The Relationship between Vitamin D Levels, Injury and Muscle Function in Adolescent Dancers.

Vitamin D has been shown to benefit a diverse range of health functions including muscle function. The aim of the present study was to identify serum 25(OH)D3 levels in a sample of adolescent dancers and compare them to muscle function and injury incidence. We incorporated a cross-sectional design to study 49 pre-professional male and female dancers (17±4.44 yrs, 52.1±6.72 kg, 1.63±0.07 m) in full-time training in Bazil. Serum 25[OH]D3 was analyzed by Enzyme-linked Immunosorbent Assay; quadriceps and hamstring peak torque and muscle fatigue were measured by isokinetic dynamometer at 60 and 300° s-1. Injury type and location in the previous 6-months were determined by self-report questionnaire. Participants were categorized into 2 groups: normal or insufficient/deficient (>or<30 ng/ml 25[OH]D3). Results indicated the normal serum 25[OH]D3 group had significantly lower fatigue rates than the insufficient/deficient group (p<0.05) but not for the other muscle function parameters. Fifty-seven percent of participants reported at least 1 injury. The most common were sprains (33%) and tendinopathies (19%). Injured dancers had significantly lower peak torque at 60°/s. The link between serum 25[OH]D3 and reduced muscle fatigue resistance has not been shown before, though the underlying mechanisms aren't apparent and the link between muscular strength and injury has been previously evidenced.

Motor trajectories of preterm and full-term infants in the first year of life.

BACKGROUND: Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life. METHODS: Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used. RESULTS: An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life. CONCLUSION: During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months). CONCLUSION: Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.

Therapeutic hypothermia as a neuroprotective strategy in newborns with perinatal asphyxia-case report.

Background: Perinatal asphyxia is a public health problem and the third major cause of death among children under 5 years. Objective: Two clinical cases of newborns with perinatal asphyxia submitted to therapeutic hypothermia and the follow-up of their motor development after hospital discharge have been reported. Methods: This retrospective case report study included two newborns with hypoxic-ischemic encephalopathy due to perinatal asphyxia who received a hypothermia protocol at the neonatal intensive care unit (NICU). The two newborns and their families were followed up at the outpatient clinic and assessed using the Hammersmith Child Neurological Examination, Alberta Child Motor Scale, and Denver Developmental Screening Test-II. Results: The newborns were submitted to a 72-hour hypothermia protocol. One newborn remained for 13 days in the NICU, while the other remained for 22 days. According to the multidisciplinary team, both cases presented with typical motor development with no cerebral palsy during the follow-up. Conclusion: Both cases showed positive results and a good prognostic for motor development. Therapeutic hypothermia may be a strategy to prevent neurologic sequelae in newborns with perinatal asphyxia, including cerebral palsy.

Gentle Touch and Sucrose for Pain Relief during Suctioning in Preterm Newborns-A Randomized Clinical Trial.

Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose.

High-Risk Preterm Infant Born to a Mother With COVID-19: A Case Report.

The COVID-19 pandemic raises concerns about risks for pregnant women and fetuses, considering factors such as vertical transmission and neonatal alterations caused by maternal infection. Despite this, neuropsychomotor and functional complications in infants delivered by mothers with COVID-19 are still little studied. Thus, we aimed to describe the health history and development based on ICF (International Classification of Functioning, Disability and Health) components of a high-risk preterm infant born to a mother hospitalized due to COVID-19 complications. This case report was based on medical records, developmental assessments, and maternal reports. The infant was born at 30 weeks and 3 days, weighing 1,300 g, measuring 40 cm, and with Apgar scores of 2, 5, 6, and 7. COVID-19 test was negative 1 and 72 h after birth. Moreover, the infant had cardiorespiratory complications and hyperechogenicity of the periventricular white matter. The infant presented speech and language delays during follow-up, but neuromotor development occurred according to age. The health care and follow-up provided helped the development of resilience mechanisms by the infant and family to overcome adversities in the prenatal, perinatal, and neonatal periods. The assessments based on ICF components can contribute to future studies on this topic.

[Assessment of preterm children's early development]. / Avaliação do desenvolvimento inicial de crianças nascidas pré-termo.

Preterm birth is an event that affects the child's healthy development. Several studies have addressed the evaluation of children born preterm and the influence that multiple risk factors have on the course of their development. This study performed a systematic review of the literature from 2000 to 2005 about the evaluation of the development of children born preterm until the age of 24 months. The biological risk factors were present in every study, with highlights on intraventricular hemorrhage, necrotizing enterocolitis, chronic pulmonary disease, and retardation of intrauterine development as the most studied risks. The child's motor development was the most studied area. In terms of age, the first evaluations focused on the first six months of life. Neonatal risk, low birth weight, baby boys, cerebral injuries, and first-week abnormal spontaneous movements were predicting factors of preterm child development at the age of two years.

Late preterm infants' motor development until term age.

OBJECTIVES:: To analyze the motor development of late preterm newborn infants (LPI) from birth to term-corrected age using the Test of Infant Motor Performance (TIMP) and to compare the obtained results with those of term infants at birth. METHODS:: Prospective cohort study, 29 late preterm newborn infants were evaluated by the TIMP at birth and every two weeks until term-corrected age. The TIMP was administered to 88 term infants at birth. RESULTS:: The mean TIMP score of late preterm newborn infants was 51.9±5.8 at 34-35 weeks and 62.6±5.2 at 40 weeks. There was a significant increase at 38-39 weeks in the LPI group (p<0.05). There were no significant differences in the motor evaluations between term infants at birth and LPI at the equivalent age. CONCLUSION:: The LPI presented a gradual progression of motor development until the term-corrected age, but differences with term infants at birth were not detected.

