Ten-Item Lower Extremity Functional Scale (LEFS-10): Instrument Reduction Based on Brazilian Patients With Lower Limb Dysfunction.

OBJECTIVE: To propose a short version of the lower extremity functional scale (LEFS), to compare our short version with the different structures proposed for the LEFS by the specialized literature, and to verify the criterion validity of the best structure of the LEFS identified in our study. DESIGN: Cross-sectional observational study. SETTING: Physiotherapy clinics. PARTICIPANTS: We included 140 patients with lower limb dysfunction (N=140). INTERVENTIONS: None. MAIN OUTCOME MEASURES: We used confirmatory factor analysis (CFA), χ2/degree of freedom (DF), comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), standardized root mean squared residual (SRMR), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The method of reducing the number of items of the LEFS considered the modification indices and factor loadings. RESULTS: The body site most affected by pain was the knee (71.4%), and the most common diagnoses were knee osteoarthritis (55%) and anterior knee pain (11.4%). LEFS reduction generated a 1-dimensional structure of the LEFS with 10 items (LEFS-10). When compared with other structures, the LEFS-10 presented the best fit indices (χ2/DF=1.88, CFI=0.975, TLI=0.968, RMSEA=0.079, and SRMR=0.058) and the lowest values of AIC (3287.063) and BIC (3345.896). LEFS-10 presents a high correlation (Spearman's correlation coefficient [ρ]=0.911, P<.001) with the 20-item LEFS. CONCLUSION: LEFS-10 is the proposal for a short version of the instrument with the most adequate internal structure, in addition to being satisfactorily correlated with the longer version of the instrument.

Correlation Between Chronic Neck Pain and Heart Rate Variability Indices at Rest: A Cross-sectional Study.

OBJECTIVE: The purpose of this study was to correlate the heart rate variability (HRV) indices with variables of pain that were experienced by individuals with chronic neck pain. METHODS: This was a blinded cross-sectional study. Individuals with chronic neck pain (n = 15) and healthy participants (n = 15), both sedentary and between 18 and 45 years of age, were included. The neck pain was assessed with the Numerical Rating Scale at rest and during cervical movements, Neck Disability Index, Catastrophic Thoughts about Pain Scale, and Tampa Scale of Kinesiophobia. The HRV indices (linear and nonlinear) were used for assessment of autonomic function at rest (in supine, sitting, and standing positions). RESULTS: We observed significant correlations between the NRS, Neck Disability Index, and Catastrophic Thoughts about Pain Scale with the linear and nonlinear HRV indices (P < .05, r ≥ 0.362), so that the worst HRV indices are associated with conditions of more intense and disabling neck pain. CONCLUSION: The HRV indices were significantly associated with pain intensity, disabilty, and catastrophizing in individuals with chronic neck pain.

Correlation Between Severity of Temporomandibular Disorder, Pain Intensity, and Pressure Pain Threshold.

OBJECTIVE: The aim of the present study was to correlate the severity of temporomandibular disorder (TMD) with the pressure pain threshold over the temporomandibular joint and masticatory muscles. METHODS: A blind, cross-sectional study was conducted involving 60 women ages 18 to 40 years with a diagnosis of myogenous TMD. Evaluations were performed using the Fonseca Anamnestic Index (FAI), the visual analogue scale, and algometry over the temporomandibular joint and masticatory muscles. Spearman's correlation coefficients (rs) were calculated to measure the association between TMD severity, pain intensity, and the pressure pain threshold. RESULTS: A moderate, significant, and negative correlation was found between TMD severity and the pressure pain threshold over the left masseter muscle (rs = -0.276; P = .034). No significant correlations were found for the other variables analyzed (P = .124-.985). CONCLUSIONS: Temporomandibular disorder measured using the FAI was associated to the pressure pain threshold over the masseter muscle. The significant and negative association found between the score of the FAI and the pressure pain threshold over the masseter muscle demonstrated that patients with more severe signs and symptoms of TMD had a lower pressure pain threshold.

Evaluation of Postural Balance and Articular Mobility of the Lower Limbs in Chronic Neck Pain Patients by Means of Low-Cost Clinical Tests.

