Pelvic floor dysfunctions in women with systemic lupus erythematosus: A cross-sectional study.

INTRODUCTION AND HYPOTHESIS: As a result of the impairment of the musculoskeletal system, the pelvic floor muscles are likely compromised in women with systemic lupus erythematosus (SLE). We hypothesized that women with SLE would report more symptoms of pelvic floor dysfunction (PFD) and there will be an association between SLE and PFD. METHODS: An online cross-sectional survey was conducted. Data were collected on demographic and anthropometric characteristics, PFD (urinary incontinence, nocturia, anal incontinence, genital-pelvic pain/penetration disorder and pelvic organ prolapse) and obstetric history using a web-based questionnaire. The groups were compared using the Mann-Whitney test for quantitative variables and the chi-squared test for categorical variables. The association between SLE and PFD was tested using logistic regression analysis. RESULTS: A total of 196 women answered the questionnaire (102 with SLE and 94 healthy controls). Women with SLE reported significantly more urinary incontinence, nocturia, anal incontinence, pelvic organ prolapse and genital-pelvic pain/penetration disorder than the healthy controls (p ≤ 0.05). Women with SLE were 2.8- to 3.0-fold more likely to report genital-pelvic pain/penetration disorder than healthy women. CONCLUSIONS: The prevalence of PFD was significantly higher in women with SLE compared to healthy women. Thus, PFD seems to be an important problem in women with this disease. An in-depth investigation of these disorders could contribute to the understanding of how SLE impacts pelvic floor function.

Is there agreement between the preference of examiner and women for unidigital and bidigital vaginal palpation? A qualitative study.

INTRODUCTION AND HYPOTHESIS: The International Continence Society recommends vaginal palpation as a method for assessing pelvic floor muscle (PFM) function. Our aim was to analyze the agreement between preferences of examiner and participants according to unidigital and bidigital vaginal palpation during PFM assessment. The second aim was to investigate qualitatively women's perception of vaginal palpation. METHODS: Maximal voluntary contractions (MVCs) were requested during both types of vaginal palpation and were classified by the Modified Oxford Scale (MOS). Examiner and participants answered if they had preferences regarding vaginal palpation. Women answered qualitatively what they felt during the assessment. Cohen's linear kappa (κ) evaluated the agreement after allocation of the women with a weaker and stronger MVC and qualitative analysis was performed by transcription considering age range (18-35; 36-59; ≥60 years). RESULTS: Agreement was almost zero for women with weaker and stronger MVC at unidigital (κ = 0.06 and κ = -0.12) and bidigital vaginal palpation (κ = 0.008 and κ = 0.005). Participants associated bidigital palpation with more perception and an easier way of contracting the PFMs. Women between 36 and 59 years associated unidigital palpation with a harder but comfortable way of contracting the PFMs. Subjects aged ≥60 years associated bidigital palpation with an uncomfortable, harder way of contracting PFM, with less space into the vagina. CONCLUSIONS: Agreement between preferences was almost zero neither between women with a weaker and stronger PFM contraction, nor between the types of vaginal palpation. Bidigital palpation increased women's perception, made the contraction easier, and was associated with less space in the vaginal canal and less comfort.

Is physical capacity associated with the occurrence of musculoskeletal symptoms among office workers? A cross-sectional study.

PURPOSE: Low physical capacity is hypothesized to be associated with the presence of musculoskeletal symptoms. Therefore, our aim was to investigate whether physical capacity is associated with the presence of musculoskeletal symptoms in the neck, shoulders, and thoracic and lumbar spine among office workers. METHODS: Sixty-seven office workers, recruited at the university, were evaluated regarding the presence of musculoskeletal symptoms through the Nordic Musculoskeletal Questionnaire (NMQ). Measurements of muscle strength and endurance of shoulder abduction, endurance of trunk flexion and extension, and back and leg flexibility were obtained. Data were analysed through a binomial logistic regression model, considering physical capacity as the independent variable and symptoms as the dependent variable. An adjusted model was also applied that controlled for individual and occupational covariates. RESULTS: The basic model showed a significant association between reduced shoulder abduction strength and neck (OR: 0.87; 95% CI 0.78-0.98) and shoulder symptoms (OR: 0.88; 95% CI 0.78-0.99), and between reduced back and leg flexibility and thoracic spine symptoms (OR: 0.92; 95% CI 0.85-0.99). The adjusted model, after controlling for the covariates, demonstrated that reduced shoulder abduction strength (OR: 0.70; 95% CI 0.52-0.94) and reduced back and leg flexibility (OR: 0.81; 95% CI 0.66-0.99) were associated, instead, with the occurrence of neck and low back symptoms, respectively, in the last 12 months. CONCLUSIONS: Physical capacity is associated with the presence of neck and low back symptoms in office workers. Furthermore, individual and occupational characteristics affect the relationship between physical capacity and musculoskeletal symptoms and should be considered for understanding and managing musculoskeletal symptoms among office workers.