CONCURRENT VALIDITY OF THE BRUNET-LÉZINE SCALE WITH THE BAYLEY SCALE FOR ASSESSMENT OF THE DEVELOPMENT OF PRETERM INFANTS UP TO TWO YEARS. / VALIDADE CONCORRENTE DA ESCALA BRUNET-LÉZINE COM A ESCALA BAYLEY PARA AVALIAÇÃO DO DESENVOLVIMENTO DE BEBÊS PRÉ-TERMO ATÉ DOIS ANOS.

OBJECTIVE: To verify the correlation between the areas evaluated by the Brunet-Lézine and the Bayley III scales of preterm infants up to two years. METHODS: The study included 88 children who were divided into 3 groups: Group 1 (1 month to 5 months and 29 days of corrected chronological ages - CCA) with 32 children; Group 2 (6 months to 11 months and 29 days of CCA) with 36 participants; and Group 3 (18 -23 months and 23 days of CCA) with 20 children. The concurrent validity of the Brunet-Lézine scale and the Bayley III scale was calculated using the Pearson correlation or its non-parametric version, the Spearman correlation. RESULTS: Group 1 showed moderate correlation between the developmental quotient for hand-eye and fine motor coordination (DQE), and fine motor score (ρ=0.448; p=0.01). Group 2 had moderate correlation between the developmental quotient for posture and gross motor function (DQP), and the gross motor score (ρ=0.484; p=0.003, between the DQE and fine motor score (r=0.489; p=0.002), and between the developmental quotient for social reactions (DQS) and the socio emotional score (r=0.435; p=0.008). Group 3 showed moderate correlation between the DQP and the gross motor score (ρ=0.468; p=0.037) and strong correlation between developmental quotient for language (DQL) and the score of language (r=0.890; p<0.001). CONCLUSIONS: The Brunet-Lézine scale showed strong correlation with the Bayley III scale regarding the language domain in Group 3, suggesting its validity to assess the language of children aged between 18 and 24 months.

OBJETIVO: Verificar a correlação entre as áreas avaliadas pela Escala Brunet-Lézine e pela Escala Bayley III no desenvolvimento de bebês pré-termo de risco até dois anos de idade. MÉTODOS: Foram incluídas no estudo 88 crianças, divididas em 3 grupos: Grupo 1 (1 mês a 5 meses e 29 dias de idade cronológica corrigida - ICC), com 32 crianças; Grupo 2 (6 meses a 11 meses e 29 dias de ICC), com 36 participantes; e Grupo 3 (18 meses a 23 meses e 23 dias de ICC), com 20 crianças. A validade concorrente entre a Escala Brunet-Lézine e a Escala Bayley III foi calculada por meio da correlação de Pearson ou de sua versão não paramétrica, a correlação de Spearman. RESULTADOS: No Grupo 1 houve correlação moderada entre o quociente de desenvolvimento da coordenação óculo-motriz (QDC) e o escore motor fino (ρ=0,448; p=0,01). No Grupo 2 foi encontrada correlação moderada entre o quociente de desenvolvimento da postura (QDP) e o escore motor grosseiro (ρ=0,484; p=0,003), entre o QDC e o escore motor fino (r=0,489; p=0,002) e entre o quociente de desenvolvimento de sociabilidade (QDS) e o escore socioemocional (r=0,435; p=0,008). No Grupo 3 foi observada correlação moderada entre o QDP e o escore motor grosseiro (ρ=0,468; p=0,037), e correlação forte entre o quociente de desenvolvimento da linguagem (QDL) e o escore da linguagem (r=0,890; p<0,001). CONCLUSÕES: A Escala Brunet-Lézine apresentou forte correlação com a Escala Bayley III quanto à linguagem no Grupo 3, o que sugere a sua validade para avaliar crianças entre 18 e 24 meses de idade nesse quesito.

Reliability and internal consistency in the assessment of neonatal pain in preterm infants during tracheal aspiration: prospective study / Confiabilidade e consistência interna na avaliação da dor neonatal de prematuros durante o procedimento de aspiração traqueal: estudo prospectivo

ABSTRACT BACKGROUND AND OBJECTIVES: Inadequate pain assessment in preterm infants (PI) is a persistent problem. Currently, a precise pain assessment is one of the main challenges for health professionals in the intensive care units (NICU). The objective of this study was to verify the correlation between the Neonatal Infant Pain Scale (NIPS) and Premature Infant Pain Prole - Revised (PIPP-R), internal consistency, and inter-evaluator reliability on pain assessment during aspiration in PI. METHODS: Prospective observational study with low birth weight PI (< 2500 g), hemodynamically stable, minimal or no sedation, under mechanical ventilation, continuous positive airway pressure, nasal cannula oxygen, or ambient air, and needing aspiration during hospitalization in the neonatal intensive care unit in the period from 2019 to 2020.. PI were evaluated during three different aspiration procedures: without intervention (1), using gentle touch (2), and using sucrose (3). NIPS and PIPP-R instruments were applied, while internal consistency was determined using Cronbach's alpha, reliability using the intraclass correlation coefficient, and concurrent validity using Spearman's correlation coefficient. RESULTS: Fifty PIs requiring tracheal aspiration were evaluated. NIPS and PIPP-R showed high (Cronbach α: 0.824) and moderate (Cronbach α: 0.655) internal consistency. Inter-e- valuation reliability was excellent in all aspiration procedures for NIPS (1: 0.991, 2: 0.987, and 3: 0.993) and PIPP-R (1: 0.997, 2: 0.986, and 3: 0.977). Concurrent validity was observed only for aspiration without intervention. CONCLUSION: Although NIPS may have better clinical utility than PIPP-R, both instruments presented good internal consistency and inter-evaluator reliability and may be used for assessing pain during aspiration in PI.

