A Preterm Rat Model for Pain Studies.

This research delves into the consequences of consistent pinprick stimulation on preterm offspring to ascertain its long-term implications for pain sensitivity. The primary objective of this protocol was to investigate the impact of neonatal pinprick stimuli on the pain threshold in the later stages of life using a preterm rat model. By establishing this model, we aim to advance the research on understanding and managing early postnatal pain associated with prematurity. The findings of this study indicate that while the baseline thresholds to mechanical stimuli remained unaffected, there was a notable increase in mechanical hypersensitivity following complete Freund's adjuvant (CFA) injection in adult rats. Interestingly, compared with male rats, female rats demonstrated heightened inflammatory hypersensitivity. Notably, maternal behavior, the weight of the litters, and the growth trajectory of the offspring remained unchanged by the stimulation. The manifestation of altered nociceptive responses in adulthood after neonatal painful stimuli could be indicative of changes in sensory processing and the functioning of glucocorticoid receptors. However, further research is needed to understand the underlying mechanisms involved and to develop interventions for the consequences of prematurity and neonatal pain in adults.

Effects of repetitive pinprick stimulation on preterm offspring: Alterations in nociceptive responses and inflammatory hypersensitivity in adulthood.

INTRODUCTION: This study investigates the effects of repetitive pinprick stimulation on preterm offspring and its impact on nociceptive responses and inflammatory hypersensitivity in adulthood. OBJECTIVES: The objective is to shed light on the potential long-term consequences of neonatal pain and prematurity on sensory processing. METHODS: Term and preterm rats were subjected to repetitive pinprick (PP) stimulation or control (CC) during the neonatal period. Adult rats received CFA injection to induce inflammatory hypersensitivity, and mechanical hypersensitivity was measured. Gender differences in inflammatory hypersensitivity were also examined. Maternal behavior, litter weight, and offspring growth were monitored to assess any potential influences of the stimulation on these parameters. RESULTS: In preterm rats, the PP stimulation did not affect baseline thresholds to mechanical stimuli, but increased mechanical hypersensitivity after CFA injection in adult rats. Females exhibited greater inflammatory hypersensitivity compared to males. Maternal behavior, litter weight, and offspring growth were not influenced by the stimulation. PP stimulation during the neonatal period led to changes in nociceptive responses in adulthood, potentially altering sensory processing. CONCLUSION: PP stimulation in preterm rats during the neonatal period resulted in changes in nociceptive responses in adulthood, leading to increased inflammatory hypersensitivity. The study emphasizes how early development can significantly impact sensory processing and further highlights the potential long-term consequences of prematurity and neonatal pain on this processing.

Validation of the Brazilian version of Knowledge and Attitudes of Pain questionnaire / Validação da versão brasileira do questionário Knowledge and Attitudes of Pain

ABSTRACT BACKGROUND AND OBJECTIVES: Health professionals attitudes and beliefs about musculoskeletal pain have a negative influence on patient beliefs and outcomes. However, there is no gold standard for assessing knowledge and attitudes toward pain among these professionals. Thus, the objective of the present study was to translate, adapt and validate the Knowledge and Attitudes of Pain (KNAP) questionnaire into Brazilian Portuguese (KNAP-Br), apply the questionnaire and analyze the correlation of its results with the Neurophysiological Pain Questionnaire (NPQ). METHODS: After being translated, back-translated and adapted, the NKAP-Br was applied to 60 physical therapy and medicine students for validation. The correlation between the results obtained by multiplying the scores of the questions of the NKAP-Br instrument and the NPQ was evaluated. To assess reliability, another 200 students responded to the initial KNAP-Br (T1), performed the Pain Education Program (PEP) in one week and one week after T1, the participants received access to answer the KNAP-Br end (T2). RESULTS: Concurrent validity was assessed by the correlation between NPQ and the final KNAP-Br score. A significant correlation was found between the NPQ result (0.3 and p-value=0.0001) and the KNAP-Br score. Intragroups, 84% improved in the KNAP-Br score after studying PEP, 43.50% improved at or above the minimal detectable difference (MDD) and at or above the minimal important difference (MID). CONCLUSION: The questionnaire was translated and adapted respecting the Brazilian population cultural aspects and presented satisfactory reliability and construct validity, being considered valid for the assessment of knowledge and the interpretation of pain by health professionals.