A Descriptive Study of Work Ability and Health Problems Among Brazilian Recyclable Waste Pickers.

To describe the work ability and health problems among Brazilian recyclable waste pickers. Sixty-one workers answered questionnaires related to the work ability (Work Ability Index-WAI), musculoskeletal problems (Nordic Musculoskeletal Questionnaire-NMQ), low back related disability (Roland Morris Questionnaire-RMQ), physical activity (International Physical Activity Questionnaire-IPAQ), smoking (Fagerström Test for Nicotine Dependence-FTND), and alcohol use (The Alcohol Use Disorders Identification Test AUDIT). Brazilian recyclable waste pickers are mostly young (25-44 years old: 54%), women (88%) with low schooling (incomplete elementary school: 54%), high turnover at work (job seniority < 12 months: 70%), low rates of sick leave (20%) and accidents at work (13%). The workers reported good (44%) or optimal (43%) work ability. The prevalence of musculoskeletal disorders in the last 12 months was high (lower back: 49%, shoulders: 28%, neck: 23%, wrists and hands: 21%), as well as the prevalence of hypertension (28%). Most of the workers reported to be physically active or very active (57%), smoke (34%) and drink alcohol (44%). This study outlined the profile of recyclable waste pickers regarding work ability and health problems, which highlight the need for preventive measures focused on musculoskeletal and cardiovascular diseases among this population.

The effects of forearm support and shoulder posture on upper trapezius and anterior deltoid activity.

[Purpose] To assess the effects of forearm support and shoulder posture on upper trapezius and anterior deltoid activity. [Subjects and Methods] Twenty-three female university students were evaluated. Muscle activity was assessed by a portable surface electromyography (sEMG) system (Myomonitor IV, Delsys, USA). Upper trapezius and anterior deltoid activity were recorded in five shoulder flexion postures: 0°, 15°, 30°, 45° and 60° and in two conditions: with the forearm supported and unsupported. Descriptive data analysis was performed and statistical analysis was conducted by a multivariate analysis of variance with three repeated factors (posture, support and side). [Results] Three-way interactions were not significant. Two-way interaction was significant for support and posture for both muscles, indicating that the muscular activity depends on the forearm support and shoulder posture. The forearm support reduced upper trapezius and anterior deltoid activity for all shoulder flexion angles. The mean and standard deviation for this decrease was 7.8 (SD=4.6)% of the maximal voluntary contraction for anterior deltoid and 3.8 (SD=2.0)% of the maximal voluntary contraction for upper trapezius. In the unsupported condition, increasing the shoulder flexion angle caused an increase in the upper trapezius and anterior deltoid activation. [Conclusion] These results highlight the importance of using forearm support and to maintain neutral shoulder posture, when the upper arms are not supported, to reduce muscle activation. Thus, this study provides evidence about the effect of these recommendations to reduce muscular activity.

Mobile Technologies for Monitoring Sleep Time: A Systematic Search of App Stores in Brazil.

Introduction Decreased sleep time is detrimental to physical and mental health, exerting negative impacts on daily functioning and quality of life. Mobile health (mHealth) applications can be useful for improving sleep quality. Objective To perform a systematic search of mHealth applications for monitoring sleep time at Brazilian online stores and evaluate the selected applications in terms of engagement, functionality, aesthetics, and quality of information. Methods A systematic search was performed at the Google Play Store and the App Store developed or updated between 2020 and 2022. The mobile app rating scale (MARS) was used to assess their quality. The characteristics and information of these applications were presented. Data were analyzed descriptively. Results Among the 2,264 relevant mHealth apps identified, 11 were eligible for inclusion. There was one app that offered only sleep time recordings, three offered sleep recordings and educational content, three monitored sleep time with audiovisual resources, two offered sleep time recordings with a focus on monitoring snoring, and two offered sleep time monitoring with individual content customizations. The apps scored fair on MARS, with a mean of 3.5 points (standard deviation: 0.8) on a scale of 1 to 5. Most apps scored low due to poor evidence-based information, aesthetics, and engagement. Conclusion Although the use of mHealth technologies for monitoring sleep time has considerable potential for investigation, it is a relatively new, underexplored topic. Collaboration between researchers, clinical professionals, patients, and application developers is necessary for the creation of new evidence-based mHealth applications focused on Brazilian users.