RESUMO JUSTIFICATIVA E OBJETIVOS: A avaliação inadequada da dor em recém-nascidos prematuros (RNPT) é um problema persistente. A avaliação precisa da dor é um dos principais desafios para profissionais de saúde nas Unidades de Terapia Intensiva Neonatais (UTIN). O objetivo deste estudo foi verificar a associação entre a Escala de Dor Neonatal (Neonatal Infant Pain Scale - NIPS) e o Perfil da Dor do Bebê Prematuro - Revisado (Premature Infant Pain Profile Revised - PIPP-R), assim como a consistência interna e a confiabilidade inter-avaliadores na aferição da dor durante a aspiração do RNPT. MÉTODOS: Estudo transversal prospectivo com RNPT de baixo peso ao nascer (<2500 g), hemodinamicamente estáveis, com mínima ou nenhuma sedação, sob ventilação mecânica, apresentando pressão positiva contínua nas vias aéreas, oxigênio na cânula nasal ou ar ambiente, e precisando de aspiração durante a internação na UTIN no período de 2019 a 2020. Os RNPT foram avaliados durante três diferentes procedimentos de aspiração: sem intervenção (1), toque gentil (2) e administração de sacarose (3). Os instrumentos NIPS e PIPP-R foram aplicados durante a avaliação. A consistência interna foi determinada pelo alfa de Cronbach, a confiabilidade pelo coeficiente de associação intraclasse e a validade concorrente pelo teste de associação de Spearman. RESULTADOS: Foram avaliados 50 RNPT que necessitaram de aspiração traqueal. A NIPS e a PIPP-R mostraram consistência interna alta (Cronbach α: 0,824) e moderada (Cronbach α: 0,655), respectivamente. A confiabilidade inter-avaliadores foi excelente em todos os procedimentos de aspiração para NIPS (1: 0,991, 2: 0,987 e 3: 0,993) e PIPP-R (1: 0,997, 2: 0,986, e 3: 0,977). A validade concorrente foi observada apenas para aspiração sem intervenção. CONCLUSÃO: Embora a NIPS possa ter melhor utilidade clínica do que o PIPP-R, ambos os instrumentos apresentaram boa consistência interna e confiabilidade inter-avaliadores, e podem ser usados para avaliar a dor durante a aspiração em RNPT.

Fatores associados à satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade / Factors associated with satisfaction and distortion of body image among children from 7 to 10 years of age

RESUMO O objetivo deste estudo é analisar a satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade e verificar quais fatores antropométricos e socioeconômicos estão associados a elas. Trata-se de um estudo transversal, realizado com 307 crianças de escolas públicas de Goiânia. A saúde da criança e os aspectos socioeconômicos da família foram avaliados por meio de um questionário semiestruturado; a imagem corporal foi avaliada por meio da Escala de Silhuetas Brasileiras Para Crianças; e também foram coletados dados antropométricos de peso, estatura, dobras cutâneas e circunferência da cintura. Observou-se homogeneidade do gênero neste estudo, predomínio de meninos (52%) eutróficos (73%). Apesar de se tratar de uma amostra com peso saudável, a insatisfação e a distorção da imagem corporal prevaleceram sobre a maior parte da amostra: a insatisfação esteve presente em 92% das crianças, prevalecendo o desejo por uma menor silhueta, enquanto a distorção esteve presente em 75% da amostra, com predomínio da subestimação da silhueta. No entanto, este estudo encontrou associação da insatisfação com a imagem corporal apenas com IMC (aferido, atual e desejado) e circunferência da cintura; e associação da distorção da imagem corporal apenas com os IMC (aferido e atual).

ABSTRACT The aim of this study is to analyze the satisfaction and distortion of body image in children from 7 to 10 years old and to verify which anthropometric and socioeconomic factors are associated with them. This is a cross-sectional study, carried out with 307 children from public schools in Goiânia. The child's health and the socioeconomic aspects of the family were assessed using a semi-structured questionnaire; body image was assessed using the Brazilian Silhouettes Scale for Children; and anthropometric data on weight, height, skinfolds and waist circumference were also collected. Gender homogeneity was observed in this study, with a predominance of eutrophic(73%) boys (52%). Despite being a sample with a healthy weight, dissatisfaction and distortion of body image prevailed over most of the sample: dissatisfaction was present in 92% of children, the desire for a smaller silhouette prevailing, while distortion was present in 75% of the sample, with a predominance of underestimation of the silhouette. However, this study found dissatisfaction association with body image only with BMI (measured, current and desired) and waist circumference; and association of the distortion of the body image only with the BMI (measured and current).

