in patients with chronic neck pain.

OBJECTIVE: To evaluate the measurement properties of the Brazilian version of the Copenhagen Neck Functional Disability Scale (CNFDS) in patients with chronic neck pain. METHODS: One hundred and five patients were included in the study. The structural validity of the CNFDS was assessed by exploratory and confirmatory factor analysis with the following fit indices: chi-square divided by degrees of freedom (chi-square/df), root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker-Lewis index (TLI). To test the construct validity, the CNFDS score was correlated with the Numerical Pain Rating Scale, the Tampa Scale of Kinesiophobia, the Pain-Related Catastrophizing Thoughts Scale, and Neck Disability Index (NDI). A subsample of 43 patients filled the CNFDS at two different times, and test-retest reliability was measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC). The internal consistency of the CNFDS was analyzed by Cronbach's alpha. RESULTS: CNFDS presented a unidimensional structure, with goodness of fit indices: chi-square/df = 1.37, CFI = 0.94, TLI = 0.93, RMSEA = 0.059. The CNFDS showed satisfactory results of reliability (ICC = 0.93) and internal consistency (Cronbach's alpha = 0.84). The SEM was 1.72 and the MDC was 4.76. The CNFDS showed a high correlation with the NDI (rho = 0.718) and a low correlation with the other instruments. There were no floor and ceiling effects. CONCLUSION: The Brazilian version of the CNFDS with a one-dimensional structure and 15 items has adequate measurement properties.

Translation, cross-cultural adaptation, and analysis of the measurement properties of the Brazilian Portuguese version of the spinal cord injury pain instrument.

STUDY DESIGN: A questionnaire validity study. OBJECTIVES: To perform the translation, cross-cultural adaptation, and analysis of the measurement properties of the Brazilian Portuguese version of the Spinal Cord Injury Pain Instrument (SCIPI) for the screening of neuropathic pain in spinal cord injury. SETTING: Neurorehabilitation hospital in north-eastern Brazil. METHODS: We performed the translation and cross-cultural adaptation of the SCIPI. The pre-final version was applied in 10 patients with spinal cord injury sequelae and pain report. The final version of the SCIPI was applied to 100 patients. The measurement properties evaluated were structural validity, test-retest reliability, internal consistency, construct validity, and diagnostic accuracy. RESULTS: None of the items in the pre-final version of the SCIPI had any comprehension problems. The one-dimensional structure of the final version of the SCIPI was adequate. There were significant correlations between the SCIPI and the Douleur Neuropathique 4 (rho = 0.546), as well as adequate test-retest reliability (intraclass correlation coefficient = 0.89, kappa ≥ 0.79), internal consistency (Cronbach's alpha ≥ 0.76), and diagnostic accuracy (area under the curve = 0.860). CONCLUSION: The Brazilian version of the SCIPI presents measurement properties that are suitable for measuring neuropathic pain related to spinal cord injury.

Translation, cross-cultural adaptation, and validation of the Athlete Fear Avoidance Questionnaire (AFAQ) into Brazilian Portuguese.

BACKGROUND: Psychological factors play an important role in the adequate return of an athlete to sport. Our aim was to perform the translation, cross-cultural adaptation, and validation of the Athlete Fear Avoidance Questionnaire (AFAQ) into Brazilian Portuguese. METHODS: We performed the translation and cross-cultural adaptation and evaluated the structural validity, construct validity, and test-retest reliability. In addition to the AFAQ, we used the Numerical Pain Scale (NPS), Pain-Related Catastrophizing Thoughts Scale (PCTS), Self-Estimated Functional Inability because of Pain Questionnaire for athletes (SEFIP-sport), and Hospital Anxiety and Depression Scale (HADS). We used the exploratory factor analysis (EFA) to analyze the internal structure of the AFAQ. We used the Spearman's correlation coefficient (rho) to determine the magnitude of correlation between the AFAQ and the other instruments. We evaluated the test-retest reliability and internal consistency by means of intraclass correlation coefficient (ICC) and Cronbach's alpha, respectively. RESULTS: No adaptation was necessary to produce the AFAQ version in Brazilian Portuguese. We included 160 participants in the study. We identified the one-dimensionality of the AFAQ through the EFA with the implementation of parallel analysis (KMO = 0.83, p < 0.001 in Bartlett's Sphericity test). In construct validity, the magnitudes of correlation between the AFAQ and the other instruments ranged from 0.257 to 0.548. We identified adequate reliability (ICC = 0.85) and internal consistency (Cronbach's alpha = 0.90). CONCLUSION: The Brazilian version of the AFAQ with one domain and 10 items has adequate measurement properties in injured professional and recreational athletes.

Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain.

BACKGROUND: Functional tests are important clinical tools, since they are non-invasive methods, with simple applicability, and low cost. However, there are few tests adapted for individuals with chronic low back pain. Thus, our objective was to evaluate the test-retest and inter-rater reliability of the 2-Minute Step Test in individuals with chronic low back pain and to correlate the test score with measures of pain and physical activity. METHODS: We included patients aged between 18 and 45 years, of both sexes, and with low back pain. The interval between the test and retest was 7 days. We analyzed the data via intra-class correlation coefficient (ICC), confidence interval at 95%, standard error of measurement, and minimum detectable change for reliability. We used the Spearman's correlation coefficient to verify the correlation between 2-Minute Step Test and measures of pain and physical activity (Numerical Pain Scale, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Baecke Habitual Physical Activity Questionnaire). RESULTS: Sample is composed of 37 individuals, most of them female, with overweight and low back pain > 60 months. 2-Minute Step Test showed excellent test-retest (ICC = 0.903) and inter-rater (ICC = 0.925) reliability. Sport domain of the Baecke showed a significant correlation with the 2-Minute Step Test (rho = 0.444). CONCLUSION: 2-Minute Step Test is a reliable measure to measure the functional capacity of patients with chronic low back pain considering different times and examiners, as well as being positively correlated with sports practice.

Barthel Index is a valid and reliable tool to measure the functional independence of cancer patients in palliative care.

BACKGROUND: Our objective was to verify the reliability, internal consistency and construct validity of the Barthel Index in Brazilian cancer patients in palliative care. METHODS: We included patients with cancer, both sexes, and age greater than or equal to 18 years. We used to evaluate patients the Barthel Index, Karnofsky Performance Scale (KPS), and European Organization for Research in the Treatment of Cancer Questionnaire-core 15 (EORTC-QLQ-C15-PAL). The measurement properties evaluated in this study were test-retest and inter-rater reliability and construct validity (tested by means of correlations with other instruments). RESULTS: We included 220 patients for construct validity and a subsample of 27 patients for reliability analyses. We observed adequate reliability (intraclass correlation coefficient ≥ 0.962) and internal consistency (Cronbach's alpha = 0.942). There were adequate correlations between the Barthel Index and the KPS (rho = 0.766), and the functional capacity domain of the EORTC-QLQ-C15-PAL (rho = -0.698). CONCLUSION: The Brazilian version of the Barthel Index presents adequate test-retest and inter-rater reliability, acceptable internal consistency, and valid construct for measuring functional independence in cancer patients.

Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

BACKGROUND: Delirium is an underdiagnosed condition and this may be related, among other causes, to the incorrect use of assessment tools due to lack of knowledge about cognitive assessment and lack of training of the care team. The aim of this study was to investigate the difficulties encountered by the nursing team in the application of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in patients on mechanical ventilation. METHODS: This is descriptive study with a qualitative approach in a private tertiary hospital located in northeast Brazil. Data collection took place from July 2018 to January 2019. We included 32 nurses and used face-to-face semi-structured interviews. The recorded data were analysed using content analysis. This study followed the recommendations of the Standards for Reporting Qualitative Research (SRQR). RESULTS: We identified three major categories: lack of knowledge of professionals, subdivided into deficit in academic formation, difficulty in the differential diagnosis of delirium and delusion, and lack of knowledge about the steps of the CAM-ICU; difficulty in patient cooperation; and lack of adequate training to apply the CAM-ICU. CONCLUSION: Nurses have a deficit in academic formation on delirium and need adequate training for the correct and frequent use of the CAM-ICU.

Short-form quality care questionnaire-palliative care has acceptable measurement properties in Brazilian cancer patients.

