There is a Lack of Clinical Homogeneity in Lower-Limb Tendinopathy Trials: A Scoping Review.

OBJECTIVE: It is unclear if clinical trials of treatments for lower-limb tendinopathies include clinically homogeneous participant populations (an assumption for pooling in meta-analyses). We assessed the recruitment setting and participant characteristics used in randomized controlled trials (RCTs) that were investigating any treatment for lower-limb tendinopathies. DESIGN: Scoping review. METHODS: We conducted a systematic literature search in the PubMed, Embase, Cochrane CENTRAL, and Web of Science databases. All RCTs that were investigating treatments for lower-limb tendinopathies in an adult population (≥18 years) were eligible for inclusion. At least 2 authors conducted independent screening and selection of full-text papers, and extracted data from included studies. RESULTS: Of 18 341 records, 342 RCTs (21 897 participants) were eligible for inclusion and data extraction. The most common diagnoses were plantar fasciopathy (n = 195, 57%), Achilles tendinopathy (n = 82, 24%), and patellar tendinopathy (n = 41, 12%). Secondary care (n = 144, 42%) was the most reported recruitment setting, followed by an open setting (n = 44, 13%). In 93 (27%) RCTs, the recruitment setting was not described. We found high heterogeneity in participant characteristics (eg, symptom duration, age, body mass index, and the Victorian Institute of Sport Assessment [VISA] questionnaire score) within and between recruitment settings. CONCLUSION: Our results question whether clinical homogeneity can be adequately assumed in clinical trials of lower-limb tendinopathies due to the lack of clear reporting of the recruitment setting and the variability within and between recruitment settings of key participant characteristics. These findings threaten assumptions for meta-analyses in lower-limb tendinopathies. J Orthop Sports Phys Ther 2024;54(1):1-10. Epub 5 December 2023. doi:10.2519/jospt.2023.11722.

Relationship between kinesiophobia, isometric hip and knee torques to pelvic, hip and knee motion during the single-leg drop jump in women with patellofemoral pain: A cross-sectional study.

BACKGROUND: Individuals with patellofemoral pain (PFP) have kinesiophobia and hip and knee strength deficits. These factors may be related to kinematic alterations of pelvic, hip and knee during a more demanding functional activity, such as jumping landing. The aim was to investigate the relationships between kinesiophobia and hip/knee torque to pelvic/hip/knee kinematics during the single-leg drop vertical jump in women with PFP. METHOD: Thirty women with PFP were assessed with Tampa Scale for Kinesiophobia; isokinetic dynamometry of the hip extensor, hip abductor, and knee extensor; and three-dimensional motion analysis system during the single-leg drop vertical jump. A Pearson correlation matrix was used to investigate relationship among variables. RESULTS: Fair correlations were found between increased kinesiophobia and increased peak hip internal rotation angle (r = 0.43; p = 0.018) as well as between greater peak knee extensor torque and greater peak knee flexion (r = 0.41; p = 0.022). Moderate to good correlation was found between increased peak hip abductor torque and increased peak contralateral pelvic drop (r = 0.52; p = 0.003). No other significant correlations were found between variables. CONCLUSIONS: Kinesiophobia is associated with hip kinematics, but not with knee kinematics, during the single-leg vertical drop jump in women with PFP. The greater hip abductor torque is associated with greater contralateral pelvic drop. The positive relationship between knee extensor torque and knee flexion indicates that rehabilitation programs involving quadriceps muscle strengthening may assist women with PFP in control knee flexion and improve load absorption during jumping landing.

Perfil epidemiológico e clínico de crianças hospitalizadas com cardiopatias congênitas / Perfil epidemiológico y clínico de niños hospitalizados con cardiopatias congénitas / Clinical and epidemiological profile of hospitalized children with congenital heart diseases