The postural control of Brazilian children aged 6 to 9 years using a smartphone is similar to their posture with eyes closed / The postural control of Brazilian children aged 6 to 9 years using a smartphone is similar to their posture with eyes closed

INTRODUCTION: Electronic devices have been used by increasingly younger people, leading researchers to investigate the impact of these technologies on the health of developing childrenOBJECTIVE: To investigate the impact of smartphone use on the postural control of Brazilian children 6 to 9 years oldMETHODS: This cross-sectional study was conducted with 278 children from public schools in Goiânia (Goiás, Brazil). The children were assessed in an orthostatic posture with the computerized baropodometry system in three conditions: eyes open, eyes closed, and using a free smartphone applicationRESULTS: The children were 8.36 years old on average, 82% of them were well-nourished, and had a daily mean screen time of 2 hours. The postural control analyses revealed that the children made greater postural adjustments with their eyes closed than with them open. When using the smartphone application, the postural adjustments were similar to those with eyes closed. In the stabilometry, the postural displacements made by the children behaved similarly to the static assessment only in total feet surface areaCONCLUSION: Smartphone use and absence of visual stimulus in the orthostatic position caused postural instability in children 6 to 9 years old. These findings can contribute to understanding the impact of technologies on children's development of balance in daily tasks

INTRODUÇÃO: O uso de dispositivos eletrônicos móveis tem alcançado usuários cada vez mais jovens e tem levado pesquisadores a investigar o impacto dessas tecnologias na saúde da criança em desenvolvimentoOBJETIVO: Investigar o impacto do uso do smartphone no controle postural de crianças brasileiras de 6 a 9 anos de idadeMÉTODO: Estudo transversal realizado com 278 crianças de escolas públicas de Goiânia (GO, Brasil). As crianças foram avaliadas na postura ortostática pelo sistema de baropodometria computadorizada em três condições: olhos abertos, olhos fechados e manuseando um aplicativo gratuito para smartphoneRESULTADOS: As crianças tinham idade média de 8,36 anos, sendo 82% de eutróficas e com tempo médio de tela de duas horas diárias. As análises do controle postural revelaram que as crianças apresentaram maiores ajustes posturais com os olhos fechados em comparação com os olhos abertos e ao usar o aplicativo do smartphone o ajuste postural foi semelhante ao encontrado com olhos fechados. Na estabilometria, os deslocamentos posturais realizados pelas crianças se comportaram de modo semelhante à avaliação estática apenas na área total da superfície dos pésCONCLUSÃO: O uso do smartphone e a ausência do estímulo visual na posição ortostática promoveram instabilidade postural nas crianças de 6 a 9 anos de idade. Estes achados podem contribuir para o conhecimento do impacto de tecnologias no desenvolvimento do equilíbrio de crianças em atividades diárias

Influência do estímulo visual e posição dos membros superiores no controle postural ortostático de crianças e adolescentes / Influence of visual stimulus and upper limbs' position in the orthostatic postural control of children and adolescents

O objetivo do estudo foi verificar a influência do estímulo visual e posicionamento dos membros superiores no controle postural ortostático e avaliar o efeito do sexo e idade nas respostas posturais de crianças e adolescentes. Estudo transversal, com amostra de 84 participantes com idade entre 11 e 14 anos, ambos os sexos (55 meninas), de escola pública de Goiânia (GO). Além do exame físico, o controle postural foi avaliado na posição ortostática pela baropodometria computadorizada em três condições: olhos abertos, olhos fechados e olhos abertos com ombros a 90° de abdução. A ausência do estímulo visual gerou maior instabilidade postural em comparação à condição de olhos abertos. Em relação as diferenças existentes entre os sexos, foi observado que as meninas tiveram menores valores de deslocamento anteroposterior e área da elipse que os meninos. Comparando-se os olhos abertos e fechados, as meninas apresentaram maiores valores na área da elipse e os meninos nos deslocamentos anteroposterior e látero-lateral. Ao analisar o efeito da idade foi observado que o grupo com 13 e 14 anos apresentou maiores valores em todas as variáveis analisadas. A ausência do estímulo visual aumentou os valores da área da elipse no grupo com 11 e 12 e dos deslocamentos no grupo com 13 e 14 anos. Não foi verificado efeito interativo entre sexo e idade. Na condição de abdução dos membros superiores não houve diferença no controle postural. Conclui-se que a ausência do estímulo visual foi mais impactante na manutenção do controle postural ortostático em crianças e adolescentes em relação as outras condições avaliadas, existindo diferença entre os sexos e a idade, em que os meninos e o grupo com 13 e 14 anos realizaram mais ajustes para manter o controle postural. (AU)

The aim of this study was to verify the influence of visual stimulus and positioning of the upper limbs in the orthostatic postural control, and to assess the effects of gender and age in the postural responses of children and adolescents. This was a transversal study involving 84 participants (of which 55 were girls) from public schools in Goiania (GO - Brazil) with age between 11 and 14 years. Besides physical examination, the participants' postural control was assessed in the orthostatic position by computerized baropodometry in three different conditions: eyes-open, eyes-closed, and eyes-open with shoulders at 90º abduction. The absence of visual stimulus generated more postural instability in relation to the eyes-open condition. Regarding gender differences, the girls had lower anteroposterior and ellipse area displacement than boys. Comparing the eyes-open and eyes-closed conditions, the girls presented higher values in the ellipse area and the boys presented higher values in the anteroposterior and laterolateral displacements. Analyzing the effect of age, the participants between 13 and 14 years old presented higher values in all variables. The absence of visual stimulus increased the values of the ellipse area in the participants between 11 and 12 years of age and the values of displacements in the participants between 13 and 14 years of age. Interactive effect between genders and age has not been verified. There were no postural control differences in the upper limbs abduction condition. Conclusion: The absence of visual stimulus was more impacting in the support of orthostatic postural control in children and adolescents than the other conditions assessed; the boys and the participants between 13 and 14 years of age made more adjustments in order to maintain postural control. (AU)

