Reliability of a simple novel field test for the measurement of plantar flexor muscle strength / Confiabilidade de um novo teste de campo simples para medir a força dos músculos flexores plantares / Confiabilidad de un nuevo test de campo simple para medir la fuerza de los músculos flexores plantares

ABSTRACT Introduction When a person is in a standing position, the plantar flexor muscles are involved in most static and dynamic body movements. Objectives The aim of this study was to investigate the trial to trial and factorial reliability of measuring the contractile characteristics of PF muscles using a simple novel field test. Methods The sample consisted of 452 healthy subjects, 120 male and 332 female. The research was conducted by means of the trial to trial testing method, using isometric dynamometry performed in field conditions. ANOVA was used to estimate the differences among the trials, Cronbach's alpha and interclass correlation to estimate the correlations among the trials, and principal component analysis to evaluate the contribution of each trial to overall variability. Results The main findings of this study are that trials differed significantly (p<0.000) for maximal force (Fmax) and maximal rate of force development (RFDmax), indicating that the three procedural trials were necessary. The trials were highly correlated (Fmax, RFDmax, r>0.9), proving that measuring was reliable, and the factorial analysis separated the second and third trials, the second trial accounting for most of the total variability. Conclusions The simple novel field test for the measurement of plantar flexor contractile characteristics recommended by this study proved to be as highly reliable as laboratory testing, but was easy to perform in conditions outside of scientific or diagnostic institutions, which greatly facilitates the work of scientists, coaches and professionals. Level of Evidence II; Diagnostic Studies - Investigating a diagnostics test.

RESUMO Introdução Quando uma pessoa está em pé, os músculos flexores plantares são envolvidos na maioria dos movimentos corporais estáticos e dinâmicos. Objetivos O objetivo deste estudo foi investigar a confiabilidade teste-reteste e fatorial da mensuração das características contráteis dos músculos plantares, usando um novo teste de campo simples. Métodos A amostra consistiu em 452 indivíduos saudáveis, 120 homens e 332 mulheres. O estudo foi realizado pelo método de teste-reteste, com dinamometria isométrica conduzida em condições de campo. Empregou-se a ANOVA para estimar a diferença entre os testes o alfa de Cronbach e a correlação interclasse para estimar a correlação entre os testes e análise de componentes principais , para avaliar a contribuição de cada teste para a variabilidade global. Resultados Os principais achados deste estudo são que os testes diferiram significativamente (p < 0,000) para a força máxima (Fmáx) e a taxa máxima de desenvolvimento de força (TDFmáx), indicando que os três testes de procedimento foram necessários. Os testes foram altamente correlacionados (Fmáx, TDFmáx, r > 0,9), provando que a medição era confiável, e a análise fatorial separou o segundo e o terceiro testes, sendo que o segundo teste apresentou a maior parte da variabilidade total. Conclusões O novo teste de campo simples para medição das características contráteis dos flexores plantares recomendado por este estudo provou ser tão confiável quanto os testes de laboratório e, ao mesmo tempo, mais fácil de realizar fora das instituições científicas ou de diagnóstico, o que facilita muito o trabalho de cientistas, treinadores e profissionais. Nível de Evidência II; Estudos Diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Introducción Cuando una persona está de pie, los músculos flexores plantares son involucrados en la mayoría de los movimientos corporales estáticos y dinámicos. Objetivos El objetivo de este estudio fue investigar la confiabilidad test-retest y factorial de la medición de las características contráctiles de los músculos plantares, usando un nuevo test de campo simple. Métodos La muestra consistió en 452 individuos saludables, 120 hombres y 332 mujeres. El estudio fue realizado a través del método de test-retest, con dinamometría isométrica conducida en condiciones de campo. Se empleó ANOVA para estimar la diferencia entre los tests, alpha de Crombach y la correlación interclase para estimar la correlación entre los tests y el análisis de componentes principales, para evaluar la contribución de cada test para la variabilidad global. Resultados Los principales hallazgos de este estudio son que los tests difirieron significativamente (p<0,000) para la fuerza máxima (Fmáx) y la tasa máxima de desarrollo de fuerza (TDFmáx) indicando que los tres tests de procedimiento fueron necesarios. Los tests fueron altamente correlacionados (Fmáx, TDFmáx, r>0,9) probando que la medición era confiable, y el análisis factorial separó el segundo y tercer test, siendo que el segundo test presentó la mayor parte de variabilidad total. Conclusiones El nuevo test de campo simple para medición de las características contráctiles de los flexores plantares recomendado por este estudio probó ser tan confiable como los tests de laboratorio y, al mismo tiempo, más fácil de realizar fuera de las instituciones científicas o de diagnóstico, lo que facilita mucho el trabajo de científicos, entrenadores y profesionales. Nivel de evidencia II; Estudios diagnósticos - Investigación de un examen para diagnóstico.

Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study

Abstract Background: The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients' functional status and presence or absence of clinical symptoms associated with FM. Methods: Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. Results: The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. Conclusion: Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups.

Administering the Sarcoidosis Health Questionnaire to sarcoidosis patients in Serbia / Aplicação do Sarcoidosis Health Questionnaire em pacientes com sarcoidose na Sérvia

Objective: The aim of this study was to use a Serbian-language version of the disease-specific, self-report Sarcoidosis Health Questionnaire (SHQ), which was designed and originally validated in the United States, to assess health status in sarcoidosis patients in Serbia, as well as validating the instrument for use in the country. Methods: This was a cross-sectional study of 346 patients with biopsy-confirmed sarcoidosis. To evaluate the health status of the patients, we used the SHQ, which was translated into Serbian for the purposes of this study. We compared SHQ scores by patient gender and age, as well as by disease duration and treatment. Lower SHQ scores indicate poorer health status. Results: The SHQ scores demonstrated differences in health status among subgroups of the sarcoidosis patients evaluated. Health status was found to be significantly poorer among female patients and older patients, as well as among those with chronic sarcoidosis or extrapulmonary manifestations of the disease. Monotherapy with methotrexate was found to be associated with better health status than was monotherapy with prednisone or combination therapy with prednisone and methotrexate. Conclusions: The SHQ is a reliable, disease-specific, self-report instrument. Although originally designed for use in the United States, the SHQ could be a useful tool for the assessment of health status in various non-English-speaking populations of sarcoidosis patients.

Objetivo: O objetivo deste estudo foi utilizar uma versão no idioma sérvio do Sarcoidosis Health Questionnaire (SHQ), um questionário de autorrelato doença-específico, concebido e originalmente validado nos EUA, para verificar o estado de saúde de pacientes com sarcoidose na Sérvia, além de validar o instrumento para uso no país. Métodos: Estudo transversal com 346 pacientes com sarcoidose confirmada por biópsia. Para avaliar o estado de saúde dos pacientes, utilizamos o SHQ, o qual foi traduzido para o sérvio para os propósitos deste estudo. Comparamos os escores do SHQ por gênero, idade, duração da doença e tratamento. Escores do SHQ mais baixos indicam pior estado de saúde. Resultados: Os escores do SHQ demonstraram diferenças no estado de saúde entre os subgrupos de pacientes avaliados. O estado de saúde foi significativamente pior entre as mulheres e pacientes mais velhos, assim como entre aqueles com sarcoidose crônica ou com manifestações extrapulmonares da doença. A monoterapia com metotrexato associou-se com melhor estado de saúde do que a monoterapia com prednisona ou a terapia combinada com prednisona e metotrexato. Conclusões: O SHQ é um instrumento de autorrelato doença-específico confiável. Embora originalmente concebido para uso nos EUA, o SHQ pode ser uma ferramenta útil na avaliação do estado de saúde de populações de pacientes com sarcoidose em vários países de língua não inglesa.

Clinical manifestations of primary syphilis in homosexual men

At the beginning of a new millennium, syphilis incidence has been increasing worldwide, occurring primarily among men who have sex with men (MSM). The clinical features of primary syphilis among MSM is described, a case-note review of the primary syphilis (PS) patients who attended the Institute of Skin and Venereal Diseases. The diagnosis was assessed based upon the clinical features and positive syphilis serology tests. Among 25 patients with early syphilis referred during 2010, PS was diagnosed in a total of 13 cases. In all patients, unprotected oral sex was the only possible route of transmission, and two out of 13 patients had HIV co-infection. Overall, 77% of men presented with atypical penile manifestation. The VDRL test was positive with low titers. The numerous atypical clinical presentations of PS emphasize the importance of continuing education of non-experienced physicians, especially in countries with lower reported incidence of syphilis.