Objetivo: Descrever o perfil epidemiológico e clínico de crianças com cardiopatias congênitas admitidas entre 2018 e 2019 em um hospital de referência em Pernambuco. Métodos: Trata-se de um corte transversal envolvendo 310 crianças com cardiopatias congênitas. Foram obtidos dados epidemiológicos e clínicos em prontuários através de formulários padronizados. Houve tabulação em planilha Excel e análise estatística descritiva por meio do Software SPSS 25. Resultados: Verificou-se média de 21,69 meses de idade e predominância do sexo masculino (55,5%). Os principais fatores de risco maternos foram infecção durante a gestação (21,3%) e idade avançada (15,8%). Dentre as doenças crônicas, destacaram-se hipertensão arterial (6,1%) e diabetes mellitus (4,2%). Os predisponentes do paciente foram prematuridade (16,1%), baixo peso ao nascer (17,7%), trissomia do 21 (17,7%) e malformações extracardíacas (7,1%). Sinais e sintomas respiratórios constituíram o principal motivo de hospitalização, sendo registradas dispneia (55,8%), tosse (30,3%) e alterações de ausculta pulmonar (16,1%). Também motivou o internamento a presença de cianose (20,3%). O sopro cardíaco se apresentou na maioria dos pacientes (80,0%). Em percentual relevante dos casos, o diagnóstico ocorreu durante a hospitalização (16,8%). Conclusão: O conhecimento acerca do perfil das cardiopatias congênitas auxilia o diagnóstico, sendo necessária a ampliação do conhecimento científico nesta temática... (AU)

Objetivo: Describir el perfil epidemiológico y clínico de niños con cardiopatías congénitas ingresados entre 2018 y 2019 en un hospital de referencia de Pernambuco. Métodos: estudio transversal con 310 niños con cardiopatías congénitas. Los datos epidemiológicos y clínicos se obtuvieron de las historias clínicas mediante formularios estandarizados. Se realizó tabulación en planilla de Excel y análisis estadístico descriptivo con el Software SPSS 25. Resultados: La edad media fue 21,69 meses y predominio del sexo masculino (55,5%). Los principales factores de riesgo maternos fueron infección durante el embarazo (21,3%) y edad avanzada (15,8%). Las principales enfermedades crónicas fueron hipertensión arterial (6,1%) y diabetes mellitus (4,2%). Los predisponentes del paciente fueron prematuridad (16,1%), bajo peso al nacer (17,7%), trisomía 21 (17,7%) y malformaciones extracardiacas (7,1%). Signos y síntomas respiratorios fueron el principal motivo de hospitalización, con disnea (55,8%), tos (30,3%) y alteraciones en la auscultación pulmonar (16,1%). Cianosis (20,3%) también motivó la hospitalización. El soplo cardíaco estuvo presente en la mayoría de los pacientes (80,0%). En un porcentaje relevante de casos, el diagnóstico se produjo durante la hospitalización (16,8%). Conclusión: El conocimiento sobre el perfil de las cardiopatías congénitas ayuda al diagnóstico, siendo necesario ampliar el conocimiento científico sobre este tema... (AU)

Objective: Describe the clinical and epidemiological profile of children with congenital heart diseases admitted between 2018 and 2019 to a referencial hospital in Pernambuco. Methods: Cross-sectional study involving 310 children with congenital cardiopathy. The data was obtained in the medical charts, using standardized forms. Tabulation was made in an Excel spreadsheet and descriptive statistical analysis done through SPSS 25 Software. Results: The average age was 21,69 months and most patients were male (55,5%). The main risk factors were infection during pregnancy (21,3%) and advanced age (15,8%). Among chronic diseases, hypertension (6,1%) and diabetes mellitus (4,2%) stood out. Predisposing factors related to the patient were prematurity (16,1%), low weight at birth (17,7%), trisomy 21 (17,7%) and extracardiac malformations (7,1%). Respiratory signs and symptoms were the main cause of hospitalization, such as dyspnea (55,8%), cough (30,3%) and changes in pulmonary auscultation (16,1%). Cyanosis also motivated admission (20,3%). Most patients presented heart murmur (80%). In a significant amount of cases, the diagnosis was made during the hospital admission (16,8%). Conclusion: the awareness about the profile of congenital heart diseases helps the diagnosis, and is necessary to expand scientific knowledge on this topic... (AU)

Adding muscle power exercises to a strength training program for people with patellofemoral pain: protocol of a randomized controlled trial.