Intra- and inter-rater reliability in the assessment and classification of the longitudinal plantar arch of children 6 to 10 years of age

Abstract Aims: This study aimed to analyze the intra- and inter-rater reliability in the assessment and classification of the longitudinal plantar arch of children from 6 to 10 years old in the eyes-open (EO) testing condition. Methods: A total of two-hundred and seventy-eight Brazilian children (556 feet), boys and girls, from 6 to 10 years of age participated in the study. The children's feet were examined on a baropodometric platform, and the Staheli index was used for calculating the plantar arch index. Footprint analyses were performed at two different times, with an interval of 7 to 10 days, by three physical therapists in a single testing condition, resulting in 3,336 footprints. To determine the reliability of the continuous measurements, the Intraclass Correlation Coefficients (ICC) with 95% confidence intervals (CIs), Standard error of the mean (SEM), absolute value and percentage, and the Minimum Detectable Change (MDC) were calculated. To determine the reliability of the longitudinal arch classification, inter-rater reliability was evaluated by Weighted Fleiss Kappa Coefficient and the test-retest reliability was estimated by Weighted Cohen Kappa Coefficient. Results: Regarding inter-rater reliability, we observed values of ICC ranging from 0.79 to 0.96; thus, the results were classified as substantial to excellent reliability), being the lowest ICC values occur for line B, mainly in the first assessments. SEM ranges from 0.08 to 0.21 (percentage: 3.74 to 28.7), being the best, the lowest SEM values occur for Plantar Arch Index assessments and the MDC varies between 0.22 and 0.59. Regarding intra-rater reliability, the results indicated excellent reliability: values of ICC range from 0.92 to 0.99, being the lowest ICC values also occurs for line B analysis. SEM ranges from 0.03 to 0.20 (percentage: 2.32 to 26.6), being the lowest SEM values occur for Plantar Arch Index assessments and MDC varies between 0.09 and 0.54. Analyzing the inter-rater reliability for the longitudinal arch classifications, we observed values of Weighted Fleiss Kappa Coefficient ranging from 0.83 to 0.87, expressing almost perfect agreement among the raters before and after evaluations. The test-retest reliability of the longitudinal arch classification resulted in values of Weighted Cohen Kappa Coefficient ranging from 0.80 to 0.996, expressing substantial to almost perfect agreement intra-rater. Conclusion: The study showed high reliability in the clinical assessment of the longitudinal plantar arch index of children from 6 to 10 years of age indicating that the Staheli method is applicable to pressure platform assessments with intra- and inter-rate reliability.

Perfil de formação e produção científica do fisioterapeuta pesquisador no Brasil / Perfil formativo y producción científica del fisioterapeuta investigador en Brasil / Profile of scientific academic background and production of researcher physical therapists in Brazil

RESUMO O objetivo deste estudo foi avaliar o perfil de formação e produção científica do fisioterapeuta pesquisador brasileiro. Trata-se de um estudo transversal, realizado por meio de levantamento dos currículos profissionais cadastrados na Plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), atualizados nos últimos 5 anos. As principais variáveis analisadas foram sexo, distribuição dos fisioterapeutas pelo Brasil, tipo de instituição de graduação, local de atuação, formação complementar, produções científicas e participação em eventos. Foram encontrados 47.741 currículos, dos quais 17.864 estavam dentro dos critérios de seleção da pesquisa e foram analisados. Predominaram fisioterapeutas do sexo feminino (75,5%) e da região Sudeste (35%). A maioria é graduada em instituições privadas (75%), realizou pós-graduação lato sensu (61,4%) e trabalhou em universidades (30%). Existem diferenças entre os sexos com relação às produções, os eventos e a formação complementar, com o melhor desempenho do sexo masculino (p<0,001) - os graduados em instituição pública têm mais produções, eventos e atividades de formação complementar (p<0,001). Os profissionais graduados em instituições privadas, porém, realizam mais cursos de pós-graduação lato sensu (p=0,05). Conclui-se, portanto, que a maioria dos fisioterapeutas pesquisadores do Brasil é do sexo feminino, graduada na região Sudeste, formada em instituições privadas, realizou pós-graduação lato sensu e trabalha em universidades. Apesar da maioria feminina, os profissionais do sexo masculino e os formados em instituições públicas apresentam maior quantidade de produções, participações em eventos e formações complementares.