OBJECTIVE: The purpose of this study was to correlate measurements of chronic neck pain with the balance and mobility of the lower limbs and to compare these variables between individuals with chronic neck pain and asymptomatic participants. METHODS: This was a blinded cross-sectional study. Participants with chronic neck pain (n = 30) and asymptomatic participants (n = 30) were included in the study. To measure pain in the neck region, the Numeric Rating Scale, Neck Disability Index, and Pain-Related Catastrophizing Thoughts Scale were applied. The assessment of postural balance and mobility of the lower limbs was made using the Timed Up and Go Test, Functional Reach Test (FRT), Lateral Reach Test, and 30-second Chair Stand Test. RESULTS: No statistically (P > .05) and clinically (d < 0.50) significant differences were identified for the variables tested here. However, regarding the correlations, a significant association was identified only between the intensity of pain during cervical movements and FRT (r = -0.312). CONCLUSION: Young adults with chronic neck pain present changes in static balance measured by means of the FRT; that is, the higher the intensity of pain, the lower the anteroposterior excursion of the body during the execution of the test.

Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain.

OBJECTIVE: This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS: This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student's t-test for comparisons and Spearman's coefficient for correlations. RESULTS: We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS: Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.

Correlation between tactile acuity, pain intensity, and functional capacity in individuals with chronic neck pain.

OBJECTIVE: The aim of this study was to verify the correlation between tactile acuity, intensity of pain at rest, and movement and functional capacity in individuals with chronic neck pain. METHODS: This was a cross-sectional study composed of two groups: individuals with chronic neck pain and individuals without neck pain. Evaluations were performed using the Numerical Rating Pain Scale at rest and movement, Neck Disability Index, and two-point discrimination test. RESULTS: The final sample consisted of 100 volunteers, 50 in each group. The groups did not show significant differences (p>0.05) in personal characteristics. It was observed that volunteers with cervical pain presented alterations in tactile care, with a significant and clinical increase in the perceived distance (Median 6.66; 95%CI 6.29-7.02; Cohen's d 7.22; 95%CI 6.15-8.30), and yet, positive, moderate, and significant correlation between two-point discrimination test, intensity of pain at rest and movement, and neck disability index (r=0.778-0.789, p<0.05). CONCLUSION: Tactile acuity is associated with pain intensity at rest and movement and functional capacity in individuals with chronic neck pain.

Brazilian Version of the Self-Estimated Functional Inability Because of Pain in Dancers: A Validation Study.

OBJECTIVE: The purpose of this study was to measure the reliability, internal consistency, construct validity, and floor and ceiling effects of the Brazilian version of the Self-Estimated Functional Inability because of Pain (SEFIP-dance) instrument. METHODS: This was a questionnaire validation study. Both professional dancers and those who use dance as a recreational activity were included in the study. For test-retest reliability, SEFIP-dance was administered to the same dancer at 2 different times, with an interval of 7 days between the moments. For construct validity, Spearman's correlation coefficient (r s) was used to determine the magnitude of the correlations between SEFIP-dance and the Numerical Rating Scale, the 36-Item Short-Form Health Survey, the Roland-Morris Disability Questionnaire for general pain, and the Örebro Musculoskeletal Pain Questionnaire. RESULTS: A total of 111 dancers were recruited and included in the study. From this total sample, a subsample of 31 was used for the calculations of test-retest reliability: when considering each item of SEFIP-dance, we observed adequate κ values (κ ≥ 0.52); considering the total score, we observed excellent reliability (intraclass correlation coefficient = 0.94). In addition, we identified adequate values for internal consistency (Cronbach's α ≥ 0.80). We observed significant correlations of the SEFIP-dance total score with the Numerical Rating Scale, 36-Item Short-Form Health Survey, the Roland-Morris questionnaire, and the Örebro Musculoskeletal Pain Questionnaire (r s varying between 0.248 and 0.489). Ceiling and floor effects were not observed. CONCLUSION: This study found that the Brazilian Portuguese version of SEFIP-dance has psychometric properties suitable for its use in dancers.

Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain

SUMMARY OBJECTIVE: This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS: This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student's t-test for comparisons and Spearman's coefficient for correlations. RESULTS: We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS: Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.

[Characteristics of the notification of violence against children in the municipality of Ribeirão Preto, São Paulo, Brazil]. / Caracterização das notificações de violência em crianças no município de Ribeirão Preto, São Paulo, no período 2006-2008.

