Reliability and Validity of Shoulder and Handgrip Strength Testing.

Purpose: This study aimed to estimate the intra- and inter-rater reliability of the JTECH computerized, wireless apparatus and its validity (compared to established devices) for measurements of maximal shoulder isometric strength and handgrip strength among healthy adults with no shoulder pathology. Methods: Twenty healthy young adults had shoulder strength tested with JTECH and Micro-FET2 hand-held dynamometers, and the handgrip strength was tested using JTECH and Jamar handgrip dynamometers. Assessments were performed by the same rater to determine intra-rater reliability and convergent validity, at least two days apart, while on a third visit, the other rater performed measures to determine inter-rater reliability. Results: The JTECH computerized, wireless devices demonstrated good to excellent intra-rater reliability (ICCs (2,1) = 0.78-0.97) and inter-rater reliability for strength measures (ICCs (2,1) = 0.76-0.95). The JTECH computerized device compared to the Micro-FET2 hand-held dynamometer showed substantial concurrent validity for shoulder flexion (R2 = 0.87), extension (R2 = 0.87), abduction (R2 = 0.88), and adduction (R2 = 0.85). Substantial concurrent validity was shown for the JTECH computerized device and Jamar handgrip dynamometers (R2 = 0.92). Conclusions: The JTECH computerized, wireless devices demonstrated high intra- and inter-rater reliability and substantial concurrent validity for shoulder isometric strength and handgrip strength in healthy adults.

Objectif : évaluer la fiabilité intraévaluateur et interévaluateur et la validité (par rapport à des appareils éprouvés) du dispositif informatisé sans fil JTECH pour mesurer la force isométrique de l'épaule et la force de préhension maximales chez des adultes en santé sans pathologie de l'épaule. Méthodologie : vingt jeunes adultes en bonne santé ont fait vérifier la force de leur épaule à l'aide des dynamomètres manuels JTECH et Micro-FET2, et leur force de préhension à l'aide des dynamomètres à poignée JTECH et Jamar. Le même évaluateur a procédé aux évaluations pour déterminer la fiabilité intraévaluateur et la validité convergente, à au moins deux jours d'intervalle, tandis qu'à un troisième rendez-vous, l'autre évaluateur a effectué des mesures pour établir la fiabilité interévaluateur. Résultats : les dispositifs informatisés sans fil JTECH possèdent une fiabilité intraévaluateur (coefficient de corrélation intraclasse, ou CCI [2,1] = 0,78 à 0,97) et une fiabilité interévaluateur pour mesurer la force (CCI [2,1] = 0,76 à 0,95) bonnes à excellentes. Par rapport au dynamomètre manuel Micro-FET2, le dispositif informatisé sans fil JTECH a démontré une validité convergente importante à l'égard de la flexion (R2 = 0,87), de l'extension (R2 = 0,87), de l'abduction (R2 = 0,88) et de l'adduction (R2 = 0,85) de l'épaule. Le dispositif informatisé JTECH et le dynamomètre manuel Jamar ont également démontré une validité convergente importante (R2 = 0,92). Conclusions : les dispositifs informatisés sans fil JTECH ont démontré une fiabilité intraévaluateur et interévaluateur élevée et une validité convergente importante pour la force isométrique de l'épaule et la force de préhension chez des adultes en santé.

Loss of Neural Automaticity Contributes to Slower Walking in COPD Patients.

The physical impairments (e.g., slower walking speed) in patients with chronic obstructive pulmonary disease (COPD) have been attributed to peripheral characteristics (e.g., muscle atrophy). However, cognitive impairment may compromise motor control including walking automaticity. The objective of this study was to investigate PFC neural activity, evaluated using changes in oxygenated hemoglobin (ΔO2Hb), during preferred paced walking (PPW) in COPD patients and age-matched controls. The ΔO2Hb from the left and right dorsolateral PFC was measured using functional near-infrared spectroscopy. Fifteen COPD patients (age: 71 ± 8) and twenty age-matched controls (69 ± 7 years) participated. Two-way mixed ANOVA demonstrated that O2Hb in both groups decreased during PPW from the start (quintile 1; Q1) to the end (quintile 5; Q5) in the left dorsolateral and medial PFC. Q1 was comprised of the data during the first 20% of the task, while Q5 included data collected in the last 20% of the task duration. PPW duration ranged between 30.0 and 61.4 s in the control group and between 28.6 and 73.0 s in COPD patients. COPD patients demonstrated a higher O2Hb in Q5 compared to the negative O2Hb in controls in the right medial and dorsolateral PFC during PPW. PPW velocity was lower in COPD patients compared to controls (1.02 ± 0.22 vs. 1.22 ± 0.14 m/s, p = 0.005). Healthy older controls exhibited automaticity during walking unlike patients with COPD. The lesser decrease in O2Hb in COPD patients may be attributed to increased executive demands or affect-related cues (e.g., pain or dyspnea) during walking.

Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women / Fatores associados com o nível de atividade física e a prática de exercício em gestantes de alto risco

Abstract Objective To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. Methods A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. Results Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81±81.84 METs), followed by work-related activities (40.77±84.71 METs). Only 19.3% women exercised during pregnancy (4.76±12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR=29.8; 95% CI 4.9-117.8). Nulliparity (OR=3.1; 95% CI 1.0-9.1), low levels of anxiety (OR=3.6; 95% CI 1.2-10.7), and unemployment (OR=4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy. Conclusion Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.

Resumo Objetivo Analisar o nível de atividade física e a prática de exercício físico, examinar as características maternas associadas, assim como níveis de ansiedade de gestantes de alto risco. Métodos Estudo observacional, transversal e quantitativo, realizado no ambulatório de Pré-Natal de Alto Risco (PNAR) de uma maternidade terciária. Foram incluídas gestantes comidade entre de 18 e 40 anos; feto único e comidade gestacional (IG) até 38 semanas.O nível de atividade física e prática de exercício físico das participantes do estudo foram investigados usando o Questionário de Atividade Física na Gestação (QAFG). Os dados sociodemográficos, antropométricos e médicos maternais foram investigados usando um formulário específico. Para níveis de ansiedade, a versão curta do Inventário de Ansiedade Traço-Estado (STAI) foi aplicado. Usamos o teste t de Student, teste qui-quadrado, razão de chances (OR) com um intervalo de confiança de 95% (IC 95%) e regressão logística multinomial. O nível de significância considerado foi 5%. Resultados Das 109 gestantes incluídas no estudo, 82 (75,2%) foi classificada como sedentária/pouco ativa. Os maiores gastos energéticos foram em atividades domésticas (133.81±81.84 METs), seguidas pelas atividades ocupacionais (40.77±84.71 METs). Apenas 19.3% praticaram exercício físico durante a gravidez (4.76±12.47 METs), sendo a caminhada lenta a atividade mais relatada. Maior grau de escolaridade foi o fator mais importante associado a gestante ser moderadamente ou vigorosamente ativa (OR=29,8; IC 95% 4,9-117,8) . Nuliparidade (OR=3,1; IC 95% 1,0-9,1), baixos níveis de ansiedade (OR=3,6; IC 95% 1,2-10,7) e não trabalhar na gestação (OR=4,8; IC 95% 1.1-19,6) foram associados à prática de exercício físico durante a gestação. Conclusão A maioria das gestantes de alto risco desenvolveram um padrão sedentário, com baixa prevalência da prática de exercício físico. Reconhecer os fatores que dificultam a adoção de um estilo de vida mais ativo fisicamente é fundamental para a orientação adequada e individualizada acerca da prática de exercício físico durante a gestação.

Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women.

OBJECTIVE: To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. METHODS: A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. RESULTS: Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81 ± 81.84 METs), followed by work-related activities (40.77 ± 84.71 METs). Only 19.3% women exercised during pregnancy (4.76 ± 12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR = 29.8; 95% CI 4.9-117.8). Nulliparity (OR = 3.1; 95% CI 1.0-9.1), low levels of anxiety (OR = 3.6; 95% CI 1.2-10.7), and unemployment (OR = 4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy. CONCLUSION: Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.