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ABSTRACT To evaluate the academic background and scientific productions' profile of researcher physiotherapists in Brazil. The study was cross-sectional in design and performed by analyzing the professional resumes that have been updated within the last 5 years in the Lattes Platform of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The main variables analyzed were sex, geographical distribution, kind of undergraduate institution, working location, complementary training, scientific production, and participation in events. The analysis was carried out on 17,864 curricula which were within the selection criteria, out of a total of 47,741. There was a predominance of female therapists (75.5%) and therapists from the southeast region (35%). Most have completed their undergraduate degree in private institutions (75%) and graduate programs (61.4%), and work at universities (30%). Males perform better (p<0.001) in scientific productions, participation in events, and complementary training activities. Graduates from public institutions have more scientific productions, events, and complementary training activities (p<0.001). However, professionals that have completed their undergraduate degree in private institutions do graduate programs the most (p=0.05). Most researcher physical therapists in Brazil are females, have completed their undergraduate degrees in the Southeast region and in private institutions, have completed graduate programs and work in universities. Despite the female predominance, male professionals and those therapists who have completed their undergraduate degree from public institutions have a greater amount of scientific productions, participation in events and complementary degrees.

Association between diabetes and vestibular dysfunction: an integrative review / Associação entre diabetes e disfunções do sistema vestibular: revisão integrativa

ABSTRACT Purpose: to identify, in the literature, the factors associated with the development of vestibular dysfunctions in individuals with type 2 diabetes mellitus (DM2). Methods: an integrative review of the literature, whose survey was conducted in the databases ISI, SciELO, LILACS and PubMed, using the following descriptors: "type 2 diabetes mellitus", "vertigo", "dizziness", and "vestibular diseases". Articles published in the last 10 years that answered the research question ("What factors are associated with the development of vestibular disorders in individuals with DM2?") were included in the study. Results: the search returned 426 articles, 10 of which met the eligibility criteria. Most of the participants of the selected studies who had vestibular dysfunctions were women over 40 years old and had more than one comorbidity related to DM2, the main one being the systemic arterial hypertension (SAH). According to the literature, the physiology of the inner ear allows small glucose alterations to influence its normal functioning, which makes diabetic individuals more susceptible to developing vestibular dysfunctions. Conclusion: according to this study, DM2 can trigger or contribute to the manifestation of vestibular dysfunction, whose main associated factors are advanced age, female gender, and various comorbidities, as dyslipidemia, SAH and metabolic syndrome.

RESUMO Objetivo: identificar na literatura os fatores que estão associados ao desenvolvimento de disfunções vestibulares em indivíduos com diabetes mellitus tipo 2 (DM2). Métodos: trata-se de uma revisão integrativa da literatura, cuja busca foi realizada nas bases de dados ISI, Scielo, LILACS e PubMed, sendo utilizados os descritores: "type 2 diabetes mellitus", "vertigo", "dizziness" e "vestibular diseases". Foram incluídos artigos publicados nos últimos dez anos e que respondessem a seguinte questão: quais fatores estão associados ao desenvolvimento de disfunções vestibulares em indivíduos com DM2? Resultados: a busca resultou em 426 artigos, sendo que 10 atenderam aos critérios de elegibilidade. A maioria dos participantes dos estudos selecionados que apresentaram disfunções vestibulares eram do sexo feminino, idade superior a 40 anos e possuíam mais de uma comorbidade associada a DM2, sendo a principal, a hipertensão arterial sistêmica (HAS). De acordo com a literatura, a fisiologia da orelha interna permite que pequenas alterações de glicose influenciem seu funcionamento normal, o que torna os indivíduos diabéticos mais suscetíveis a desenvolverem disfunções vestibulares. Conclusão: o presente estudo constatou que a DM2 pode desencadear ou contribuir para a manifestação da disfunção vestibular, tendo como principais fatores associados a idade avançada, o sexo feminino e comorbidades diversas, tais como dislipidemia, HAS e síndrome metabólica.

Distorção da imagem corporal em bailarinas jovens / Body image distortion in young dancers / Distorción de imagen corporal en balerina joven

O objetivo do estudo foi analisar a imagem corporal de bailari- nas jovens e relacionar com suas medidas antropométricas. Um objetivo secundário foi comparar as medidas antropométricas aferidas e referi- das pelas bailarinas. O estudo teve delineamento transversal com uma amostra de 33 bailarinas entre 13 e 17 anos de idade. Foram coletados dados biossocioeconômicos, e a imagem corporal foi avaliada através do Body Shape Questionnaire (BSQ), para determinar a sua distorção e preo- cupação. Os resultados mostraram que a maioria das bailarinas apre- sentou distorção da imagem corporal, no entanto, houve baixa preva- lência de preocupação com a imagem corporal. Além disso, as bailarinas subestimam seu índice de massa corporal em relação à medida aferida pelos pesquisadores.

The aim of the study was to analyze body image and relate it to anthropometric measurements of young dancers. The secondary objective was to compare the anthropometric measures measured and reported by the dancers. The study had a cross-sectional design with a sample of 33 dancers between 13 and 17 years of age. Socioeconomic data were collected, and body image was assessed using the Body Shape Questionnaire (BSQ) to determine distortion and concern with body image. The results showed that most dancers presented distortion of body image, however there was a low prevalence of concern with body image. In addition, the dancers underestimate their body mass index in relation to the measurement measured by the researchers.