Mobile health technologies for workers' health and wellbeing: A systematic search of mHealth applications in Brazil.

BACKGROUND: Inadequate working conditions and sedentary work can exert a negative impact on workers' health and wellbeing, leading to musculoskeletal disorders and disability. Mobile health (mHealth) applications (apps) have high potential for the self-management of workers' health. OBJECTIVE: To identify mHealth apps aimed at promoting workers' health and wellbeing available in Brazilian online stores and assess these apps in terms of engagement, functionality, aesthetics and information quality. METHODS: A systematic search for apps was conducted in the Brazilian online App Store and Play Store in December 2022. Only smartphone apps in Brazilian Portuguese directed at workers' health were assessed. The appraisal of the quality of the applications was performed using the Mobile App Rating Scale (MARS). RESULTS: Among the 3449 mHealth apps found, ten were eligible for inclusion. The mean overall score was 3.15 ± 0.91 on a scale of 1-5. The lowest score was found for the "credibility" item. Exercises and breaks were the most frequent strategies. Most apps provided low-quality information from questionable sources and therefore received a mean score of 2.1 ± 1.5 on the MARS information subscale. CONCLUSION: Ten relevant mHealth apps were eligible for inclusion. The mHealth apps for the promotion of workers' health and wellbeing currently available in Brazil exhibited moderate quality and limited functionality.

Association between pelvic floor muscle function and stress urinary incontinence in the third gestational trimester: A cross-sectional observational study.

OBJECTIVE: Investigate the association between pelvic floor muscle function and stress urinary incontinence (SUI) in women in the third trimester of pregnancy. METHODS: Cross-sectional observational study. Urinary symptoms were collected through a questionnaire. The physical examination of the pelvic floor muscle was performed by vaginal palpation and manometry. Multivariate logistic regression analyses were performed to investigate the factors associated with SUI. RESULTS: Analysis of the data collected from nulliparous and multiparous women identified an association between decreased pelvic floor muscle function (i.e. Power, Repetition, and Maximal Voluntary Contraction (MVC)) and the presence of SUI. There were also associations noted between power and SUI [AOR (95% CI) = 1.41 (1.01-1.97)], repetition and SUI [AOR (95% CI) = 1.31 (1.06-1.63)], and MVC and SUI [AOR (95% CI) = 1.02 (1.00-1.03)]. In the analysis of nulliparous women, there was also an association between low resting vaginal pressure (manometry) and SUI [AOR (95% CI) = 1.03 (1.01-1.06)]. CONCLUSIONS: Low pelvic floor muscle strength, low MVC, and decreased ability to repeat sustained pelvic floor muscle contractions were associated with SUI in the third gestational trimester. In nulliparous women, there was an association between low resting vaginal pressure and SUI; however, none these associations were identified in multiparous women.

Telerehabilitation for musculoskeletal pain - An overview of systematic reviews.

Background: Alternative measures for minimizing musculoskeletal pain, such as telerehabilitation, can be implemented in the context of the COVID-19 pandemic. Objective: The aim of the present overview was to examine evidence from systematic reviews of telerehabilitation for managing musculoskeletal pain. Methods: This study was conducted following the PRISMA recommendations. Searches were conducted of the Pubmed/Medline, Scopus, Cochrane Library, Web of Science and Embase databases for review articles published from the inception of the database to July 2022. To be included, the studies needed to be a systematic review, include any type of telerehabilitation and present any outcome related to musculoskeletal pain. Studies not available in English were excluded. Theses, dissertations, letters, conference abstracts and narrative reviews were also excluded. The methodological quality of the reviews was appraised using the Assessing the Methodological Quality of Systematic Reviews criteria. Data extraction was performed by two reviewers and included the characterization of the clinical condition and telerehabilitation program, main outcomes, method for appraising the methodological quality of the primary studies, results and quality of evidence. Results: The search led to the retrieval of 390 potentially eligible studies and 16 systematic reviews were included in this overview. Eleven reviews had meta-analyses and most had high methodological quality. Five of six systematic reviews reported evidence supporting the telehealth intervention for chronic pain conditions; and two of three high-quality systematic reviews reported the absence of evidence for non-specific low back pain. Conclusions: This overview of systematic reviews enables a better understanding of the characteristics of telerehabilitation programs, provides information for use in clinical practice and describes gaps in the research that need to be filled.