OBJETIVO: Analisar o nível de atividade física e a prática de exercício físico, examinar as características maternas associadas, assim como níveis de ansiedade de gestantes de alto risco. MéTODOS: Estudo observacional, transversal e quantitativo, realizado no ambulatório de Pré-Natal de Alto Risco (PNAR) de uma maternidade terciária. Foram incluídas gestantes com idade entre de 18 e 40 anos; feto único e com idade gestacional (IG) até 38 semanas. O nível de atividade física e prática de exercício físico das participantes do estudo foram investigados usando o Questionário de Atividade Física na Gestação (QAFG). Os dados sociodemográficos, antropométricos e médicos maternais foram investigados usando um formulário específico. Para níveis de ansiedade, a versão curta do Inventário de Ansiedade Traço-Estado (STAI) foi aplicado. Usamos o teste t de Student, teste qui-quadrado, razão de chances (OR) com um intervalo de confiança de 95% (IC 95%) e regressão logística multinomial. O nível de significância considerado foi 5%. RESULTADOS: Das 109 gestantes incluídas no estudo, 82 (75,2%) foi classificada como sedentária/pouco ativa. Os maiores gastos energéticos foram em atividades domésticas (133.81 ± 81.84 METs), seguidas pelas atividades ocupacionais (40.77 ± 84.71 METs). Apenas 19.3% praticaram exercício físico durante a gravidez (4.76 ± 12.47 METs), sendo a caminhada lenta a atividade mais relatada. Maior grau de escolaridade foi o fator mais importante associado a gestante ser moderadamente ou vigorosamente ativa (OR = 29,8; IC 95% 4,9­117,8) . Nuliparidade (OR = 3,1; IC 95% 1,0­9,1), baixos níveis de ansiedade (OR = 3,6; IC 95% 1,2­10,7) e não trabalhar na gestação (OR = 4,8; IC 95% 1.1­19,6) foram associados à prática de exercício físico durante a gestação. CONCLUSãO: A maioria das gestantes de alto risco desenvolveram um padrão sedentário, com baixa prevalência da prática de exercício físico. Reconhecer os fatores que dificultam a adoção de um estilo de vida mais ativo fisicamente é fundamental para a orientação adequada e individualizada acerca da prática de exercício físico durante a gestação.

Decreased automaticity contributes to dual task decrements in older compared to younger adults.

PURPOSE: To contrast older and younger adults' prefrontal cortex (PFC) neural activity (through changes in oxygenated hemoglobin) during single and dual tasks, and to compare decrements in task performance. METHODS: Changes in oxygenated hemoglobin of dorsolateral PFC were monitored using functional near-infrared spectroscopy during single tasks of spelling backwards (cognitive task) and 30 m preferred paced walk; and a dual task combining both. Gait velocity was measured by a pressure sensitive mat. RESULTS: Twenty sex-matched younger (27.6 ± 3.5 years) and 17 older adults (71.2 ± 4.9 years) were recruited. The left PFC oxygenated hemoglobin decreased from start (1st quintile) to the end (5th quintile) of the walking task in younger adults ( - 0.03 ± 0.03 to - 0.72 ± 0.20 µM; p < .05) unlike the non-significant change in older adults (0.03 ± 0.06 to - 0.41 ± 0.32 µM, p > .05). Overall, oxygenation increased bilaterally during dual versus single walk task in older adults (Left PFC: 0.22 ± 0.16 vs. - 0.23 ± 0.21 µM, respectively; Right PFC: 0.17 ± 0.18 vs. - 0.33 ± 0.22 µM, respectively), but only in right PFC in younger adults ( - 0.02 ± 0.15 vs. - 0.47 ± 0.13 µM). Older adults exhibited lower velocity during the dual task compared to younger adults (1.03 ± 0.16 vs. 1.20 ± 0.17 m/s, respectively). Older age was associated with dual task cost on velocity during walking after adjusting for confounding variables. CONCLUSIONS: Age-related cognitive decline in older adults may increase neural activity for cognitive tasks and diminish walking automaticity that may lead to decrements during dual tasking; the greater PFC increases in the oxygenated hemoglobin and lower velocity may be due to increased cognitive load and limited attentional resources.

Dietary intake profile in high-risk pregnant women according to the degree of food processing.

BACKGROUND/OBJECTIVE: Studies that address dietary intake theme during pregnancy are generally centered on specific nutrients or on dietary patterns. However, the maternal dietary profile according to the degree of food processing is poorly understood. The purpose of the present study was to describe the dietary profile of high-risk pregnant women according to the degree of food processing. MATERIALS AND METHODS: A prospective cohort study was conducted at Prof. Dr. Jose Aristodemo Pinotti Women's Hospital (CAISM), University of Campinas, Brazil, with high-risk pregnant women in the third trimester of gestation. RESULTS: Data from 125 high-risk pregnant women were collected between September 2017 and April 2019. The mean total energy intake (EI) was 1778.3 ± 495.79 kcal/day and the majority of the calories was from unprocessed foods (52.42%), followed by ultra-processed foods (25.46%). The consumption of free sugar and sodium exceeded recommendations, while the consumption of fiber, calcium, folate and iron was below recommendations. The ultra-processed foods intake affects dietary patterns negatively. CONCLUSION: More than 50% of the EI of high-risk pregnant women is from unprocessed or minimally processed foods, but it is insufficient for meeting dairy fiber, iron, folate and calcium recommendations.