El objetivo del estudio fue analizar la imagen corporal y relacionarla con mediciones antropométricas de jóvenes bailarines. El objetivo secundario fue comparar las medidas antropométricas medidas e informadas por los bailarines. El estudio tuvo un diseño transversal con una muestra de 33 bailarines entre 13 y 17 años. Se recogieron datos biosocioeconómicos y se evaluó la imagen corporal utilizando el cuestionario de forma corporal (BSQ) para determinar la distorsión y la preocupación por la imagen corporal. Los resultados mostraron que la mayoría de los bailarines presentaron distorsión de la imagen corporal, sin embargo, hubo una baja prevalencia de preocupación con la imagen corporal. Además, los bailarines subestiman su índice de masa corporal en relación con la medición medida por los investigadores.

Brazilian Girls Who Practice Classical Ballet Develop Different Motor Strategies Regarding Postural Stability / Meninas Brasileiras que Praticam Balé Clássico Desenvolvem Diferentes Estratégias de Controle Postural

INTRODUCTION: The growth and development of children is a product of the interaction of biological and environmental factors. Dance practice can optimize various aspects of motor control, coordination and balance in childhood and adolescenceOBJECTIVE: The objective of the present study was to verify how the practice of classical ballet, at a professional level, can influence the plantar pressures and balance of children and adolescents, as well as to verify if subjects' vision and posture of the upper limbs can interfere in this resultMETHODS: Cross-sectional study performed with 111 girls aged 10 to 15 years who practice classical ballet (n = 56) and non-dancers (n = 55). Anthropometry (BMI), plantar pressures and postural stability (baropodometry platform) were assessed. Three different conditions: eyes open (EO), eyes closed (EC) and arms outstretched (AO) were observed. Data analysis performed by using group comparison and correlation testsRESULTS: Those who practiced classical ballet placed less weight onto the left forefoot, presented lower values of maximum pressure and plantar surface area in all the evaluated conditions and moved less in the stabilometry analysis. It also observed that ballet dancers were more influenced by vision and positioning of the upper limbs than the group of non-dancers. Length of time as a dancer influenced the results foundCONCLUSIONS: Girls who practice classical ballet have specific characteristics of plantar pressure and develop different postural control strategies when compared to typical girls of similar age, especially in the arms outstretch position

INTRODUÇÃO: O crescimento e o desenvolvimento de crianças é produto da interação de fatores biológicos e ambientais. A prática de dança pode otimizar vários aspectos do controle motor, da coordenação e do equilíbrio na infância e adolescênciaOBJETIVO: O objetivo do presente estudo foi verificar como a prática do balé clássico, em nível profissional, pode influenciar as pressões plantares e o controle postural de crianças e adolescentes, assim como verificar se a visão e a posição dos membros superiores pode interferir neste resultadoMÉTODO: Estudo transversal desenvolvido com 111 meninas com idades entre 10 e 15 anos praticantes (n = 56) e não praticantes (n = 55) de balé clássico. Foram avaliados os dados antropométricos (IMC), as pressões plantares e a estabilidade postural (baropodometria). Três diferentes condições: olhos abertos (OA), olhos fechados (OF) e braços abertos (BA) foram observadas. A análise de dados foi realizada por meio da comparação de grupos e testes de correlaçãoRESULTADOS: As praticantes de balé clássico realizaram menor descarga de peso em antepé E, apresentaram menores valores de pressão máxima e área de superfície plantar em todas as condições avaliadas e tiveram menores deslocamentos posturais. Observou-se ainda que as bailarinas foram mais influenciadas pela visão e posicionamento dos membros superiores do que o grupo das não praticantes de balé, e que o tempo de dança interferiu de forma a modificar os resultados encontradosCONCLUSÃO: Meninas que praticam balé classico têm características específicas de pressão plantar e desenvolvem diferentes estratégias de controle postural quando comparadas a meninas típicas da mesma idade, principalmente na posição de braços abertos

Comparação entre instrumentos de avaliação do equilíbrio em mulheres adultas e idosas da comunidade / Comparison between balance assessment instruments for adult and elderly women in the community

Objetivo: Comparar dois instrumentos de avaliação do equilíbrio, BESTest e Baropodometria, em mulheres da comunidade e verificar a influência da idade, comorbidades e visão no equilíbrio. Método: Estudo tranversal, analítico, realizado com mulheres adultas (50 a 64 anos) e idosas (a partir dos 65 anos). O equilíbrio foi avaliado por uma plataforma baropodométrica e com o Balance Evaluation Systems Test (BESTest). Aplicou-se teste T, Anova, Bonferroni e Regressão Linear utilizando o Software SPSS 23.0, adotando-se p<0,05. Resultados: Participaram 156 mulheres sendo 54 adultas (59 anos ± 3,93) e 102 idosas (71 anos ± 4,8). O BESTest verificou que as mulheres adultas apresentaram melhor desempenho (p<0,01) em relação à idosas nas categorias restrições biomecânicas, transições e antecipações, orientação sensorial, estabilidade de marcha e escore total. Houve relação entre o BESTest e o autorrelato de doenças no grupo de idosas nas categorias restrições biomecânicas, transições/antecipações e escore total (p<0,01). A baropodometria identificou alteração do deslocamento latero-lateral com olhos fechados entre os grupos (p=0,01), sendo que, as idosas apresentaram pior desempenho. Todavia, as ferramentas supracitadas apresentaram pouca relação entre si, tendo sua associação variando entre 5 e 11%. Conclusão: O BESTest e a baropometria foram capazes de detectar diferenças entre o equilíbrio de mulheres adultas e idosas, porém apresentam baixa associação entre si. Sugere-se que sejam adotadas como avaliações complementares e não substituíveis na prática clínica do fisioterapeuta.