What are the cut-off points for vaginal manometry to differentiate women with a weak from those with a strong pelvic floor muscle contraction?: Vaginal manometry to classify a pelvic floor muscle contraction.

BACKGROUND: Vaginal manometry is regarded as an objective method to assess pelvic floor muscles (PFM) function and can measure several variables during contraction. OBJECTIVE: To determine which variables could differentiate women with/without a weak/strong PFM contraction and determine their cut-off points. METHODS: This is a diagnostic accuracy study performed on 156 women with a mean age of 40.4 (SD, 15.9) years. The reference test was vaginal palpation and the index test was vaginal manometry (Peritron™ manometer). Variables were pressure at rest, pressure achieved with maximal voluntary contraction (MVC), MVC average, duration, gradient, and area under the curve (AUCm). The Receiver Operating Curve (AUC/ROC) and logistic regression were used to analyze the data and obtain cut-off points. RESULTS: Excellent ability to discriminate women with a weak/strong PFM contraction was found for MVC average (cut-off: 28.93 cmH2O), MVC (cut-off: 38.61 cmH2O), and the AUCm (cut-off: 1011.93 cm²*s). The gradient variable had good discrimination ability (AUC/ROC=0.81; cut-off: 28.68 cmH2O/s). The MVC average assessed by manometry, menopausal status, and the presence of stress urinary incontinence (SUI) were associated with a weak/strong PFM contraction in the multivariate analysis; however, the most parsimonious model to discriminate weak/strong PFM contraction included only the MVC average (AUC/ROC = 0.95; sensitivity: 0.87; specificity: 0.91). CONCLUSION: These results suggest which manometry variables are appropriate to assess and classify PFM function in females. These could be used to help physical therapists to make clinic decisions about the management of female PFM.

Sleep Quality as a Mediator of Burnout, Stress and Multisite Musculoskeletal Pain in Healthcare Workers: A Longitudinal Study.

This study aimed to verify whether sleep quality is a mediator of the relationship between burnout, stress and multisite pain in healthcare workers in a longitudinal study with 12 months of follow-up during the COVID-19 pandemic. Online questionnaires were used for data collection. The sociodemographic questionnaire contained personal and occupational data. The short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II-Br) was used to assess burnout and stress. The Pittsburgh Sleep Quality Index (PSQI-Br) assessed sleep quality over one month. The Nordic Musculoskeletal Questionnaire (NMQ) aimed to identify the presence of multisite musculoskeletal pain in the last 12 months and the last 7 days. Mediation analysis was used to verify whether the effect of the predictor variables (burnout and stress) on the dependent variable (number of pain sites in the last 12 months and 7 days) was due to an intervening variable (sleep quality). Stress and burnout were associated with multisite pain in healthcare workers in the last 12 months and the last 7 days. Sleep quality was a significant mediator of this association in the last 12 months, indicating that some of the association between burnout, stress and multisite pain can be explained by poor sleep quality. Thus, a comprehensive approach to long-term multisite pain should consider psychosocial aspects such as burnout, stress and sleep quality.

Pelvic floor dysfunctions in women with fibromyalgia: A cross-sectional study.