Aerobic and breathing exercises improve dyspnea, exercise capacity and quality of life in idiopathic pulmonary fibrosis patients: systematic review and meta-analysis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with significant dyspnea and limited exercise capacity. This systematic review aimed to synthesize evidence of exercise interventions during pulmonary rehabilitation that aim to improve exercise capacity, dyspnea, and health-related quality of life (HRQL) in IPF patients. METHODS: Searches were performed in MEDLINE, Embase, CENTRAL, SPORTDiscus, PubMed and PEDro from inception to January 2019 using search terms for: (I) participants: 'IPF or interstitial lung disease'; (II) interventions: 'aerobic training or resistance training or respiratory muscle training'; and (III) outcomes: 'exercise capacity or dyspnea or health-related quality of life'. Two reviewers independently screened titles, abstracts and full texts to identify eligible studies. Methodological quality of studies was assessed using the Downs and Black checklist and meta-analyses were performed. RESULTS: Of 1,677 articles identified, 14 were included (four randomized controlled trials and 10 prospective pre-post design studies) that examined 362 patients receiving training and 95 control subjects. Exercise capacity was measured with the 6-minute walk distance, peak oxygen consumption, peak work rate, or endurance time for constant work rate cycling, which increased after exercise [aerobic exercise; aerobic and breathing exercises; aerobic and inspiratory muscle training (IMT) exercises] compared to the control groups. Dyspnea scores improved after aerobic and breathing exercises. HRQL also improved after aerobic exercise training alone or combined with breathing exercises. Aerobic training alone or combined with IMT or breathing exercises improved exercise capacity. CONCLUSIONS: Breathing exercises appears to complement exercise training towards improved dyspnea and HRQL in patients with IPF.

Interactive Video Gaming Improves Functional Balance in Poststroke Individuals: Meta-Analysis of Randomized Controlled Trials.

The main objective of this study was to evaluate the effects of interactive video games on functional balance and mobility in poststroke individuals. The Health Science databases accessed included Medline via PubMed, LILACS, SciELO, and PEDro. The inclusion criteria were as follows: clinical studies evaluating the use of interactive video games as a treatment to improve functional balance and mobility in individuals poststroke and studies published in the Brazilian Portuguese, English, or Spanish language between 2005 and April 2016. PEDro Scale was used to analyze the methodological quality of the studies. The Berg Balance Scale and Timed Up and Go Test (TUGT) data were evaluated using a meta-analysis, the publication bias was assessed by funnel plots, and the heterogeneity of the studies by I2 statistic. Eleven studies were included in the final analysis. Functional balance improved in individuals treated using interactive video games (mean difference = 2.24, 95% confidence interval [0.45, 4.04], p = .01), but no improvement was observed in mobility as measured by TUGT. The studies presented low heterogeneity (24%). The mean score on the PEDro Scale was 6.2 ± 1.9. Interactive video games were effective in improving functional balance but did not influence the mobility of individuals poststroke.

The effect of mental tracking task on spatiotemporal gait parameters in healthy younger and middle- and older aged participants during dual tasking.

To evaluate the effect of dual tasking that combines walking with a mental tracking task on spatiotemporal gait parameters in younger and older adults. After completing the International Physical Activity Questionnaire (IPAQ), participants performed single tasks: preferred paced walk (PPW); fast paced walk (FPW); single-leg stance (SLS); spelling backwards cognitive task (CT). Thereafter, dual tasks: PPW + CT; FPW + CT; SLS + CT. Spatiotemporal gait parameters and the durations of SLS and SLS + CT were measured. Twenty younger and 20 older adults participated. The IPAQ scores were similar in both groups. Compared to the single task, stride length was shorter, stride time was longer, and stride length and time variability were higher during the PPW and FPW dual tasks in both groups. Older age was associated with shorter stride length during PPW and FPW, and longer stride time during FPW dual compared to single tasks. The older group exhibited shorter times during SLS and SLS + CT compared to younger group. Despite similar self-reported fitness, older age is associated with shorter stride length and longer stride time during FPW dual tasks as well as short times during SLS + CT, which may indicate diminished balance and posture stability.

Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial.

OBJECTIVE: To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients. DESIGN: Phase-II, randomized, parallel-group, allocation-concealed, assessor-blinded, single-center controlled trial. SETTING: Inpatient rehabilitation sector. SUBJECTS: Patients following living donor liver transplantation. INTERVENTIONS: The quadriceps muscle stimulation and the control groups received bilateral muscle electrical stimulation on the quadriceps and tibialis anterior muscles, respectively. Neuromuscular electrical stimulation sessions in both groups were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist. MAIN MEASURES: Quadriceps muscle strength and quadriceps muscle thickness. RESULTS: Neuromuscular electrical stimulation was applied to the quadriceps muscles group ( n = 23) or the tibialis anterior muscle in the control group ( n = 22). The decrease in quadriceps muscle thickness differed significantly between both groups on postoperative day 30 (median -3 vs -8, P < 0.01). The changes in predicted quadriceps strength and 6 minutes walking distance were not significantly different between groups (quadriceps strength median -12% vs -5%, P = 0.40; 6 minutes walking distance median -18 vs -21 m, P = 0.74). CONCLUSION: Neuromuscular electrical stimulation of the quadriceps muscle for liver transplantation recipients was able to maintain the quadriceps muscle thickness after surgery. Future larger scale studies are needed to consider the effectiveness of neuromuscular electrical stimulation and how to incorporate this intervention in the overall strategy of the physical therapy program.

Quality of life in obese women with symptoms of urinary incontinence / Qualidade de vida em mulheres obesas com sintomas de incontinência urinária / Calidad de vida en mujeres obesas con síntomas de incontinencia urinaria

Abstract Introduction: Obesity is a contributing factor to the development of urinary incontinence (UI). Objective: The objective of this study was to evaluate the prevalence of UI symptoms in women with morbid obesity and their impacts on quality of life (QOL), correlating the influence of age and body mass index (BMI) with the presence of UI. Method: Sixty-five women undergoing preoperative bariatric surgery, aged 35.8 ± 9.97 years, with an average BMI of 45.04 ± 6.79 kg/m2 were asked about the presence of UI symptoms; when they answered positively, the King's Health Questionnaire (validated into Portuguese) was applied. The questionnaire was self-administered and all answers were assigned numerical scores. These scores were distributed according to quartiles and correlated with age and BMI. The level of hypothesis rejection was 5%, and analyses were performed using BioEstat software version 5.3. Results: Among 65 interviewees, 19 (29.23%) had symptoms of UI and went on to answer the questionnaire. The highest-scoring areas were "incontinence impact" (36.8) and "general health perception" (32.9). There was no significant correlation between questionnaire scores and BMI. In the association with age, the "incontinence impact" domain showed a significant, positive and moderate correlation (r = 0.52; p = 0.02). Conclusion: The prevalence of UI symptoms in the sample had a slight negative effect on QOL; however, UI associated with older ages significantly affected the QOL of the studied volunteers.

Resumo Introdução: A obesidade é considerada um fator contribuinte para o desenvolvimento da incontinência urinária (IU). Objetivo: O objetivo deste estudo foi avaliar a prevalência dos sintomas da IU em mulheres obesas mórbidas, seu impacto sobre a qualidade de vida (QV) e correlacionar a influência da idade e do índice de massa corporal (IMC) sobre a presença de IU. Método: Foram avaliadas, 65 mulheres, em pré-operatório de cirurgia bariátrica, com idade de 35,8±9,97 anos e IMC de 45,04±6,79 kg/m 2 sendo questionadas sobre sintomas de IU e, se confirmados, responderam ao King's Health Questionnaire, validado para o português. O questionário foi auto administrado e foram atribuídos valores numéricos às respostas, esses escores foram avaliados em quartis e correlacionados com a idade e o IMC. O nível de rejeição da hipótese foi 5% e as análises foram realizadas com o software BioEstat, versão 5.3. Resultados: Das 65 mulheres que foram entrevistadas, dezenove delas (29,23%) apresentaram os sintomas da IU e responderam ao questionário. Os domínios que apresentaram maior pontuação foram "impacto da IU" (36,8) e "percepção geral da saúde" (32,9). Não foi encontrada correlação significativa entre os escores do questionário e o IMC. Já na associação com a idade, o domínio "impacto da IU" apresentou correlação positiva, significativa e moderada (r = 0,52; p = 0,02). Conclusão: Diante dos achados, com a prevalência de sintomas de IU na amostra estudada, pode-se inferir que a IU compromete pouco a QV, entretanto o aumento da idade quando associada à IU pode afetar significativamente a QV de mulheres obesas classe II e III.

