Defining text neck: a scoping review.

BACKGROUND: Text neck is regarded as a global epidemic. Yet, there is a lack of consensus concerning the definitions of text neck which challenges researchers and clinicians alike. PURPOSE: To investigate how text neck is defined in peer-reviewed articles. METHODS: We conducted a scoping review to identify all articles using the terms "text neck" or "tech neck." Embase, Medline, CINAHL, PubMed and Web of Science were searched from inception to 30 April 2022. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) guidelines. No limitation was applied for language or study design. Data extraction included study characteristics and the primary outcome relating to text neck definitions. RESULTS: Forty-one articles were included. Text neck definitions varied across studies. The most frequent components of definitions were grouped into five basis for definition: Posture (n = 38; 92.7%), with qualifying adjectives meaning incorrect posture (n = 23; 56.1%) and posture without a qualifying adjective (n = 15; 36.6%); Overuse (n = 26; 63.4%); Mechanical stress or tensions (n = 17; 41.4%); Musculoskeletal symptoms (n = 15; 36.6%) and; Tissue damage (n = 7; 17.1%). CONCLUSION: This study showed that posture is the defining characteristic of text neck in the academic literature. For research purposes, it seems that text neck is a habit of texting on the smartphone in a flexed neck position. Since there is no scientific evidence linking text neck with neck pain regardless of the definition used, adjectives like inappropriate or incorrect should be avoided when intended to qualify posture.

Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies.

BACKGROUND: Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults. METHODS: MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses. RESULTS: Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07-1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08-1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92-1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63-0.68). CONCLUSIONS: Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age.

Are perinatal factors associated with musculoskeletal pain across the lifespan? A systematic review with meta-analysis.

BACKGROUND: Musculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. OBJECTIVE: To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. METHODS: MEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to "perinatal factors" and "musculoskeletal pain". There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. RESULTS: Among the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9-3.8, I2 = 0; n = 157) or pre-term birth (OR 0.5, 95% CI 0.0-4.5; I2 = 78%; n = 374) in adults, respectively. Overall, the quality of evidence after applying the GRADE approach was very low across all the studies. CONCLUSION: In adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.

Contributions of birthweight, annualised weight gain and BMI to back pain in adults: a population-based co-twin control study of 2754 Australian twins.

PURPOSE: To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight. METHODS: The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total sample; within-pair case-control for monozygotic and dizygotic twins together; and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Birthweight was not associated with back pain (OR 0.99; 95% CI 0.99-1.00), but a weak association was found between weight gain (OR 1.01; CI 1.00-1.01) or current BMI (OR 1.02; 95% CI 1.00-1.05) and back pain in the total sample analysis. These associations did not remain significant after adjusting for genetics. The associations did not differ between those whose were born with low or full birthweight. CONCLUSION: Birthweight was not associated with prevalence of back pain in adulthood. Weight gain and current BMI were weakly associated with back pain prevalence in the total sample analysis but did not differ between those born with low or full birthweight. However, the small-magnitude association only just achieved significance and appeared to be confounded by genetics and the early shared environment. Our results suggest that a direct link between these predictors and back pain in adults is unlikely. These slides can be retrieved under Electronic Supplementary Material.

Estado de humor na Artrite Reumatoide / Mood state in Rheumatoid Arthritis

Introdução: A Artrite Reumatoide (AR) é uma doença autoimune de caráter progressivo e incapacitante, associada a perturbações de humor. Contudo, constata-se pouca atenção aos potenciais efeitos das alterações emocionais. Objetivos: Caracterizar e comparar o estado de humor de pacientes com AR, com base no nível de atividade da doença. Métodos: Foram avaliados 80 indivíduos com AR, com 52,72 ± 15,14 anos. Para avaliação do nível de atividade de doença, foi utilizado o Disease Activity Score-28 (DAS-28). A avaliação do Estado de Humor foi realizada com a Escala de Humor Brasileira (BRAMS). Resultados: Foram observadas alterações de humor nos domínios raiva, tensão e vigor sendo que o grupo classificado em alta atividade da doença apresentou os piores quadros de humor. Conclusão: Estes dados ressaltam a importância de um tratamento multidisciplinar, visando melhora do estado de humor e da qualidade de vida desses indivíduos, conduzindo a uma melhor gestão terapêutica da AR.

Introduction: Rheumatoid arthritis (RA) is a progressive and disabling autoimmune associated with mood disorders. However, little attention is paid to the potential effects on the emotional alterations. Objectives: To characterize and compare the mood state of patients with RA, based on the level of disease activity. Methods: 80 subjects were evaluated with RA, with 52.72 ± 15.14 years. The Disease Activity Score-28 (DAS-28) was used to assess the level of the disease activity. The evaluation of the Mood State was performed with the Brazilian Humor Scale (BRAMS). Results: Mood alterations were observed in the anger, tension and vigor domains, of which the group classified as having a high disease activity had the worst mood pictures. Conclusion: These data highlight the importance of a multidisciplinary treatment aiming to improve the mood and quality of life of these individuals, leading to a better therapeutic management of RA

Efeitos da fisioterapia aquática em indivíduos com dor lombar crônica / Effects of aquatic therapy in patients with chronic low back pain