Objective: To compare two balance assessment instruments, BESTest and Baropodometry, in community women and to verify the influence of age, comorbidities and vision on balance. Method: Cross-sectional, analytical study conducted with adult women (50 to 64 years old) and elderly women (65 years old and older). Balance was assessed by a baropodometric platform and the Balance Evaluation Systems Test (BESTest). T test, Anova, Bonferroni and Linear Regression were applied using the SPSS 23.0 software, adopting p <0.05. Results: 156 women participated in the study, 54 adults (59 years ± 3.93) and 102 elderly women (71 years ± 4.8). BESTest found that adult women performed better (p <0.01) than older women in the categories biomechanical restrictions, transitions and anticipations, sensory orientation, gait stability and total score. There was a relationship between BESTest and disease self-report in the elderly group in the biomechanical restrictions, transitions / anticipations and total score categories (p <0.01). Baropodometry identified altered lateral-lateral displacement with eyes closed between the groups (p = 0.01), and the elderly presented worse performance. However, the aforementioned tools had little relation to each other, and their association ranged from 5 to 11%. Conclusion: BESTest and baropometry were effective in detecting differences between the balance of adult and elderly women but had a low association with each other. It is suggested that they be adopted as complementary and not substitutable evaluations in the physiotherapist's clinical practice.

Identification of risk factors in infants participating in a Follow-up program / Identificação de fatores de risco em bebês participantes de um programa de Follow-up

ABSTRACT Purpose: to identify the main health risk factors of infants participating in a follow-up program. Methods: a longitudinal prospective study conducted with 540 high-risk infants observed in the follow-up clinic of the Hospital Materno Infantil in Goiânia in the State of Goiás, Brazil. All biological data of the infants from birth, prenatal, and postnatal periods were collected through assessment sessions with their mothers and medical chart reviews. Data were analyzed through binary logistic regression to identify the highest-risk variables for the infants' health. Results: in a predictive analysis, the findings showed that neonatal risk was statistically associated with a lower Apgar score at the fifth minute of life, male infants, and longer hospital stay. Infants with increased neonatal risk were more likely to show alterations identified in cranial ultrasound examinations. Moreover, the longer hospital stay was related to mixed breastfeeding after discharge. Conclusion: the main risk factors for the health of high-risk infants in the follow-up program were: low Apgar score at the fifth minute; male sex; longer hospital stay; alterations detected in transfontanellar ultrasound; and mixed feeding after discharge.

RESUMO Objetivo: identificar os principais fatores de risco para a saúde dos bebês participantes de um programa de Follow-up. Métodos: estudo longitudinal-prospectivo, realizado com 540 bebês de risco acompanhados no Ambulatório de Follow-up do Hospital Materno Infantil de Goiânia, GO. Todos os dados biológicos do pré-natal, nascimento e pós-natal dos bebês foram coletados por meio de avaliação com as mães e consultas aos prontuários. Os dados coletados foram analisados por meio de regressão logística binária para a identificação das variáveis de maior risco para a saúde do bebê. Resultados: na análise preditiva, os achados revelaram que o risco neonatal foi associado estatisticamente com menor Apgar no quinto minuto, gênero masculino, maior tempo de internação hospitalar. Bebês com maior risco neonatal tiveram mais chance de apresentar alterações no exame de ultrassom de crânio. Além disso, o maior tempo de internação do recém-nascido esteve relacionado com aleitamento misto após a alta hospitalar. Conclusões: os principais fatores de risco para a saúde dos bebês de risco participantes de follow-up foram baixo Apgar no quinto minuto, gênero masculino, maior tempo de internação, presença de alterações no ultrassom transfontanela e aleitamento misto após a alta hospitalar.

[The effect of an exercise program to strengthen pelvic floor muscles in multiparous women]. / Efeito de um programa de exercícios para o fortalecimento dos músculos do assoalho pélvico de multíparas.

PURPOSES: To investigate the effect of an individualized and supervised exercise program for the pelvic floor muscles (PFM) in the postpartum period of multiparous women, and to verify the correlation between two methods used to assess PFM strength. METHODS: An open clinical trial was performed with puerperal, multiparous women aged 18 to 35 years. The sample consisted of 23 puerperal women divided into two groups: Intervention Group (IG, n=11) and Control Group (CG, n=12). The puerperal women in IG participated in an eight-week PFM exercise program, twice a week. The puerperal women in CG did not receive any recommendations regarding exercise. PFM strength was assessed using digital vaginal palpation and a perineometer. The statistical analysis was performed using the following tests: Fisher's exact, χ(2), Student's t, Kolmogorov-Smirnov for two samples, and Pearson's correlation coefficient. Significance was defined as p<0.05. RESULTS: The participants' mean age was 24 ± 4.5 years in IG and 25.3 ± 4 years in CG (p=0.4). After the exercise program, a significant difference was found between the groups in both modalities of muscle strength assessment (p<0.001). The two muscle strength assessment methods showed a significant correlation in both assessments (1(st) assessment: r=0.889, p<0.001; 2(nd) assessment: r=0.925, p<0.001). CONCLUSIONS: The exercise program promoted a significant improvement in PFM strength. Good correlation was observed between digital vaginal palpation and a perineometer, which indicates that vaginal palpation can be used in clinical practice, since it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. the use of a perioneometer.