BACKGROUND: Strong evidence supports the proximal combined with quadriceps strengthening for patellofemoral pain (PFP) rehabilitation. However, most reported rehabilitation programs do not follow specific exercise prescription recommendations or do not provide adequate details for replication in clinical practice. Furthermore, people with PFP have power deficits in hip and knee muscles and it remains unknown whether the addition of power exercises would result in superior or more consistent outcomes. Therefore, this study is designed to verify whether the benefits of a rehabilitation program addressing proximal and knee muscles comprising power and strength exercises are greater than those of a program consisting of strength exercises only. METHOD: This study will be a randomized controlled trial that will be conducted at university facilities. A minimum of 74 people with PFP between the ages of 18 and 45 years will be included. The experimental group will engage in a 12-week resistance training program focusing on proximal and knee muscles using power and strength exercises. The control group will engage in a 12-week resistance training program focusing on proximal and knee muscles using strength exercises only. Primary outcomes will be pain intensity and physical function; and secondary outcomes will be kinesiophobia, self-reported improvement, quality of life, peak hip and knee torque, and hip and knee rate of force development. The primary outcomes will be evaluated at baseline, and after 6 weeks, 12 weeks, 3 months, 6 months, and 1 year. The secondary outcomes will be evaluated at baseline and immediately after the interventions. Therapists and participants will not be blinded to group allocation. DISCUSSION: This randomized clinical trial will investigate if adding power exercises to a progressive resistance training may lead to more consistent outcomes for PFP rehabilitation. The study will provide additional knowledge to support rehabilitation programs for people with PFP. TRIAL REGISTRATION: ClinicalTrials.gov NCT03985254. Registered on 26 August 2019.

Condição de saúde bucal de pacientes oncológicos / Oral health condition for oncological patients

Este estudo teve como objetivo avaliar a condição de saúde bucal de pacientes em terapia oncológica. Trata-se de um estudo observacional transversal realizado no Centro OncoHematologico de Pernambuco (CEONHPE), vinculado ao Hospital Universitário Oswaldo Cruz (HUOC), da Universidade de Pernambuco (UPE). Foram incluídos no estudo pacientes com idade entre 1 e 19 anos, de ambos os sexos, totalizando uma amostra de 177 pacientes, dentre os quais 25 realizaram o índice de placa, 111 submeteram-se ao índice de Dentes Cariados, Perdidos e Obturados (CPOD) e 129 ao índice de Dentes Decíduos Cariados, Com Extração Indicada e Obturados (ceo-d). Foi realizada coleta de dados secundários obtidos nas fichas clínicas dos pacientes que estiveram em atendimento no ano de 2018. Através da análise estatística descritiva foram consideradas as variáveis: condição de saúde bucal, idade, gênero, diagnóstico oncológico e fase atual do tratamento. Com relação às condições de saúde bucal foram avaliadas: condições de higiene oral (índice de placa de O´Leary); cárie (CPO-D e ceo-d). Verificou-se que houve predominância do índice CPO-D e ceo-d em zero e o índice de placa foi considerado insatisfatório na maioria dos pacientes. Portanto, apesar de baixo índice de cárie, foi constatado elevado índice de placa bacteriana...(AU)

This study aimed to assess the oral health condition of patients undergoing cancer therapy. This is a cross-sectional observational study carried out at the Centro OncoHematologico de Pernambuco (CEON-HPE), linked to the Hospital Universitário Oswaldo Cruz (HUOC), of the University of Pernambuco (UPE). The study included patients aged between 1 and 19 years old, of both sexes, totaling a sample of 177 patients, among whom 25 underwent the plaque index, 111 underwent the Decayed, Lost and Filled Teeth Index (CPOD) and 129 to the Decayed Deciduous Teeth Index, with Extraction Indicated and Filled (ceo-d). Secondary data were collected from the clinical records of patients who were in care in 2018. Through the descriptive statistical analysis, the variables were considered: oral health condition, age, gender, cancer diagnosis and current treatment stage. Regarding oral health conditions, the following were evaluated: oral hygiene conditions (O´Leary plaque index); caries (CPOD e ceo-d). It was found that there was a pre dominance of the CPOD index and ceo-d at zero and the plaque index was considered unsatisfactory in most patients. Therefore, despite a low rate of caries, a high rate of plaque was found... (AU)

Proprioceptive Training on Dynamic Neuromuscular Control in Fencers: A Clinical Trial.

CONTEXT: Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. OBJECTIVE: To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. DESIGN: The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. SETTING: The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. PARTICIPANTS: The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14-35 years, from a multisport club. INTERVENTIONS: The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. MAIN OUTCOME MEASURES: Dynamic neuromuscular control. RESULTS: The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. CONCLUSIONS: The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.

Effects of proprioceptive training on the incidence of ankle sprain in athletes: systematic review and meta-analysis.