Trata-se de um estudo piloto com objetivo de avaliar o efeito de um programa de fisioterapia aquática na aptidão física, no equilíbrio postural e na dor de pacientes com dor lombar crônica oriunda de hérnia de disco lombar. A amostra foi composta por sete indivíduos,que foram avaliados e submetidos ao programa de tratamento em grupo durante 20 sessões. Como instrumentos foram utilizados: a)Teste Time Up and Go (TUG); b) Teste de Velocidade da Marcha;c) Questionário Rolland Morris e d) Escala Visual Analógica de dor,que foram aplicados antes do início do programa e após a décima e a vigésima sessão. Os resultados demonstram que não houve melhora significativa em nenhuma das variáveis estudadas, embora tenham sido registradas discretas modificações benéficas na velocidade da marcha (0,98 m/s; 1,03 m/s e 1,05 m/s), no tempo do TUG (13,2s; 12,6 s e 11,5 s) e na intensidade da dor (6,42; 5,57 e 5,28). Portanto, o programa de Fisioterapia Aquática proposto promoveu uma discreta alteração no quadro de dor e na capacidade funcional do grupo pesquisado, porém esses dados devem ser vistos com cautela, já que não houve diferença significativa. Assim, sugere-se continuar as investigações utilizando essa terapêutica com número maior de sujeitos.

This pilot study aimed to evaluate the effect of an aquatic therapy program on physical fitness, postural balance and pain in patients with chronic low back pain after lumbar disc herniation. The sample consisted of seven individuals who were evaluated and subjected to the treatment program in group, for 20 sessions. The instruments used were: a) Time up and Go Test (TUG), b) March Speed Test,c) Rolland Morris Disability Questionnaire, and d) Visual Analogue Scale (VAS), which were applied before the program starts and after the tenth and twentieth session. Regarding the results, there was no significant improvement in any of the variables studied, although it was registered a slight increase in walking speed (0.98 m/s, 1.03 m/sand 1.05 m/s), slight decrease in the TUG (13.2 s, 12.6 s and 11.5s) and pain intensity (6.42, 5.57 and 5.28). The refore, the proposed Aquatic Physical Therapy program promoted a little improvement on postural balance and on intensity of pain. However, these results should be viewed with caution since there was no significant difference. Thus, it is suggested to continue investigations using this therapy with larger number of subjects.

Artrite reumatóide e exercício físico: resgate histórico e cenário atual / Rheumatoid arthritis and physical exercise: historical research and current scenario

A Artrite Reumatóide (AR) é considerada uma doença inflamatória crônica, de origem auto-imune e etiologia desconhecida. Além do tratamento fisioterápico e farmacológico, fortes evidências apontam benefícios no uso de exercícios físicos (EF) na sua terapêutica. Porém, ainda não existe consenso quanto ao melhor tipo, intensidade, freqüência e duração. O presente estudo de revisão teve por objetivo realizar um resgate histórico da interpretação e tratamento da doença e expor uma perspectiva atualizada da prescrição de EF para portadores de AR. A seleção das publicações foi realizada a partir das bases de dados Web of Science e Pubmed Central. Outros artigos foram eventualmente incluídos para fortalecer e aprimorar a discussão. Sob a luz da literatura revisada, a terapia com fármacos, repouso e Crisoterapia parecem ter sido a base do tratamento no século passado. Os EF, já mencionados nos primeiros anos de estudos, permanecem até hoje como parte da terapêutica e se configuram cada vez mais como protagonistas na história do controle da AR. É possível admitir que, embora não exista consenso com relação a um protocolo ou programa padrão de EF, existem pontos de comum acordo entre autores que podem ser assumidos como norteadores na confecção de programas terapêuticos para o tratamento da AR. Parece ser fundamental no tratamento da doença que a prática regular de EF seja incluída na rotina da vida diária do paciente o que, em conjunto com a terapia farmacológica, pode proporcionar maior independência e qualidade na vida dos portadores de AR.

The Rheumatoid Arthritis (RA) is considered a chronic inflammatory disease, of autoimmune origin and unknown etiology. Besides the physical therapy and the pharmacological treatment, strong evidences point out to the benefits of the use of physical exercises (PE) in its treatment. However, there is still no consensus regarding the best type, intensity, frequency and duration. The aim of the present study was to perform a historical research of the interpretation and therapeutics of the disease and to expose an up to date perspective of the prescription of PE in the treatment of RA. The selection of these publications was performed on the Web of Science and Pubmed Central data basis. Other articles were eventually included to strengthen and improve the discussion. Regarding the revised literature, the pharmacological therapy, rest and Crisotherapy were the basis for the treatment of the disease. The PE, already mentioned in the first years of study remain until this day as a part of the therapy and seem to be increasingly important in the history of the control of the RA. It is possible to admit that, even though there is no consensus regarding a protocol or a standard program of PE, there are points in which many authors agree, that may be assumed as references in the creation of therapeutic programs for the treatment of RA. It seems to be fundamental in the treatment of the disease that the regular practice of PE is included in the daily routine of the patient, which, along with the pharmacological therapy, may provide a greater independence and quality of life to the people with RA.