OBJECTIVE: to describe the cases of violence against children reported in Ribeirão Preto-SP, Brazil. METHODS: this was a descriptive study using data provided by the Violence and Accidents Surveillance System (VIVA), of the Municipal Health Department of Ribeirão Preto-SP, Brazil, from 2006 to 2008. RESULTS: a total of 498 cases of violence against children (0-9 years old) were reported in the period, with an increase in the number of notifications, from 112 in 2006 to 197 in 2008; 79.3% of the notifications came from the Health area; and most children were female (56.4%), aged between two and five years old (over 60%); most aggressors were male (53.6%) and the father figure stood out (22.7%); physical aggressions were the most frequent (59.2%) and the most frequent place of the occurrence was the family household (75.5%). CONCLUSION: most victims were female, abused by men, mostly fathers and other family members, at the family household.

Correlation between tactile acuity, pain intensity, and functional capacity in individuals with chronic neck pain

SUMMARY OBJECTIVE: The aim of this study was to verify the correlation between tactile acuity, intensity of pain at rest, and movement and functional capacity in individuals with chronic neck pain. METHODS: This was a cross-sectional study composed of two groups: individuals with chronic neck pain and individuals without neck pain. Evaluations were performed using the Numerical Rating Pain Scale at rest and movement, Neck Disability Index, and two-point discrimination test. RESULTS: The final sample consisted of 100 volunteers, 50 in each group. The groups did not show significant differences (p>0.05) in personal characteristics. It was observed that volunteers with cervical pain presented alterations in tactile care, with a significant and clinical increase in the perceived distance (Median 6.66; 95%CI 6.29-7.02; Cohen's d 7.22; 95%CI 6.15-8.30), and yet, positive, moderate, and significant correlation between two-point discrimination test, intensity of pain at rest and movement, and neck disability index (r=0.778-0.789, p<0.05). CONCLUSION: Tactile acuity is associated with pain intensity at rest and movement and functional capacity in individuals with chronic neck pain.

Queixas musculoesqueléticas no ombro: características dos usuários e dos atendimentos na atenção primária / Quejas musculoesqueléticas en el hombro: características de los pacientes en las consultas de la atención primaria / Musculoskeletal shoulder complaints: characteristics of patients and consultations in primary care

RESUMO A dor no ombro representa a terceira principal queixa musculoesquelética da população. Afeta fatores físicos, psicológicos e econômicos do indivíduo. A atenção primária à saúde é essencial para a eficácia do cuidado dos pacientes acometidos. Este estudo é observacional transversal e obteve um perfil dos usuários e das consultas médicas com relato de dor no ombro durante um ano na atenção primária do município de Ribeirão Preto (SP). Foram analisados em prontuários os registros das consultas médicas agendadas e sem agendamento prévio. Nestes registros foram coletados dados dos pacientes que apresentaram queixas de dor musculoesquelética no ombro (dados sociodemográficos e características das consultas), que foram analisados de forma descritiva e pelos testes qui-quadrado de Pearson, razão de chance e regressão logística múltipla. A frequência de consultas médicas por queixa de dor no ombro foi de 9,2%. O perfil dos indivíduos que se queixaram de dor no ombro se caracterizava por mulheres, com idade avançada, casadas, alfabetizadas e que apresentavam alguma ocupação. As consultas em sua maioria tiveram retornos agendados, oferecimento de orientações terapêuticas e poucos encaminhamentos.

RESUMEN El dolor en el hombro representa la tercera principal queja musculoesquelética de la población. Acomete los factores físicos, psicológicos y económicos del individuo. La atención primaria a la salud es esencial para la eficacia del cuidado de los pacientes afectados. Este estudio de tipo observacional transversal obtuvo un perfil de los usuarios y de las consultas médicas en que había relato de dolor en el hombro durante un año en la atención primaria del municipio de Ribeirão Preto (SP). Se analizaron los registros de las consultas médicas programadas y sin programación previa. En estos registros se recolectaron los datos de los pacientes que se quejaban de dolor musculoesquelético en el hombro (sus datos sociodemográficos y las características de las consultas), los cuales fueron analizados de forma descriptiva y por la prueba chi-cuadrado de Pearson, por las razones de prevalencia y por la regresión logística múltiple. La frecuencia de consultas médicas por queja de dolor en el hombro fue del 9,2%. El perfil de los individuos que se quejaron de dolor en el hombro fue de mujeres, con edad avanzada, casadas, alfabetizadas y que se dedicaban a alguna actividad. Las consultas en su mayoría tuvieron retornos programados, ofrecimiento de orientaciones terapéuticas y pocos encaminamientos.