BACKGROUND: Fibromyalgia (FM) is a rheumatic syndrome that causes musculoskeletal disorders and is associated with several problems that affect quality of life. As the musculoskeletal system is affected, it can have an impact on the pelvic floor muscles, leading to pelvic floor dysfunction (PFD). OBJECTIVE: Investigate the occurrence of PFD, such as urinary incontinence (UI) and anal incontinence (AI), sexual problems, and pelvic organ prolapse (POP), in women with FM compared to a control group composed of women without FM; and investigate the association between FM and PFD. STUDY DESIGN: This was an online cross-sectional survey. Demographic and anthropometric data, the description of PFD (UI, nocturia, AI, genital-pelvic pain/penetration disorder, and POP), and previous obstetric history were collected through a web-based questionnaire. The groups were compared using the independent t-test for quantitative variables and the chi-square test for categorical variables. The association between FM and PFD was tested using logistic regression analysis. RESULTS: A total of 175 women answered the questionnaire (97 with FM and 78 healthy controls). The women with FM reported significantly more UI, mixed urinary incontinence, AI, POP, and vaginismus than the healthy controls (p ≤ 0.05). FM was associated with mixed urinary incontinence (OR: 2.6; 95 % CI: 1.1-6.4; p = 0.04), anal incontinence (OR: 2.9; 95 % CI: 1.3-6.1; p = 0.01), and flatus incontinence (OR: 2.6; 95 % CI: 1.2-5.4; p = 0.01). CONCLUSION: The prevalence of PFD was significantly higher in women with FM compared to healthy women. Indeed, the women with FM were 2.6-fold to 2.9-fold more likely to report mixed urinary incontinence, anal and flatus incontinence than those in the control group. The present findings show possible impairment of the pelvic floor musculature in women with FM.

Exercise effects on motor function, manual dexterity, and brain oscillatory activity in individuals with Parkinson's disease: Randomized controlled trial protocol.

BACKGROUND: Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. Exercise protocols are promising interventions to improve PD symptoms, however, the best modality and its neural correlates are still unknown. OBJECTIVES: To evaluate the effects of the aerobic, strength and task-oriented upper-limb exercises in motor function, manual dexterity, and brain oscillations of individuals with PD. METHOD: In this clinical trial, 44 PD patients aged 40-80 years will be randomized in four groups: aerobic training (AT), strength training (ST), task-oriented training (TOT), and waiting list group (CG). The AT group will perform 30 min of a cycle ergometer on 50%-70% of the reserve heart rate. The ST group will use equipment for upper limb muscles and will perform two series of 8-12 repetitions for each exercise, and intensity between 50% and 70% of one maximum repetition will be used. The TOT group will perform a program consisting of three activities to enhance reaching, grasping, and manipulation. All the groups will perform three sessions per week for 8 weeks. We will use the UPDRS Motor function section, Nine-Hole Peg Test, and quantitative electroencephalography to measure motor function, manual dexterity, and brain oscillations, respectively. ANOVA and regression models will be used to compare outcomes within and between groups.

Association between offensive behaviors and burnout and depression risks in health workers. / Asociación entre comportamientos ofensivos y riesgo de burnout y depresión en trabajadores de la salud.

OBJECTIVE: to evaluate the occurrence of offensive behaviors at work, their characteristics and association with sex, stress, burnout and depression in health workers. METHOD: a cross-sectional, descriptive and quantitative study carried out with 125 workers from the Brazilian Unified Health System. The data were collected from June 2021 to April 2022 through three self-applied questionnaires that assess personal and occupational characteristics; offensive behaviors, stress and burnout; and depressive symptoms. Descriptive statistics, the chi-square association test and logistic regression analysis were applied. RESULTS: 44% of the sample reported 83 behaviors, with threats of violence as the most frequent ones (26%). Nursing technicians/assistants, nurses and physicians were the most exposed professionals. The main aggressors were the patients, except for bullying, which was perpetrated by co-workers (48%). There was an association between offensive behaviors and burnout (OR: 4.73; 95% CI: 1.29-17.3; p=0.02) and between offensive behaviors and depression symptoms (OR: 1.05; 95% CI: 1.01-1.10; p=0.02). CONCLUSION: the occurrence of offensive behaviors in health work is frequent and characteristic and burnout and depressive symptoms respectively increased 4.73 and 1.05 times the chances of workers suffering these offensive behaviors in the work environment.

Post-COVID-19 functional status scale: Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version.