OBJECTIVE:: To investigate how dynamic neuromuscular control, postural sway, joint position sense, and incidence of ankle sprain are influenced by balance training in athletes compared with the control group in randomized clinical trials. DATA SOURCES:: The search strategy included MEDLINE, Physical Therapy Evidence Database, Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Center on Health Sciences Information. Randomized controlled trials (RCTs) were published by June of 2018. METHODS:: RCTs that evaluate the effectiveness of proprioception in these outcomes: dynamic neuromuscular control, postural sway, joint position, and the incidence of ankle sprains in athletes aged between 18 and 35 years. Two reviewers independently screened the searched records, extracted the data, and assessed risk of bias. The treatment effect sizes were pooled in a meta-analysis using the RevMan 5.2 software. Internal validity was assessed through topics suggested by Cochrane Collaborations. RESULTS:: Of the 12 articles included ( n = 1817), eight were in the meta-analysis ( n = 1722). The balance training reduced the incidence of ankle sprains in 38% compared with the control group ( RR: 0.62; 95% CI: 0.43-0.90). In relation to the dynamic neuromuscular control, the training showed increase in the distance of reach in the anterior (0.62 cm, 95% CI: 0.13-1.11), posterolateral (4.22 cm, 95% CI: 1.76-6.68), and posteromedial (3.65 cm, 95% CI: 1.03-6.26) through the Star Excursion Balance test. Furthermore, training seems to improve postural sway and joint position sense. CONCLUSION:: Balance training reduces the incidence of ankle sprains and increases dynamic neuromuscular control, postural sway, and the joint position sense in athletes.

Evaluation of Perception and Care in the Sanitation of Toothbrushes / Avaliação da Percepção e Cuidados na Higienização das Escovas Dentais

As escovas dentais são contaminadas diariamente por bactérias presentes na cavidade oral ou no meio externo, por isso são consideradas depósitos de microorganismos, capazes de causar e transmitir doenças. O presente trabalho teve como objetivo avaliar o conhecimento e práticas quanto à higienização e armazenamento das escovas dentais, a fim de comparar ações executadas por grupos diferentes, e identificar falta de informações adequadas frente ao assunto. Os dados foram coletados através de questionários, em que foram avaliados três grupos experimentais: 1- Pacientes (n=50) atendidos no Sistema Único de Saúde (SUS), 2- Acadêmicos de Odontologia (n=50) do Centro Universitário Doutor Leao Sampaio e 3- Cirurgiões-dentistas (n=50) de Juazeiro do Norte, Ceará. Foi realizada análise descritiva de distribuição de frequência, Anova 1 critério e teste post hoc de Bonferroni foram os testes utilizados, adotando-se um nível de significância de 5%. Na presente pesquisa, constatou-se que o grupo dos Cirurgiões-dentistas tem maior conhecimento e praticam melhores ações quanto às práticas de higienização das escovas dentais, superior ao grupo dos Acadêmicos e esses dos Pacientes. Porém, em relação ao armazenamento, os grupos demostraram não ter conhecimento acerca do local mais adequado e da maneira ideal para armazenar suas escovas. Conclui-se que, o grupo dos Cirurgiões-dentistas realiza a maior parte das manobras aconselháveis sobre os cuidados frente a higienização das escovas dentais relacionado aos outros grupos em questão, apesar de não ter conhecimento acerca de novas tecnologias para desinfecção das escovas.(AU).

Toothbrushes are daily contaminated by bacteria in the oral cavity or outside, therefore they are considered containers for microorganisms, capable of causing and transmitting diseases. The current work aimed to evaluate the knowledge and practices regarding hygiene and storage of toothbrushes, in order to compare actions executed by different groups, and identify the lack of adequate information when facing the subject. Data were collected through a questionnaire, in which three experimental groups were evaluated: 1- patients (n=50) treated at Sistema Único de Saúde (SUS), 2- Dental students (n=50) from Centro Universitário Doutor Leão Sampaio and 3- Dental clinicians (n=50) from Juazeiro do Norte. A descriptive analysis of frequency distribution was performed, and One Way Anova and Bonfrerroni Post Hoc tests were performed, at a significance level of 5%. In the current research, it was found that the group of Dentists has a greater knowledge and practice better actions regarding the toothbrushes sanitation , higher than that of the group of Students, which was better that that of the group of Patients. However, regarding storage, the groups demonstrated to have not enough information regarding the adequate place and the ideal manner of storing their toothbrushes. It was concluded that, the group of Dentists performs the most part of recommended maneuvers regarding the care for toothbrushes hygiene compared to the other evaluated groups.(AU).