ABSTRACT Shoulder pain is the third most common musculoskeletal complaint of the world population. It affects the physical, psychological and financial situation of the individual. Primary care is essential to an effective health care for affected patients. This cross-sectional and observational study has the purpose of characterizing the profile of users of the primary health care service, and analyzing the medical records with shoulder pain reports over an one-year period in the primary care service of Ribeirão Preto - SP. Medical records of patients with scheduled and unscheduled medical consultations were analyzed. Data from patients with musculoskeletal shoulder pain - sociodemographic data and the consultation characteristics - were collected and analyzed descriptively and by Pearson's Chi-squared test, Odds Ratio and Multiple Logistic Regression. The frequency of shoulder pain in the primary care was 9.2%. The profile of individuals who complained about shoulder pain was advanced age, married, literate and working women. Most consultations had scheduled follow-up consultations, therapeutic guidance and few referrals.

Estilo de vida e nível de atividade física de indivíduos com dor no ombro atendidos em um serviço público / Lifestyle and physical activity level in shoulder pain individuals assisted in a public service

Esse estudo teve como objetivo caracterizar o Perfil de Estilo de Vida Individual (PEVI) de indivíduos com dor no ombro em relação à atividade física (AF), nutrição, controle do estresse, relacionamento social e comportamento preventivo e verificar a correlação entre o componente AF do PEVI e o domínio de incapacidade avaliado pelo Shoulder Pain and Disability Index (SPADI). Trata-se de um estudo transversal, com 100 indivíduos adultos e idosos com dor no ombro (55,3 ± 12 anos, 83% mulheres) atendidos em um serviço público de fisioterapia em 2015/2016. Os indivíduos responderam ao questionário PEVI e ao SPADI para avaliação da dor e incapacidade do ombro. Os resultados indicam que 84% dos avaliados apresentaram PEVI de regular a ruim (pontuação ≤ 33), sendo positivo (pontuação média = 2 a 3) para comportamento preventivo e relacionamento social em 94% e 53% dos indivíduos, respectivamente. Nos demais componentes, as respostas se concentraram no perfil regular (pontuação média = 1 a 1,99) e positivo, mas o componente AF apresentou o maior número de indivíduos (30%) com perfil negativo (pontuação média < 1) e identificou que a maioria não realiza AF moderada a intensa e exercícios de força e alongamento muscular. Os níveis de incapacidade do ombro e de AF apresentaram uma correlação baixa (-0,179; p=0,040). Em conclusão, indivíduos com dor no ombro apresentam estilo de vida regular, sendo importante incentivar a prática de atividade física para melhora da qualidade de vida.

This study aimed to characterize the Individual Lifestyle Profile (PEVI) of individuals with shoulder pain in relation to physical activity (PA), nutrition, stress management, social relationship and preventive behavior and to verify the correlation between PA component of PEVI and the disability domain assessed by the Shoulder Pain and Disability Index (SPADI). This is a cross-sectional study with 100 adult and elderly individuals with shoulder pain (55.3 ± 12 years, 83% female) attending in a public physiotherapy service in 2015/2016. Individuals answered the PEVI questionnaire and SPADI for shoulder pain and disability assessment. The results indicate that 84% of the patients presented PEVI from regular to poor (score ≤ 33), and positive (mean score = 2 to 3) for preventive behavior and social relationships in 94% and 53% of the individuals, respectively. For the other components, responses were concentrated in the regular profile (mean score = 1 to 1.99) and positive, but the PA component had the highest number of individuals (30%) with a negative profile (mean score <1) and identified most do not perform moderate to intense PA and muscle strength and stretching exercises. Shoulder disability levels and PA showed a low correlation (-0.179; p = 0.040). In conclusion, individuals with shoulder pain present a regular lifestyle, and it is important to encourage the practice of physical activity to improve the quality of life.