BACKGROUND: Our objective was to perform the translation, cross-cultural adaptation, and validation of the Quality Care Questionnaire-Palliative Care (QCQ-PC) into Brazilian Portuguese for cancer patients in palliative care. The translation and cross-cultural adaptation comprised the following stages: translation, synthesis of translations, back-translation, analysis by a committee of experts, testing of the pre-final version, and definition of the final version. The evaluated measurement properties were: structural validity using factor analysis, test-retest reliability using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's alpha, and construct validity using the correlations between the QCQ-PC and other questionnaires already validated in Brazil. RESULTS: Two hundred and twenty-five cancer patients were included for validity analyses, and a subsample of 30 patients was used for test-retest reliability. The most adequate fit indexes were for the short version of the QCQ-PC (SF-QCQ-PC), with two domains and 12 items. There was adequate reliability and internal consistency, with values of the ICC ≥ 0.83 and Cronbach's alpha ≥0.82. There were correlations > 0.30 between the SF-QCQ-PC and the Karnofsky Performance Scale, the Palliative Prognostic Index, the sadness domain of the Edmonton Symptom Assessment System, the Barthel Index, and all domains related to the McGill Quality of Life Questionnaire and the European Organization for Research in the Treatment of Cancer Questionnaire-core. CONCLUSION: The short version of the SF-QCQ-PC has acceptable psychometric properties for use in Brazil.

Assessment of the Reliability of the Leg Lateral Reach Test to Measure Thoraco-Lumbo-Pelvic Rotation in Individuals With Chronic Low Back Pain.

PURPOSE: The purpose of this study was to evaluate the intrarater and interrater reliability of the Leg Lateral Reach Test (LLRT) to measure the mobility of the thoraco-lumbo-pelvic segment in individuals with nonspecific chronic low back and the correlations among pain intensity, kinesiophobia, and LLRT scores. METHODS: Thirty participants with nonspecific chronic low back pain were selected. The main variables were LLRT, pain intensity (measured with the Numeric Pain Rating Scale) and kinesiophobia (Tampa Scale of Kinesiophobia). The reliability of the LLRT was evaluated by means of intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change. RESULTS: Most participants were women (83.3%), young adults (mean = 30.86; standard deviation = 8.56), with overweight and nonspecific chronic low back for more than 59 months of duration. In the intrarater analysis, we observed reliability values ranging from substantial to excellent (ICC ≥ .889; SEM ≤ 7.97%). In the interrater analysis, we observed excellent reliability (ICC ≥ .947; SEM ≤ 5.62%). There was a weak and positive correlation between pain and LLRT, and no correlation between kinesiophobia and LLRT. CONCLUSION: LLRT is a reliable test to measure thoraco-lumbo-pelvic rotation in individuals with nonspecific chronic low back pain.

Reliability and Accuracy of 2-Minute Step Test in Active and Sedentary Lean Adults.

OBJECTIVE: The purpose of this study was to evaluate the intrarater and interrater reliability of the 2-minute step test (2MST) in active and sedentary lean adults and to identify the test cutoff point to differentiate active from sedentary individuals. METHODS: This observational study involved 4 mixed-sex groups (each with 50 lean participants): group 1, sedentary and aged 18 to 24 years; group 2, active and aged 18 to 24 years; group 3, sedentary and aged 25 to 44 years; and group 4, active and aged 25 to 44 years. The 2MST was administered independently by 2 examiners (with 3 months' training) at 2 different times, with a 7-day interval. Habitual physical activity was evaluated by means of the Baecke Questionnaire (BQ). In statistical analysis, the Pearson correlation coefficient was used to verify the correlation between the 2MST and BQ; intraclass correlation coefficients (ICC2,3) were used to determine the intrarater and interrater reliability of the 2MST; and the receiver operating characteristic curve was used to identify the accuracy of the 2MST. RESULTS: Excellent intrarater and interrater reliability were found for all 4 groups (intraclass correlation coefficients ≥ 0.83). Correlating the 2MST score with the BQ score, a significant, positive, weak correlation was observed (r = 0.344, P < .001). For differentiating active from sedentary individuals, the 2MST showed low accuracy (area under the curve = 0.671), with 61% sensitivity and 67% specificity. CONCLUSION: This study showed that the 2MST is a reliable test with a low amount of inherent error. There was a significant correlation between the 2MST and usual physical activity measured, and slight accuracy in differentiating active from sedentary individuals.

Phenotyping cardiopulmonary exercise testing measures in heart failure with reduced ejection fraction: A comparison between Italy and Brazil.

