Multimodal therapeutic intervention program associated with photobiomodulation therapy for individuals with chronic nonspecific neck pain: protocol for a clinical trial.

BACKGROUND: Neck pain is a prevalent global musculoskeletal issue, significantly contributing to the loss of years of healthy life due to disability. Chronic nonspecific neck pain (CNNP) involves diverse symptoms impacting mobility and quality of life. While therapeutic exercises demonstrate efficacy, the role of photobiomodulation therapy (PBMT) remains uncertain. This study aims to assess the additional effects of PBMT within a multimodal therapeutic intervention for CNNP. METHODS: A randomized, two-arm, controlled, blind clinical trial follows CONSORT and SPIRIT guidelines. Participants diagnosed with CNNP will receive a stand-alone multimodal therapeutic intervention or the same program with additional PBMT. The primary outcomes will be assessed by the functional disability identified through applying the NDI (Neck Disability Index). Secondary outcomes will be pain intensity during rest and active neck movement, catastrophizing and kinesiophobia, functionality, and disability assessed at baseline, after 8 weeks, and at a 4-week follow-up. Both groups receive pain education before personalized interventions, including resistance exercises, neuromuscular activities, mobility, and body balance. The PBMT group undergoes low-level light therapy. Intention-to-treat analysis, using linear mixed models, employs data presented as mean, standard deviation, and differences with a 95% confidence interval. Non-normally distributed variables transform. Statistical significance is set at 5%. DISCUSSION: This study addresses a critical gap in understanding the combined effects of PBMT and therapeutic exercises for CNNP. The findings aim to guide clinicians, researchers, and CNNP sufferers through rigorous methodology and diverse outcome assessments, offering valuable insights into evidence-based practices for CNNP management. Data confidentiality is maintained throughout, ensuring participant privacy during statistical analysis. TRIAL REGISTRATION: Effects of adding photobiomodulation to a specific therapeutic exercise program for the treatment of individuals with chronic nonspecific neck pain, registration number: NCT05400473, on 2022-05-27.

Association between adherence to a home exercise program and central sensitization, pain intensity, and functionality in individuals with knee osteoarthritis.

OBJECTIVE: To analyze the association between adherence to a home exercise program and central sensitization, pain intensity, and functionality in individuals with knee osteoarthritis (KOA). METHODS: A cross-sectional study was conducted involving 57 individuals with KOA. Evaluations were performed using the Exercise Adherence Rating Scale (EARS), the numerical rating scale (NRPS), the International Knee Documentation Committee (IKDC), The Central Sensitization Inventory (CSI), and the 30 sec sit and stand test (30SSST). Histograms were created to determine the normality of the data. The Kolmogorov-Smirnov test was used to determine the normality of the data. Thus, Pearson's (r) and determination (R2) correlation coefficients were calculated to determine the strength of associations between variables. RESULTS: No significant association was found between adherence behavior or reasons for adherence and central sensitization symptoms, the intensity of pain on rest and movement, knee disability symptoms, and functionality. CONCLUSION: No significant association was identified between adherence to a home exercise program and central sensitization, pain intensity, and functionality in individuals with KOA.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults.

OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults

SUMMARY OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

Association of photobiomodulation therapy and therapeutic exercises in relation to pain intensity and neck disability in individuals with chronic neck pain: a systematic review of randomized trials.

Exercise is often pointed out as an effective form of treatment in the clinical management of chronic neck pain (CNP). However, due to its complex range of causal factors and great diversity of signs and symptoms, other resources such as photobiomodulation therapy (PBMT) have been routinely used for the treatment of CNP. The aim of this study was to systematically review the literature on the use of the association of PBMT and therapeutic exercises in relation to pain intensity and neck disability in individuals with CNP. PubMed, Medline (via Ovid), Embase (via Ovid), Cinahl (via Ebsco), and Central (via Cochrane library) databases were searched using the following terms: "laser," "low-level laser," "photobiomodulation," "light emitting diodes," "phototherapy," "exercise," "chronic neck pain." After verification and implementation of eligibility criteria, seven manuscripts were considered eligible for data analysis. These manuscripts had methodological quality between 5 and 8 points on the PEDro scale. Most studies used low infrared laser therapy to perform PBMT, with a wide range of parameters and energy density between 2 and 7 J/cm2 and a total treatment time between 2 and 6 weeks. Four studies showed significant benefits in terms of pain intensity at short-term follow-up and one at intermediate-term follow-up. However, only one showed a minimal clinically important change. No studies have shown significant improvement in disability. This review demonstrates that the association of PBMT with therapeutic exercises in general promotes significant benefits only for the intensity of pain. However, it does not seem to promote a minimally effective clinical difference in individuals with CNP.

Self-Estimated functional inability because of pain questionnaire for workers: a reliability and construct validity study.

OBJECTIVE: The objective of this study was to investigate the reliability and construct validity of the Self-Estimated Functional Inability because of Pain questionnaire for workers in a sample of Brazilian workers with musculoskeletal pain. METHODS: This is a questionnaire validation study. Workers with musculoskeletal pain were included. Besides the Self-Estimated Functional Inability because of Pain questionnaire for workers, we used the following instruments to perform construct validity: the Work Ability Index and the Numerical Pain Rating Scale. A subsample answered the Self-Estimated Functional Inability because of Pain questionnaire for workers in two moments to calculate reliability by means of the intraclass correlation coefficient and internal consistency by means of the Cronbach's alpha. RESULTS: A total of 190 Brazilian workers were included. Regarding the construct validity, we observed a correlation with magnitude above 0.50 between the Self-Estimated Functional Inability because of Pain questionnaire for workers and the Numerical Pain Rating Scale, given that these two instruments have similarity in the construct, and correlations above 0.30 between the Self-Estimated Functional Inability because of Pain questionnaire for workers and the domains 2, 3, and 4 of the Work Ability Index. Regarding reliability, we observed adequate reliability (intraclass correlation coefficient=0.864) and internal consistency (Cronbach's alpha=0.807). CONCLUSION: The Self-Estimated Functional Inability because of Pain questionnaire for workers is a reliable and valid instrument to be used in Brazilian workers with musculoskeletal pain.