Caracterização das notificações de violência em crianças no município de Ribeirão Preto, São Paulo, no período 2006-2008 / Characteristics of the notification of violence against children in the municipality of Ribeirão Preto, São Paulo, Brazil / Caracterización de las notificaciones de violencia en niños en el municipio de Ribeirão Preto, São Paulo, en el periodo 2006-2008

OBJETIVO: descrever os casos de violência contra crianças notificados no município de Ribeirão Preto-SP, Brasil. MÉTODOS: estudo descritivo com dados do Sistema de Vigilância de Violências e Acidentes (VIVA) da Secretaria Municipal de Saúde de Ribeirão Preto-SP, Brasil, no período de 2006 a 2008. RESULTADOS: foram registrados 498 casos de violência contra crianças (0-9 anos) no período, com elevação no número de notificações, de 112 em 2006 a 197 em 2008, 79,3% das notificações foram provenientes da área da Saúde, a maioria das crianças era do sexo feminino (56,4%) e apresentava idade entre dois e cinco anos (mais de 60%); prevaleceram agressores do sexo masculino (53,6%), com destaque para a figura paterna (22,7%); agressões físicas foram as mais frequentes (59,2%) e o local de maior ocorrência foi a casa da família (75,5%). CONCLUSÃO: predominaram vítimas do sexo feminino, agredidas por homens, predominantemente pais e outros familiares, na casa da família.

OBJECTIVE: to describe the cases of violence against children reported in Ribeirão Preto-SP, Brazil. METHODS: this was a descriptive study using data provided by the Violence and Accidents Surveillance System (VIVA), of the Municipal Health Department of Ribeirão Preto-SP, Brazil, from 2006 to 2008. RESULTS: a total of 498 cases of violence against children (0-9 years old) were reported in the period, with an increase in the number of notifications, from 112 in 2006 to 197 in 2008; 79.3% of the notifications came from the Health area; and most children were female (56.4%), aged between two and five years old (over 60%); most aggressors were male (53.6%) and the father figure stood out (22.7%); physical aggressions were the most frequent (59.2%) and the most frequent place of the occurrence was the family household (75.5%). CONCLUSION: most victims were female, abused by men, mostly fathers and other family members, at the family household.

OBJETIVO: describir los casos de violencia contra niños notificados en el municipio de Ribeirão Preto-SP, Brasil. MÉTODOS: estudio descriptivo con datos del Sistema de Vigilancia de Violencias y Accidentes (VIVA) de la Secretaria Municipal de Salud de Ribeirão Preto-SP, de 2006 a 2008. RESULTADOS: se registraron 498 casos de violencia infantil (de 0 a 9 años) en dicho periodo, aumentando las notificaciones de 112 en 2006 y 197 en 2008, siendo el 79,3% provenientes del área de salud; la mayoría de los niños era de sexo femenino (56,4%) de edad entre dos y cinco años (más de 60%); prevalecieron agresores de sexo masculino (53,6%), destacándose la figura paterna (22,7%); las agresiones físicas fueran las más practicadas (59,2%) y el lugar de mayor ocurrencia fue la casa de la familia (75,5%). CONCLUSIÓN: predominaron víctimas de sexo femenino agredidas por hombres, en gran parte padres y otros familiares en casa de la familia.

Prevalência de encaminhamentos às doenças musculoesqueléticas segundo a classificação estatística internacional de doenças (CID-10): reflexões para formação do fisioterapeuta na área de musculoesquelética / Prevalencia de las remisiones a las enfermedades musculo esqueléticas según la Clasificación Estadística Internacional de Enfermedades (CIE-10): reflexiones a la formación del fisioterapeuta en el área de musculo esquelético / Referrals Prevalence of the musculoskeletal diseases according to the international statistical classification of diseases (ICD-10): reflections for education in musculoskeletal physiotherapy