Resumen Introducción: La obesidad se considera un factor contribuyente para el desarrollo de la incontinencia urinaria (IU). Objetivo: El objetivo de este estudio fue evaluar la prevalencia de los síntomas de IU en las mujeres obesas morbidas, el impacto en la calidad de vida (CV), y la influencia de la edad y el índice de masa corporal (IMC) sobre la presencia de IU. Método: Fueron evaluados 65 mujeres, en preoperatorio de cirugía bariátrica, con edad de 35,8 ± 9,97 años e IMC de 45,04 ± 6,79 kg/m 2 siendo cuestionadas sobre síntomas de IU y, si confirmados, respondieron al King's Health Questionnaire, validado para el portugués. El cuestionario fue auto administrado y se asignaron valores numéricos a las respuestas, los escores fueron evaluados en cuartiles y correlacionados con la edad y el IMC. El nivel de rechazo del análisis fue del 5% y los análisis se realizaron con el software BioEstat, versión 5.3. Resultados: De las 65 mujeres que fueron entrevistadas, diecinueve de ellas (29,23%) presentaron los síntomas de la IU y respondieron al cuestionario. Los dominios que presentaron mayor puntuación fueron "impacto de la IU" (36,8) y "percepción general de la salud" (32,9). No se encontró correlación significativa entre los puntajes del cuestionario y el IMC. En la asociación con la edad, el dominio "impacto de la IU" presentó correlación positiva, significativa y moderada (r = 0,52; p = 0,02). Conclusión: Ante los hallazgos, con la prevalencia de síntomas de IU en la populacion estudiada, se puede inferir que la IU compromete poco la QV, sin embargo el aumento de la edad cuando está asociada a la IU puede afectar significativamente a la CV de mujeres obesas clase II y III.

Translation and cultural adaptation of the short-form food frequency questionnaire for pregnancy into Brazilian portuguese / Tradução e adaptação cultural da versão curta do questionário de frequência alimentar para gestantes em português do Brasil

Abstract Objective To translate and culturally adapt the short-formFood Frequency Questionnaire (SFFFQ) for pregnant women, which contains 24 questions, into Brazilian Portuguese. Methods Description of the process of translation and cultural adaptation of the SFFFQ into Brazilian Portuguese. The present study followed the recommendation of the International Society for Pharmacoeconomics and Outcomes Research for translation and cultural adaptation with the following steps: 1) preparation; 2) first translation; 3) reconciliation; 4) back translation; 5) revision of back translation; 6) harmonization; 7) cognitive debriefing; 8) revision of debriefing results; 9) syntax and orthographic revision; and 10) final report. Five obstetricians, five dietitians and five pregnant women were interviewed to contribute with the language content of the SFFFQ. Results Few changes were made to the SFFFQ compared with the original version. These changes were discussed with the research team, and differences in language were adapted to suit all regions of Brazil. Conclusion The SFFFQ translated to Brazilian Portuguese can now be validated for use in the Brazilian population.

Resumo Objetivo Traduzir e adaptar culturalmente, para o português do Brasil, a versão curta do Questionário de Frequência Alimentar (VCQFA), que contém 24 questões, voltado para gestantes brasileiras. Métodos Este estudo descreve o processo de tradução e adaptação cultural do VCQFA para o Português do Brasil. Este estudo seguiu as diretrizes da Sociedade Internacional para Farmacoeconomia e Pesquisa de Resultados para tradução e adaptação cultural, e foram realizadas as seguintes etapas: 1) preparação; 2) primeira tradução; 3) reconciliação; 4) tradução retrógrada; 5) revisão da tradução retrógrada; 6) harmonização; 7) discussão cognitiva; 8) análise dos resultados do desdobramento; 9) revisão de sintaxe e ortografia; e 10) relatório final. Cinco obstetras, cinco nutricionistas e cinco gestantes foram entrevistadas para contribuírem com o conteúdo de linguagem do VCQFA. Resultados Poucas mudanças foram realizadas no VCQFA em comparação com a versão original. Essas mudanças foram discutidas com a equipe de pesquisa, e as diferenças de linguagem foram adaptadas para que o questionário seja adequado a todas as regiões do Brasil. Conclusão A versão traduzida do VCQFA para o português do Brasil pode ser validada para a população brasileira.