RESUMO JUSTIFICATIVA E OBJETIVOS: As atitudes e as crenças dos profissionais de saúde sobre dor musculoesquelética têm influência negativa nas crenças e resultados dos pacientes. Entretanto, não existe um padrão ouro para avaliar o conhecimento e as atitudes relativas à dor entre esses profissionais. Dessa forma, o objetivo deste estudo foi traduzir, adaptar e validar o questionário Knowledge and Attitudes of Pain (KNAP) para a língua portuguesa brasileira (KNAP-Br), aplicar o questionário e analisar a correlação dos seus resultados com o Questionário Neurofisiológico de Dor (QND). MÉTODOS: Após ser traduzido, retrotraduzido e adaptado, o KNAP-Br foi aplicado em 60 estudantes de fisioterapia ou medicina para validação. Foi avaliada a correlação entre os resultados obtidos pela multiplicação dos escores das questões dos instrumentos KNAP-Br e QND. Para avaliação da confiabilidade, outros 200 estudantes responderam o KNAP-Br inicial (T1), realizaram em uma semana o Programa de Educação em Dor (PED) e uma semana após T1 os participantes receberam acesso para responder o KNAP-Br final (T2). RESULTADOS: A validade concorrente foi avaliada pela correlação entre QND e o escore final do KNAP-Br. Foi encontrada uma correlação significativa entre o resultado do QND (0,3 e valor de p=0,0001) e o escore do KNAP-Br. Intragrupos, 84% melhoraram no escore do KNAP-Br após estudar PED, 43,50% melhoraram igual ou acima da menor diferença detectável (MDD) e igual ou acima da diferença mínima importante (DMI). CONCLUSÃO: O questionário foi traduzido e adaptado, respeitando os aspectos culturais da população brasileira, e apresentou satisfatória confiabilidade e validade de constructo, sendo considerado válido para avaliação do conhecimento e para a interpretação da dor por profissionais de saúde.

Remote physical therapy during COVID-19 pandemic: guidelines in the Brazilian context / Atendimentos remotos em fisioterapia na pandemia por COVID-19: diretrizes no contexto brasileiro

Abstract Introduction: On March 11, 2020, Covid-19 was characterized by the World Health Organization as a pandemic. In this context, different health professional councils have adopted initiatives to use communication technologies to provide services at a distance. Specifically, for physiotherapy, the Federal Council of Physiotherapy and Occupational Therapy (COFFITO) made possible the modalities of teleconsultation, teleconsulting, and telemonitoring. Objective: This study aimed to develop guidelines for physiotherapists who provide teleservices, which will help ensure the safety and quality of their professional practice during the COVID-19 pandemic. Methods: An integrative literature review was conducted through PubMed (National Library of Medicine), Cochrane Library, Higher Education Personnel Improvement Coordination Portal - CAPES, Virtual Health Library, Google Scholar, and personal experience within the team to develop guidelines for remote physical therapy during the COVID-19 pandemic. Results: Initially, 3,298 articles were selected from all cited search bases, scaled to 2,031 after exclusion due to repetition, 78 were in compliance with the proposed study, 73 of which were excluded for not answering the guiding question; therefore, 5 articles were accepted for the final analysis and used for the elaboration of the guidelines. Conclusion: The results provide an overview of the literature and guidelines for physiotherapists to implement physiotherapy teleconsultation, as well as some of the challenges that need to be considered.

Resumo Introdução: Em 11 de março de 2020, a COVID-19 foi caracterizada pela Organização Mundial da Saúde (OMS) como uma pandemia. Nesse contexto, diferentes conselhos de classes das categorias profissionais de saúde adotaram iniciativas para o uso de tecnologias de comunicação como modalidade de prestação de serviços à distância. Especificamente para a fisioterapia, o Conselho Federal de Fisioterapia e Terapia Ocupacional (COFFITO) possibilitou o teleatendimento nas modalidades de teleconsulta, teleconsultoria e telemonitoramento. Objetivo: Elaborar diretrizes para os fisioterapeutas que prestam teleatendimento, as quais ajudarão a ampliar a segurança e qualidade da sua prática profissional no período da pandemia de COVID-19. Métodos: Realizou-se uma revisão integrativa da literatura nas bases de dados PubMed (National Library of Medicine), Cochrane Library, Portal da Coordenação de Aperfeiçoamento de Pessoal de nível Superior - CAPES, Virtual Health Library (VHL) e Google Scholar e utilizou-se a experiência pessoal dentro da equipe para propor diretrizes para o atendimento não presencial para o período da pandemia por COVID-19. Resultados: Inicialmente foram selecionados 3.298 artigos em todas as bases de buscas citadas, dimensionado para 2.031 após exclusão por repetição. Destes, 78 trabalhos apresentavam aderência ao estudo proposto, porém 73 foram excluídos por não responderem à questão orientadora; portanto, cinco artigos foram admitidos para a análise final e utilizados para a elaboração das diretrizes. Conclusão: Os resultados fornecem uma visão geral da literatura e diretrizes para os fisioterapeutas implementarem um teleatendimento em fisioterapia, bem como alguns dos desafios mais amplos que precisam ser considerados.