BACKGROUND: The Post-COVID-19 Functional Status (PCFS) scale was created to assess the functional status of patients after hospital discharge due to COVID-19. OBJECTIVE: To perform cross-cultural adaptation of the PCFS Scale and Manual into Brazilian Portuguese and evaluate its measurement properties in patients post-COVID-19. METHODS: For the cross-cultural adaptation, independent translations and back-translations were performed. This was followed by a pre-test, with analysis of the Content Validity Index (CVI), and preparation of the final version, after evaluating the measurement properties. Spearman's correlation between the PCFS and the WHO Disability Classification Scheme (WHODAS 2.0) was used for convergent validity. Weighted Kappa (wκ) was used for test-retest and interobserver reliability for PCFS scores and Kappa (κ) for PCFS items. Internal consistency was assessed using Cronbach's alpha. Only patients with post-discharge COVID-19 were evaluated through video-conferencing platforms. RESULTS: The CVI was 0.75-0.83 for comprehension and 0.83-0.84 for the language of the self-administered questionnaire and the structured interview version. For measurement properties, 63 patients were evaluated, 68% male, 51.50 (12.60) years, 12.28 (7.62) days of hospitalization. For the convergent validity, a strong correlation was found (r = 0.73; p<0.01). The test-retest (wκ=0.54) and interobserver (wκ=0.43) reliability was moderate and the item-by-item analyzes ranged from fair to substantial (κ=0.25-0.66) and weak to substantial (κ=0.07-0.79). Internal consistency was excellent (0.85). CONCLUSION: The final PCFS in Brazilian Portuguese showed adequate content validity, reliability, internal consistency, and convergent validity for the functional assessment of patients after hospital discharge due to COVID-19.

Impact of urinary incontinence on quality of life in female CrossFit practitioners: A cross-sectional study.

OBJECTIVE: Investigate the impact of urinary incontinence (UI) on quality of life (QoL) in female CrossFit practitioners and to verify the strategies used by them to minimize the occurrence of urine leakage. In addition, to verify whether anthropometric and clinical characteristics increase the UI impact on QoL of female CrossFit practitioners. STUDY DESIGN: This was an online cross-sectional survey. The impact of UI on QoL was investigated by International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Associations between the impact of UI on QoL and the clinical (age, BMI, gestations, mode of delivery, practice of other physical activities) and the others pelvic floor dysfunctions (PFD) related independent variables were tested using logistic regression analysis. RESULTS: A total of 828 female CrossFit practitioners answered the questionnaire and 36% reported UI symptoms. The women who obtained the highest score on the ICIQ-SF have high UI interference in QoL. Previous history of two or more gestations and sexual dysfunctions (dyspareunia or vaginismus) or pelvic organ prolapse increase 2.65 and 1.82 times the risk of female CrossFit practitioners with UI having a high impact of UI on their QoL, respectively (OR = 2.65 95% CI 1.30-5.40, p = 0.01; and OR = 1.82 95% CI 1.04-3.21, p = 0.04, respectively). The most strategies used by them to minimize the occurrence of urine leakage were emptying the bladder before training (77.5%) and use absorbent (17.8%). CONCLUSIONS: Women who had higher scores on the ICIQ-SF reported greater impact on QoL, and the previous history of two or more gestations and sexual dysfunction/pelvic organ prolapse increase the risk of women with UI who practice CrossFit to have a greater impact on QoL. Multigravida and women with sexual dysfunction/pelvic organ prolapse who practice CrossFit could have more attention on the UI symptoms due to the high impact on their QoL.

Interventions used by Brazilian physiotherapists in the rehabilitation of patellofemoral pain: A web-based survey.

BACKGROUND: No studies have evaluated whether interventions used by Brazilian physiotherapists for the treatment of patellofemoral pain (PFP) are in line with the best existing scientific evidence. OBJECTIVES: Identify the interventions most commonly used by Brazilian physiotherapists for the rehabilitation of PFP and determine whether characteristics of physiotherapists and knowledge regarding evidence-based practice (EBP) influence the choice of interventions. DESIGN: Cross-sectional web-based survey. METHODS: Brazilian physiotherapists who treat patients with PFP participated in the study. Characteristics of the participants, information regarding EBP and interventions used in the treatment of PFP were collected through an online questionnaire. Descriptive analysis of the data was performed. Logistic regression analysis was employed to investigate associations between the interventions and both the characteristics of the physiotherapists and their knowledge regarding EBP. RESULTS: One hundred and ninety-four physiotherapists completed the questionnaire, 97.4% of whom reported using combined hip and quadriceps strengthening exercises, whereas only 25.3% reported using foot orthoses. A significant number of physiotherapists also reported using interventions that are not recommended (such as patellar mobilization, lumbar, hip and knee mobilization/manipulation and biophysical agents). Physiotherapists with a master's or doctoral degree and those who were aware of clinical practice guidelines were respectively 2.57-fold and 3.81-fold more likely to use recommended interventions. CONCLUSION: Most Brazilian physiotherapists choose interventions that are in line with current scientific evidence. However, a significant number also use interventions that are not recommended for the treatment of PFP.