Translation and Cultural Adaptation of the Short-Form Food Frequency Questionnaire for Pregnancy into Brazilian Portuguese.

OBJECTIVE: To translate and culturally adapt the short-form Food Frequency Questionnaire (SFFFQ) for pregnant women, which contains 24 questions, into Brazilian Portuguese. METHODS: Description of the process of translation and cultural adaptation of the SFFFQ into Brazilian Portuguese. The present study followed the recommendation of the International Society for Pharmacoeconomics and Outcomes Research for translation and cultural adaptation with the following steps: 1) preparation; 2) first translation; 3) reconciliation; 4) back translation; 5) revision of back translation; 6) harmonization; 7) cognitive debriefing; 8) revision of debriefing results; 9) syntax and orthographic revision; and 10) final report. Five obstetricians, five dietitians and five pregnant women were interviewed to contribute with the language content of the SFFFQ. RESULTS: Few changes were made to the SFFFQ compared with the original version. These changes were discussed with the research team, and differences in language were adapted to suit all regions of Brazil. CONCLUSION: The SFFFQ translated to Brazilian Portuguese can now be validated for use in the Brazilian population.

OBJETIVO: Traduzir e adaptar culturalmente, para o português do Brasil, a versão curta do Questionário de Frequência Alimentar (VCQFA), que contém 24 questões, voltado para gestantes brasileiras. MéTODOS: Este estudo descreve o processo de tradução e adaptação cultural do VCQFA para o Português do Brasil. Este estudo seguiu as diretrizes da Sociedade Internacional para Farmacoeconomia e Pesquisa de Resultados para tradução e adaptação cultural, e foram realizadas as seguintes etapas: 1) preparação; 2) primeira tradução; 3) reconciliação; 4) tradução retrógrada; 5) revisão da tradução retrógrada; 6) harmonização; 7) discussão cognitiva; 8) análise dos resultados do desdobramento; 9) revisão de sintaxe e ortografia; e 10) relatório final. Cinco obstetras, cinco nutricionistas e cinco gestantes foram entrevistadas para contribuírem com o conteúdo de linguagem do VCQFA. RESULTADOS: Poucas mudanças foram realizadas no VCQFA em comparação com a versão original. Essas mudanças foram discutidas com a equipe de pesquisa, e as diferenças de linguagem foram adaptadas para que o questionário seja adequado a todas as regiões do Brasil. CONCLUSãO: A versão traduzida do VCQFA para o português do Brasil pode ser validada para a população brasileira.

Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

BACKGROUND: Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer. METHODS: Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale. RESULTS: Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points. CONCLUSIONS: KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.

Body mass Index changes during pregnancy and perinatal outcomes - A cross-sectional study / Mudanças do índice de massa corporal na gravidez e resultados perinatais - um estudo transversal

Abstract Objective To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. Methods A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequateweight, overweight, and obese. The BMIwas calculated at the first and at the last prenatal care visits, and these values were compared. Results An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetalmacrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83). Conclusion Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

Resumo Objetivo Avaliar a relação entre mudanças no percentual do índice de massa corporal (IMC), refletidas na curva de Atalah, e resultados perinatais. Métodos Foi realizado um estudo transversal com 1.279 mulheres. Os dados sobre o peso na gestação, características sociodemográficas e resultados perinatais foram coletados através de prontuários, cartão pré-natal e entrevistas no pós-parto. As mulheres foramclassificadas de acordo coma curva de Atalah nas seguintes categorias: baixo peso, peso adequado, sobrepeso e obesidade. O IMC foi calculado na primeira e na última visita ao pré-natal e esses valores foram comparados. Resultados Houve aumento na categoria do IMC segundo a classificação de Atalah em 19,9% das mulheres grávidas e um aumento de 3,4; 5,8 e 6,4 pontos do IMC foram encontrados para mulheres respectivamente classificadas nas categorias peso adequado, sobrepeso e obesidade na primeira consulta pré-natal. As mulheres com educação secundária apresentaram menor chance de aumentar sua classificação de IMC (odds ratio [OR] 0:47 [0,24- 0,95]). As mulheres que evoluíram com o aumento na classificação de Atalah foramassociadas a cesariana (OR 1,97-2,28),macrossomia fetal (OR 4,13-12,54) e recém-nascido grande para a idade gestacional (OR 2,88-9,83). Conclusão Gestantes com ganho de peso excessivo, o suficiente para aumentar sua classificação do IMC segundo a curva de Atalah, tiverammaiores chances de cesariana e macrossomia. As mulheres classificadas como obesas na primeira visita pré-natal, de acordo com a curva de Atalah, tiveram uma grande chance de cesariana e recémnascido grande para a idade gestacional.