Acute effect of different time periods of passive static stretching on the hamstring flexibility.

BACKGROUND: Several factors are associated with the presence of chronic low back pain; one of them is the flexibility of the hamstring muscles that influences the posture of the pelvic spine. OBJECTIVE: Investigate the influence of two different time periods of passive static stretching on the flexibility of the hamstring. METHODS: Forty-six physiotherapy students were divided into two groups performing stretching exercises: 30 s and 60 s duration. The collections consisted of: (1) pre-test: evaluation of the flexibility of the hip and knee, using a manual goniometer by means of the following tests: Straight Leg Raise Test (SLR), Passive Hip Flexion Test (PHFT) and Modified Knee Extension Test (MKET), (2) intervention: stretching with different runtimes, (3) post-test: reappraisal of flexibility, conducted immediately after the intervention. RESULTS: Significant difference was observed intra groups, group that did stretching exercises lasting 30 seconds (G30) (SLR p = 0.000. PHFT p = 0.003 and MKET p = 0.000) and group that did stretching exercises lasting 60 seconds (G60) (SLR p = 0.000. PHFT p = 0.001 and MKET p = 0.002). Comparing the groups, no significant difference was found (SLR p = 0.307; PHFT p = 0.904; MKET p = 0.132). CONCLUSION: Thus it can be inferred that 30 seconds are sufficient for increased flexibility of young women. Therefore the time-treatment sessions can be optimized. Only the acute effect of stretching was observed; further investigation of the long-term effect is required.

Repercussões da fisioterapia na unidade de terapia intensiva neonatal / Repercussion of physiotherapy in the neonatal intensive care unit

Objetivos: O objetivo deste trabalho é avaliar o impacto e os benefícios da intervenção do fisioterapeuta no desfecho dos recém-nascidos internados na unidade de terapia intensiva neonatal (UTIN) do Hospital AgamenonMagalhães (HAM), da cidade de Recife, PE, por comparação entre os anos de 2005 e 2007, em que houve aumentodo tempo de permanência do fisioterapeuta na UTIN. Metodologia: A pesquisa foi realizada por análisede prontuários no sistema de arquivos médicos e estatísticos (Same) para adquirir informações sobre os recémnascidos (RNs) internados na UTIN no ano de 2005 e 2007. Em um total foram analisados 195 prontuários,sendo destes 110 do ano de 2005 e 85 de 2007. Os dados foram analisados por meio do programa SPSS versão13.0 para Windows e Excel 2003. Resultados: Os dados obtidos demonstram que, no ano de 2007, os RNs tinham idade gestacional e peso, ao nascimento, menores quando comparados com o ano de 2005. Não houve diferença significativa, entre os anos de 2005 e 2007, quanto ao tempo de ventilação mecânica, tempo de ventilação não invasiva e tempo de oxigenoterapia, como era de se esperar, já que os RNs de 2007 eram menores. Foi observada, no entanto, uma diminuição significativa na fração inspirada de oxigênio no ano de 2007. Conclusão: De acordocom os resultados obtidos, observa-se uma influência positiva da maior permanência do fisioterapeuta na UTIN.

OBJECTIVES: The aim of this study is to evaluate the impact and benefits of the physiotherapist intervention on the outcome of infants interned in the neonatal intensive care unit (Nicu) of Hospital Agamenon Magalhães (HAM), Recife, PE, comparing the years of 2005 and 2007, in which there was an increase of the physiotherapist's permanence at the Nicu. METHODS: Data were collected from medical record of the years 2005 and 2007, accessed at the system of medical and statistical archives (Same). A total of 195 records were found and assessed, 110 of 2005 and 85 of 2007. Statistical analysis was processed by SPSS version 13.0 for Windows and Excel 2003. RESULTS: The obtained data demonstrate that, at 2007, infants had lower gestational age and birthweight when compared to 2005. There was no significant difference, between the years 2005 and 2007, in relation to time of mechanical ventilation, time of non-invasive ventilation and time of oxygentherapy, as it would be expected, since the newborns of 2007 were smaller. It was observed a significant decrease in the oxygen inspired fraction at 2007. CONCLUSION: According to obtained results, it is observed a positive influence of the physiotherapist's longer permanence at the Nicu.