BACKGROUND: While patients with heart failure (HF) with reduced left ventricular ejection fraction (HFrEF) constitutes a global health crisis the incidence, prevalence and prognosis of the disease may differ depending on the continent and country. OBJECTIVE: To profile, analyze and compare cardiopulmonary exercise testing (CPET) data of patients with HFrEF between Italian and Brazilian cohorts. METHODS: In this observational study, a total of 630 patients with clinical and functional diagnosis of HFrEF (315 patients from Brazil and 315 patients from Italy) performed CPET. RESULTS: Although Brazilian patients were slightly younger (Brazil 60±10 vs Italy 64±11 p<0.001) with a better peak oxygen consumption (V̇O2), circulatory power and left ventricular ejection fraction (LVEF) (p<0.01), ventilatory inefficiency and oscillation ventilation was higher when compared to the Italian cohort. When stratifying patients with LVEF≤30 % and age≥60 years, Brazilian patients presented worse ventilatory efficiency, and lower peak V̇O2 compared to the Italian cohort. CONCLUSION: Patients with HFrEF from Brazil exhibited higher ventilatory inefficiency and a greater prevalence of oscillatory ventilation during CPET compared to patients with the same diagnosis from Italy.

The Brazilian version of the work role functioning questionnaire 2.0 with 5 items (WRFQ-5) has adequate measurement properties.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an important instrument within the context of occupational health, consisting of 27 items and 5 domains. In addition, a short version of WRFQ 2.0 with 5 items (WRFQ-5) was proposed, showing agreement with the long version. Thus, we aimed to confirm the number of factors of the WRFQ-5 short version and to verify the structural, construct, and criterion validity, reliability, internal consistency, and analysis of ceiling and floor effects of the Brazilian version of the WRFQ-5 in a general workers population. METHODS: A questionnaire validation and measurement properties study. We evaluated the internal structure of the WRFQ-5 by means of confirmatory factor analysis. Construct validity was assessed by correlating the WRFQ-5 with the Numerical Pain Rating Scale (NPRS), Work Ability Index (WAI), and Self-Estimated Functional Inability because of Pain (SEFIP-work). Criterion validity was assessed by correlating the WRFQ-5 with the 5 domains of the WRFQ 2.0. Test-retest reliability and internal consistency were also evaluated. RESULTS: We observed positive correlations (p < .05) between the WRFQ-5 and the WAI (rho = 0.161 to 0.308) and negative correlations (p < .05) between the WRFQ-5 and the SEFIP-work (rho = -0.293). The WRFQ-5 significantly and positively correlates with the 5 domains of WRFQ 2.0 (rho = 0.742 to 0.830). The test-retest reliability of the WRFQ-5 was excellent (ICC2,1 = 0.935) and the internal consistency was adequate (Cronbach's alpha = 0.938). We did not observe ceiling and floor effects. CONCLUSION: The one-dimensional internal structure of the WRFQ-5 in Brazilian Portuguese has a valid internal structure and construct, as well as adequate reliability and internal consistency.

The six-minute step test can predict COPD exacerbations: a 36-month follow-up study.

The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.

Unilateral seated shot-put test, muscle strength, and range of motion on recreational athletes with chronic shoulder pain: Cross-sectional study.

OBJECTIVE: To correlate the functional performance assessed by means of the Unilateral Seated Shot-Put Test (SSPT) with shoulder muscle strength, range of motion (ROM), and handgrip strength in recreational athletes with chronic shoulder pain. METHODS AND MATERIALS: The sample was composed of recreational athletes with nonspecific pain in the dominant shoulder ≥3 months, both sexes, aged between 18 and 45 years. We diagnosed shoulder pain by reporting pain intensity ≥3 points on the Numerical Rating Pain Scale and used the Shoulder Pain and Disability Index, Pain-Related Catastrophizing Thoughts Scale, and Baecke Questionnaire. Moreover, shoulder muscle strength, handgrip strength, ROM, and functional performance using the SSPT were evaluated. We used the Spearman correlation coefficient to investigate the correlation between the variables. RESULTS: Nineteen participants were included. Most of the sample consisted of adult women with adequate body mass and pain predominantly in the right shoulder. We observed higher correlation magnitudes of the SSPT with handgrip strength (rho = 0.818 to 0.833, p < 0.05). Correlations of the SPPT with shoulder musculature strength were of low to moderate magnitude (rho = 0.461 to 0.672, p < 0.05). The only significant correlation (p < 0.05) found was between the SSPT and ROM (horizontal adduction), however, with a weak magnitude (rho <0.50). CONCLUSION: SSPT correlates strongly with handgrip strength and moderately with shoulder muscle strength in recreational athletes with chronic shoulder pain.