Fatigue, sleep quality and mental health symptoms in Brazilian women during the COVID-19 pandemic: longitudinal study.

To assess the impact of the COVID-19 pandemic on the variables of sleep quality, fatigue, anxiety, and depression in healthy Brazilian women. Longitudinal observational study conducted through an online questionnaire with women in 2020 and 2021. The Pittsburgh Sleep Quality Index, the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale were used. The data were analyzed descriptively and the comparison between the data obtained in the first and second evaluation was performed using the McNemar test. A logistic regression was applied to test the association between the variables that showed a significant difference. A total of 235 women responded to the questionnaires. There was a significant increase in fatigue between the two moments (p < 0.05). In the first assessment, depression (OR: 2.39; 95% CI: 1.14-4.99), anxiety (OR: 2.68; 95% CI: 1.37-5.22) and sleep quality (OR: 4.01; 95% CI: 1.71-9.67) were associated with fatigue. In the second assessment, depression (OR: 2.93; 95% CI: 1.19-7.18) and anxiety (OR: 2.69; 95% CI: 1.27-5.71) were associated with fatigue. There was an impact on biopsychosocial aspects during the COVID-19 pandemic, with worsening of fatigue symptoms within a 6-month interval. In addition, fatigue was associated with symptoms of depression and anxiety, and worse sleep quality in the first year of the pandemic, remaining associated with symptoms of depression and anxiety in the second year of the pandemic in the country.

Factors associated with symptoms of physical and emotional burden in informal caregivers of the elderly.

OBJECTIVES: to analyze the personal and work-related burden factors associated with physical and emotional symptoms of informal caregivers of the elderly. METHODS: cross-sectional study conducted with 121 informal caregivers and 121 seniors who received care, assessed individually for the risk of: physical overload, musculoskeletal symptoms, Self-Reporting Questionnaire, effort perception, and Katz index. RESULTS: a greater perception of effort raises up to 3.3 times the chances of presenting symptoms of pain in the spine region (p=0.01), and lower functional capacity of the elderly increases up to 1.3 times the chances of presenting pain symptoms in the spine region (p=0.02). The symptoms of emotional overload were associated with the caregiver's low income (p=0.02). CONCLUSIONS: the perception of effort, dependence of the elderly, caregiver's age, and symptoms of emotional overload are involved with caregivers' symptoms of physical overload, and low income, with emotional overload.

Poor Health Conditions among Brazilian Healthcare Workers: The Study Design and Baseline Characteristics of the HEROES Cohort.

This study was conducted to describe the health conditions (the psychosocial aspects, sleep quality, and musculoskeletal symptoms) among Brazilian healthcare workers in the context of the pandemic. Workers answered an online questionnaire, including the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II), the Pittsburgh Sleep Quality Index (PSQI), the Nordic Musculoskeletal Questionnaire (NMQ), and the Beck Depression Inventory (BDI). The most unfavourable psychosocial factors were work pace (61%; 95% CI: 52-69%), emotional work demands (75%; 95% CI: 67-82%), predictability (47%; 95% CI: 39-56%), work-family conflict (55%; 95% CI: 46-64%), burnout (86%; 95% CI: 78-91%), and stress (81%; 95% CI: 73-87%). Most workers (74%; 95% CI: 66-81%) were classified as poor sleepers. Musculoskeletal symptoms were frequent in the neck (64%; 95% CI: 55-72%), shoulders (62%; 95% CI: 54-70%), upper back (58%; 95% CI: 50-67%), and lower back (61%; 95% CI: 52-69%). Depressive symptoms were also highly prevalent (mild: 22%; 95% CI: 15-30%, moderate: 16%; 95% CI: 11-23%, severe: 8%; 95% CI: 4-14%). Most healthcare workers experience unfavourable psychosocial factors, poor sleep quality, as well as musculoskeletal and depressive symptoms. These findings underscore the urgent need to acknowledge and address psychological and physical distress to improve the personal and professional well-being of this population.