A dor musculoesquelética pode ser caracterizada como aguda ou crônica e é o sintoma mais prevalente na população mundial. É possível afirmar que estará presente na vida de todos os adultos. A incidência tem aumentado muito nos últimos anos em função das mudanças nos hábitos de vida, meio ambiente, além do estresse e aumento das cobranças no mundo corporativo. Os gastos com esse agravo são cada vez maiores e suas consequências físicas, psicológicas e sociais são evidentes. Embora com significativo impacto na vida das pessoas com dor musculoesquelética, poucas são as reflexões que relacionam ensino, demandas de serviços e as doenças musculoesqueléticas. Trata-se de um estudo epidemiológico quantitativo descritivo, tipo levantamento, que teve como objetivo descrever o perfil dos encaminhamentos aos serviços de Fisioterapia e procedimentos relacionados a Classificação Estatística Internacional de Doenças, CID-10, na cidade de Ribeirão Preto e fornecer reflexões para a formação profissional no Brasil. Os resultados apontaram uma maior frequência de encaminhamentos do sexo feminino (70,52%), a dor lombar baixa representou a CID-10 mais frequente (12,14%) e os profissionais Fisioterapeutas, Fisiatras e Médicos Clínicos foram os que mais encaminharam, com 48,57% dos casos. A maioria dos encaminhamentos foi para serviços ambulatoriais (57,55%). Com os resultados, almejou-se fornecer aos gestores dos serviços de saúde e aos responsáveis pela formação em saúde elementos para organizar a demanda de cuidado aos usuários, capacitação de servidores e fundamentar iniciativas de pesquisa, acompanhamento, prevenção desse agravo, além de atualizar as estratégias de ensino.

El dolor musculo esquelético puede caracterizarse como agudo o crónico y es el síntoma más frecuente en la población mundial. Es posible afirmar que estará presente en la vida de todos los adultos. Su incidencia como aguda o crónica ha aumentado mucho en los últimos años en función de cambios en el estilo de vida, del medioambiente, además del estrés y aumento de los cobros en el mundo laboral. Se gasta mucho con este problema y sus consecuencias físicas, psicologías y sociales son evidentes. Aunque con significativo impacto en la vida de los sujetos con dolor musculo esquelético, las reflexiones que relacionan enseñanza, demanda por servicios a las enfermedades musculo esqueléticas son pocas. Se trata de un estudio epidemiológico cuantitativo descriptivo, de tipo encuesta, que tuvo por objetivo describir el perfil de las remisiones a los servicios de fisioterapia y los procedimientos relacionados a la Clasificación Estadística Internacional de Enfermedades, CIE-10, en la ciudad de Ribeirão Preto, SP, con el fin de producir reflexiones a la formación profesional en el Brasil. Los resultados muestran una mayor frecuencia de remisiones del género femenino (70,52%), el dolor lumbar baja representó la CIE-10 más frecuente (12,14%) y los profesionales fisioterapeutas, fisiatras y médicos clínicos fueron los que más encaminaron la gente, con el 48,57% de los casos. La mayoría de las remisiones fueron para servicios de ambulatorio (57,55%). Con los resultados, se anheló proporcionar a los gestores de salud y a los responsables por la formación en salud elementos para organizar la demanda de cuidado a los sujetos, capacitación de los empleados públicos y fundamentación de iniciativas de investigación, supervisión, prevención del problema, además de actualización de estrategias de enseñanza.

Musculoskeletal pain can be characterized as acute or chronic and is the most prevalent symptom in the population. It might be assumed that pain will be present in the lives of all adults. Its incidence has greatly increased in recent years due to changes in lifestyle, environment as well as stress and the increasing demands of the cor porate world. Expenses with this injury are increasing and their physical, psychological and social consequences are evident. Although with significant impact on the lives of people with musculoskeletal pain, there are few reflec tions that relate teaching, service demands and muscu loskeletal diseases. This is a descriptive quantitative epi demiological study type survey, which aimed to describe the profile of referrals for physical therapy procedures and related services to International Statistical Classification of Diseases, ICD-10, in the city of Ribeirão Preto and provide reflections for professional training in Brazil. The results showed a higher frequency of referrals of female patients (70.52%), low back pain represented the most frequent ICD-10 (12.14%) and Physical Therapists, Physiatrists and Clinical Doctors were responsible for most of the referrals, with 48.57% of cases. Most referrals were for outpatient services (57.55%). It is aimed to provide to health service managers and those responsible for health training with the results of this research some elements to organize the demand for care users, server training and support re search initiatives, monitoring, preventing these events and updating the teaching strategies.