Effects of a Knee Brace With a Patellar Hole Versus Without a Patellar Hole in Patients With Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed. Both groups presented significant reduction in pain perception, higher function of the lower extremities, and greater mobility while wearing a knee brace. However, the patients who wore a knee brace without a patellar hole presented more favorable results than those who wore a knee brace with a patellar hole: a 1.6-point reduction was found versus 1.1 points in the VAS, the patients presented 0.7 s less time versus 0.4 s in the TUG, and the speed was reduced by 1.4 s versus 0.8 s in the 8MWT. Therefore, the knee brace without a patellar hole presented more favorable results when compared with the knee brace with a patellar hole.

Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional Study.

OBJECTIVE: To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. METHODS: A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared. RESULTS: An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetal macrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83). CONCLUSION: Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

OBJETIVO: Avaliar a relação entre mudanças no percentual do índice de massa corporal (IMC), refletidas na curva de Atalah, e resultados perinatais. MéTODOS: Foi realizado um estudo transversal com 1.279 mulheres. Os dados sobre o peso na gestação, características sociodemográficas e resultados perinatais foram coletados através de prontuários, cartão pré-natal e entrevistas no pós-parto. As mulheres foram classificadas de acordo com a curva de Atalah nas seguintes categorias: baixo peso, peso adequado, sobrepeso e obesidade. O IMC foi calculado na primeira e na última visita ao pré-natal e esses valores foram comparados. RESULTADOS: Houve aumento na categoria do IMC segundo a classificação de Atalah em 19,9% das mulheres grávidas e um aumento de 3,4; 5,8 e 6,4 pontos do IMC foram encontrados para mulheres respectivamente classificadas nas categorias peso adequado, sobrepeso e obesidade na primeira consulta pré-natal. As mulheres com educação secundária apresentaram menor chance de aumentar sua classificação de IMC (odds ratio [OR] 0:47 [0,24- 0,95]). As mulheres que evoluíram com o aumento na classificação de Atalah foram associadas a cesariana (OR 1,97­2,28), macrossomia fetal (OR 4,13­12,54) e recém-nascido grande para a idade gestacional (OR 2,88­9,83). CONCLUSãO: Gestantes com ganho de peso excessivo, o suficiente para aumentar sua classificação do IMC segundo a curva de Atalah, tiveram maiores chances de cesariana e macrossomia. As mulheres classificadas como obesas na primeira visita pré-natal, de acordo com a curva de Atalah, tiveram uma grande chance de cesariana e recém-nascido grande para a idade gestacional.

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study.

OBJECTIVES: The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. METHODS: We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. RESULTS: Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. CONCLUSIONS: Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study

OBJECTIVES: The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age. METHODS: We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals. RESULTS: Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity. CONCLUSIONS: Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.

Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis.

[Purpose] The aim of the study was to evaluate the benefits of physical therapy for urinary incontinence in patients with multiple sclerosis and to verify the impact of urinary incontinence on the patient's quality of life. [Subject and Methods] A case study of a 55-year-old female patient diagnosed with multiple sclerosis and mixed urinary incontinence was conducted. Physical therapy sessions were conducted once a week, in total 15 sessions, making use of targeted functional electrical vaginal stimulation, along with active exercises for the pelvic floor muscles and electrical stimulation of the posterior tibial nerve, behavioral rehabilitation and exercise at home. [Results] After 15 physical therapy sessions, a patient diagnosed with multiple sclerosis and mixed urinary incontinence showed continued satisfactory results after five months. She showed better quality of life, higher strength of pelvic floor muscle and reduced urinary frequency without nocturia and enuresis. [Conclusion] The physical therapy protocol in this patient with multiple sclerosis and mixed urinary incontinence showed satisfactory results reducing urinary incontinence symptomatology and improving the patient's quality of life.