Neck Strength Evaluated With Fixed and Portable Dynamometers in Asymptomatic Individuals: Correlation, Concurrent Validity, and Agreement.

OBJECTIVE: The purpose of this study was to assess the correlation, concurrent validity, and agreement between the isometric cervical force measurements obtained with fixed and portable dynamometers in asymptomatic individuals. METHODS: Fifty asymptomatic individuals performed 3 maximal isometric contractions for flexion, extension, and lateral flexion of the cervical spine using fixed and portable dynamometers. The correlation and concurrent validity for the measurements of the portable and fixed dynamometers were analyzed using Spearman's correlation coefficient and the intraclass correlation coefficient (ICC), respectively. The agreement between the force values of the portable and fixed dynamometers was measured using the Bland-Altman method. RESULTS: Isometric cervical force measurements obtained with the fixed dynamometer and portable dynamometer showed a moderately to highly significant correlation for flexion (rs = 0.74), extension (rs = 0.82), right lateral flexion (rs = 0.74), and left lateral flexion (rs = 0.68). The concurrent validity was moderate to good for all measurements (ICC2,3 = 0.67-0.80). The fixed and portable dynamometers did not agree, with a significant mean difference between the methods of 2.8 kgf (95% confidence interval [CI], 2.1-3.4 kgf) for cervical flexion, 5.3 kgf (95% CI, 4.2-6.4 kgf) for extension, and 9.1 kgf (95% CI, 0.4-2.1 kgf) for left lateral flexion. The limits of agreement were broad for all movements, with errors that varied between 61% and 77% of the mean force obtained with the fixed dynamometer. CONCLUSION: The neck strength measurements obtained with the fixed and portable dynamometers demonstrated high to moderate correlation and had moderate to good comparability for asymptomatic participants. However, they did not agree in that the 2 methods did not provide equivalent measurements, and, therefore, based on these findings, the same equipment should always be used when reassessing an individual.

Inclinometer Reliability for Shoulder Ranges of Motion in Individuals With Subacromial Impingement Syndrome.

OBJECTIVE: This study aimed to determine the intra- and interrater reliability of active and passive range of motion in the shoulders of individuals with subacromial impingement syndrome using a digital inclinometer. METHODS: The raters evaluated active and passive range of motion in the shoulder of 50 individuals with unilateral subacromial impingement syndrome in movements including flexion, abduction, extension, external rotation in a neutral position, external rotation with the arm at 90° of abduction, and internal rotation with the arm at 90° of abduction. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and were repeated by 1 examiner after a 2- to 4-day interval. Reliability was analyzed using the intraclass correlation coefficient (ICC2,3). RESULTS: There was moderate to excellent interrater (ICC2,3 = 0.50-0.95) and intrarater (ICC2,3 = 0.74-0.94) reliability. In the interrater analysis, the standard error of measurement (SEM) ranged from 4.1° to 10°, the percentage SEM (%SEM) ranged from 2% to 17%, and the minimum detectable change ranged from 9.5° to 23.4°. In the intrarater analysis, the SEM ranged from 4° to 9.2°, %SEM ranged from 3% to 14%, and the minimum detectable change ranged from 9.3° to 21.4°. CONCLUSION: The digital inclinometer showed moderate to excellent reliability for measuring active and passive range of motion in shoulders with unilateral subacromial impingement syndrome.

Promoção de saúde para uma equipe de saúde da família: enfoque na percepção corporal / Health promotion for a family health team: an approach focused on body perception

A Política Nacional de Promoção da Saúde incentiva a adoção e a divulgação de ações alternativas e inovadoras direcionadas à Estratégia Saúde da Família (ESF), sendo definidas como prioridades as iniciativas de prática corporal e atividade física. Os objetivos deste trabalho foram promover práticas fisioterapêuticas vinculadas à percepção corporal para uma equipe de saúde da família e refletir sobre promoção de saúde. A partir da demanda de uma equipe de saúde da família de Ribeirão Preto por informações sobre alongamento e relaxamento, um grupo formado por professores, pós-graduandos e graduandos de fisioterapia propôs uma intervenção desenvolvida em três encontros. Um folheto recordatório e ilustrativo também foi elaborado com o intuito de facilitar a assimilação e a reprodução do conteúdo abordado. O primeiro encontro consistiu de uma dinâmica de apresentação dos participantes e de práticas de alongamento e relaxamento. No segundo encontro, duplas voluntárias da equipe demonstraram os alongamentos aos demais participantes, enquanto os monitores anotaram as dúvidas e dificuldades apresentadas. Por fim, no terceiro encontro, foi realizada uma vivência de automassagem em um grupo. Os participantes relataram dificuldade para reproduzir e transmitir os exercícios. No entanto também relataram que a atividade despertou a atenção para questões relacionadas a seus corpos, possibilitando uma reflexão para melhora da qualidade de vida. Assim, o trabalho colaborou com a implementação de uma nova estratégia de promoção de saúde voltada à ESF ao demonstrar a importância de despertar a percepção corporal junto a seus membros, que no cotidiano negligenciam o cuidar de si mesmos.

The National Policy on Health Promotion stimulates the adoption and wider exposure of alternative and innovative actions oriented toward the Family Health Strategy (FHS), the defined priorities being the initiatives for body practice and physical activity. The objectives of this study were to promote physiotherapy interventions related to body perception for a Family Health Team (FHT) and to develop the thinking on health promotion. In response to the need expressed by an FHT in Ribeirão Preto for information on stretching and relaxation techniques, a group composed of physiotherapy professors, graduate students, and under-graduates was formed. They proposed an intervention, carried out in three meetings. A handout was prepared with illustrations and notes to make both the assimilation and the reproduction of the content easier. The first meeting consisted of group dynamics to introduce the participants and the practices of stretching and relaxation. In the second meeting, a pair of FHT volunteers demonstrated the stretching exercises for the other participants, while monitors took notes on uncertainties and difficulties that arose. Finally, in the third meeting, an experience in self-massage techniques was conducted. Participants reported difficulty in reproducing and explaining the exercises they were taught. However, they also reported that they began to pay attention to things related to their body after these interventions. This enabled them to reflect on improving of quality of life. Thus, this intervention contributed to the implementation of an innovative health promotion strategy for the FHS by demonstrating the importance of stimulating body perception to team members, who routinely are victims of self-neglect.